1. OIE Headquarters, Paris
OIE update on MERS CoV
Dr Gounalan Pavade
OIE Headquarters, Paris
GF-TADs sub regional conference on camel diseases February 2016 Abu Dhabi, UAE

2. Notification of MERS CoV in animals
MERS CoV in animals is reportable to OIE in accordance with article of the OIE Terrestrial Animal Health Code
Emerging disease with public health impact
Notified when positive PCR results or isolation of the virus from animals
OIE Member Countries would be obliged to report to the OIE a confirmed case of MERS CoV in animals, as an “emerging disease” in accordance with article of the OIE Terrestrial Animal Health Code
Following the confirmation of a human MERS CoV in a small farm in Qatar, joint health and veterinary authorities collected animal samples from the patient farm which included 14 camels, 1 sheep, some pigeons and environmental samples (water, soil, animal food and grass). The samples were sent to Netherlands and 3 camels tested positive by PCR
OIE has also informed the other Delegates (Kuwait, Jordan, in the region to inform MERS CoV identification in animals is notifiable to OIE

3. Criteria for listing an emerging animal diseases
Emerging disease
Means a newly recognised infection resulting from the evolution or change of an existing pathogenic agent, a known infection spreading to a new geographic area or population, or a previously unrecognised pathogenic agent or a disease diagnosed for the first time and which has a significant impact on public health
OIE Member Countries would be obliged to report to the OIE a confirmed case of MERS CoV in animals, as an “emerging disease” in accordance with article of the OIE Terrestrial Animal Health Code
Following the confirmation of a human MERS CoV in a small farm in Qatar, joint health and veterinary authorities collected animal samples from the patient farm which included 14 camels, 1 sheep, some pigeons and environmental samples (water, soil, animal food and grass). The samples were sent to Netherlands and 3 camels tested positive by PCR
OIE has also informed the other Delegates (Kuwait, Jordan, in the region to inform MERS CoV identification in animals is notifiable to OIE

4. Countries notified MERS CoV to OIE
Qatar (November 2013, April 2014 and June 2014)
Kuwait (June 2014)
Oman (May 2014)
Iran (October 2014)
Saudi Arabia (January 2016)

5. Question and answers on MERS CoV
OIE prepared and posted a Question and Answers document on website
Document updated regularly based on latest scientific information
Provides information on scientific and general aspects of the disease
enter/docs/pdf/Disease_cards/Q_A_MERS- CoV_EN_update_August_2014_Final.pdf

6. OIE ad hoc group on MERS CoV
In July 2014 OIE convened an ad hoc group on MERS CoV
Term epidemiological studies more appropriate than surveillance
The objectives of the epidemiological studies should focus on
Determine if the MERS CoV present in camels in a country, holding or camel population
Assess the risk profile of a country
Assess public health risk and management measures
Monitor strains and lineages of MERS CoV circulating in camel population

7. Surveillance for MERS CoV in camels
Sample camels of different age groups from different industry sectors
Generate data on incubation period, shedding period and risk factors for infection
Investigate significant morbidity/ mortality events in camels
Studies in wild and domestic animals

8. Recommendations on further MERS CoV research studies in animals
Further develop and validate user-friendly diagnostic tests as fit for purpose (live animals and at slaughter)
Comparative epidemiological studies in all countries to determine prevalence, distribution and demographics
Experimental and naturally infected studies to characterise the clinical and pathological effects, kinetics of virus shedding and immune response
Studies to assess risk factors and potential exposure sources for camel infections and the relationship with human cases

9. Recommendations on further MERS CoV research studies in animals
Studies to investigate and assess the intervention measures to reduce public health risk
Conduct genetic analysis of the virus and hosts from different geographical areas
Presence, viability and survival of virus in different animal products and the environment
Research on immunology and vaccine development

10. Recommendations on further MERS CoV research studies in animals
Identification and evaluation of socioeconomic factors associated with infection
Studies to obtain an insight into culturally acceptable risk reduction measures
Studies to determine the original animal source of the virus, including wildlife

