Burden of acute respiratory disease of epidemic and pandemic potential in the WHO Eastern Mediterranean Region: a literature review

There are gaps in the knowledge about the burden of severe respiratory disease in the Eastern Mediterranean Region [EMR]. This literature review was therefore conducted to describe the burden of epidemic- and pandemic-prone acute respiratory infections [ARI] in the Region which may help in the development of evidence-based disease prevention and control policies. Relevant published and unpublished reports were identified from searches of various databases; 83 documents fulfilled the search criteria. The infections identified included: ARI, avian influenza A[H5N1], influenza A[H1N1]pdm09 and Middle East respiratory syndrome coronavirus [MERS-CoV] infection. Pneumonia and ARIs were leading causes of disease and death in the Region. Influenza A[H1N1] was an important cause of morbidity during the 2009 pandemic. This review provides a descriptive summary of the burden of acute respiratory diseases in the Region, but there still remains a lack of necessary data

Enhanced surveillance and investigation of coronavirus: what is required?

Following the discovery in September 2012 of 2 patients, both with links to the Eastern Mediterranean Region, with serious respiratory illness due to novel coronavirus, all countries have instigated surveillance and laboratory activities to detect further cases, with intensive case contact investigations undertaken on laboratory confirmation of cases. A total of 30 cases, of whom 18 have died, and at least 3 clusters have been detected to date [1 cluster among health-care workers and another 2 clusters among family members]. To date, transmission studies have shown a low risk of onward human transmission, with clinical presentation remaining severe for the majority. Many questions remain including the zoonotic source and geographical extent of infection. Surveillance has been extended to include clusters of cases or health-care workers with severe, undiagnosed respiratory illness regardless of travel history. Environmental studies, on-going surveillance and linked case-contact investigations will provide a critical role in answering some of these issues