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MERS-CoV: Deadly SARS-like virus a warning to Southeast Asia

MERS-CoV: Deadly SARS-like virus a warning to Southeast Asia
Published 30 Apr 2014   Follow @elliotbrennan

Most experts agree that it is only a matter of time until Asia will have to respond to another large-scale disease epidemic, as was seen with the SARS outbreak. As a result of the 2003 SARS virus, stockmarkets collapsed, borders were closed and fear ran through the world. It killed 774 people, most of those in China and Hong Kong.

In the past month, with several new outbreaks in the region, we have been reminded of the threat and of the need for regional disease control and preparedness. Perhaps most worrying (and occupying sensationalist column inches in regional newspapers) is the spread of the novel MERS-CoV virus. 

A new SARS-like virus, Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) was recently discovered in Southeast Asia. One man was quarantined in the Philippines in a suspected case and a Malaysian man died after returning from a hajj in Saudi Arabia, where the virus has killed over 100 people.

MERS-CoV has a monstrously high 40% fatality rate (SARS was about 10%). The WHO reports that 75% of cases may be from close human-to-human contact.  As one Australian virologist notes, there have been more reported MERS-CoV cases this month than in all of 2013

In the shadow of the MERS-CoV lie other reports of disease outbreaks in Southeast Asia this month. Many of these are much more common and widespread, such as the measles 'epidemic' in Vietnam, the outbreak of dengue in Malaysia, and drug-resistant malaria in Myanmar. Then there is the less common but equally concerning H1N1. In Thailand's Trang Hospital 50 confirmed cases of seasonal H1N1 flu infection have been recorded this year alone.

In Southeast Asia, concern over new outbreaks has been met with some proactive dialogue and policy. [fold]

In March, Cambodia and Vietnam held talks and agreed to more bird flu monitoring along their shared border. Vietnam and China have continued to monitor bird flu in their large cross-border poultry trade.

While these bilateral measures are important, today's environment requires additional regional approaches. Disaster specialists met in Phuket, Thailand, in April for the two-day ASEAN Disaster Medicine Workshop. Such workshops are crucial and bolster preparedness for joint response to health crises. Unfortunately, they are not frequent enough and don't provide for whole-of-government education, a powerful tool when panic sets in among populations and markets.

In preparing against the possible spread of MERS-CoV in the region, Southeast Asian countries will likely be extra vigilant with passengers returning from the Persian Gulf in coming months. The regions are closely linked through migrant worker populations and religious pilgrimages to Saudi Arabia. Governments will also have to prepare for a potential domestic anti-Muslim backlash. These  should be cautionary measures, as the spread of the virus remains only one of many possible health epidemics that threaten the region. 

Disease control and preparedness is an area of the utmost regional concern. It is imperative that governments in the region remain cognisant of the threat without an unpleasant reminder such as MERS-CoV.

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