11. Need of an OIE Collaborating Centre for Camels
Discussion of MERS CoV at Global Conference of the OIE Reference Centres Incheon (2014)
The Camel health control is not easy; the type of dominant farming system is extensive, nomadic and performed in remote areas
It is necessary to get reliable data on camel health status to improve vet competencies on MERS-CoV and other diseases.
Encourage collection of samples and diagnosis essay validation with collaboration of OIE RL
The need to set up a network of laboratories for diseases of camels was expressed on this issue and confirmed by OIE Biological Standards Commission
Regional networks (Asia, Africa, ME) would be a first step to build a global network for epidemiology and diagnosis of camel diseases
Need of an OIE Collaborating Centre for Camels

12. Establishment of an OIE Reference Centre for MERS CoV
OIE received requests from member countries to establish Reference Centre of expertise for MERS CoV
A twinning project was launched between OIE reference network of laboratories from Italy (Parent) and the Abu Dhabi Food Control Authority Animal Health Centre for diagnostic and research (Candidate) for camel diseases including MERS CoV

13. WHO roadmap for global MERS CoV research and product development
WHO convened the meeting in Geneva (December 2015)
WHO is developing a blueprint for emergency research and development to prevent the impact of infectious disease outbreaks. MERS-CoV is one of the 8 pathogens prioritized in the blueprint
OIE participated and shared the recommendations of OIE ad hoc group on MERS CoV research priorities

14. WHO roadmap for global MERS CoV research and product development
Diagnostic tests:
Nucleic acid amplification tests (NAATs) are currently the gold standard of MERS-CoV diagnostic platforms
Serology - Immunofluorescence, immunochromatography, ELISA, serum neutralisation tests
Need for optimization and validation of existing assays and development of next generation diagnostics
Need for simple to use commercial tests in fields

15. WHO roadmap for global MERS CoV research and product development
Vaccine development:
Three vaccine scenarios
- A single dose vaccine during outbreaks (human)
Two dose schedule to induce durable protection camel health care workers
- Camel vaccine to prevent transmission to humans
Dozen vaccine candidates in preclinical development
Two vaccines tested in camels
- Modified Vaccinia virus Ankara (MVA)

16. WHO high level mission to Saudi Arabia for MERS-CoV (Jan 2016)
February 2016 – 1638 human cases including 587 deaths
Saudi Arabia – 1281 human cases (78% of global number)
Experts - WHO, OIE, CDC, University of Bonn, Institut Pasteur, University of Hong Kong, Public Health UK, Canada
Objectives – Review ongoing MERS situation and implementation of previous mission recommendations
Met Deputy Ministers of MoH, MoA and teams, visit human and animal health labs, hospitals, research institutes and camel farm, market, slaughter houses

17. WHO high level mission to Saudi Arabia for MERS-CoV (Findings and observations)
Substantial progress has been made in the country
Health Electronic Surveillance Network (HESN) – online system to monitor all suspected and lab cases
Improved collaboration between MoH and MoA
Field investigations done for human animal interface cases
Surveillance done on various animal samples and tested
MoH lab operating well for diagnosis of cases
MoA lab established facilities for serology and PCR screening and in transition phase to new lab for better facilities
Funding for priority public and animal health research on MERS-CoV established

18. WHO high level mission to Saudi Arabia for MERS-CoV (Recommendations)
Focus on preparedness to respond and prevent primary infections in community and future hospital outbreaks
Developing a national strategic plan for prevention and control involving all concerned Ministries
Identify and nominate a leader to implement the plan
Reinforce joint investigations of community acquired infections by joint rapid investigation teams (One health approach)
The research programmes should be prioritized that serve public health agenda

19. Understanding MERS-CoV at animal human interface
FAO convened this meeting in January 2016
Inventory of completed, current and planned research activities and field projects compiled
Surveillance design, evaluation of diagnostic tests and value chain studies were discussed
FAO to undertake field programme to understand the disease dynamics at the human animal interface
Scientific network for MERS-CoV as in the model of OFFLU discussed

20. Conclusions Member Countries report MERS CoV to the OIE
Surveillance for MERS-CoV initiated in many camel rearing countries and veterinary laboratories improve capacity and expertise for MERS- CoV
Diagnostic tests available but validation needed
Vaccine development in preclinical stage and needed more research
OIE, FAO and WHO collaborate and provide advice for MERS-CoV international missions and meetings
A One Health approach needed to control MERS CoV at the human animal interface

21. Thank you for your attention
Organisation Mondiale de la Santé Animale
World Organisation for Animal Health
Organización Mundial de Sanidad Animal
Thank you for your attention
12 rue de Prony, Paris, France - –