WHO says 22 deaths worldwide from coronavirus (Update)

May 23, 2013 by John Heilprin

World Health Organization officials said Thursday that their probe into the deadly new coronavirus that has now claimed 22 lives is being delayed because of a dispute over the ownership rights to a sample—a claim disputed by the researcher at the center of the issue.

Dr. Keiji Fukuda, WHO's assistant director-general for health security, says the organization is "struggling with diagnostics" into the Middle East respiratory syndrome coronavirus, or MERS, because of the dispute.

Officials at the World Health Assembly in Geneva then publicly decried the public health impacts—and legal fallout—because a sample taken by Saudi microbiologist Ali Mohamed Zaki was mailed last year to virologist Ron Fouchier at the Erasmus Medical Center (EMC) in the Netherlands, where it was tested, sequenced and identified as a new virus.

Other researchers who want to obtain samples must first sign a material transfer agreement with the private medical center denoting ownership and user rights. That has delayed some of the testing, including serological tests of blood serum and other bodily fluids, according to officials. However a few other places including facilities in Canada, Britain and Germany that have obtained samples, the officials said.

WHO's director-general, Dr. Margaret Chan, railed against the arrangement, which seemed to take some in the assembly hall by surprise. She pleaded with the hundreds of health officials at the annual World Health Assembly to "share your specimens with WHO collaborating centers, not in a bilateral manner."

"Please, I'm very strong on this point, and I want you to excuse me," she said. "Tell your scientists in your country, because you're the boss. You're the national authority. Why would your scientists send specimens out to other laboratories on a bilateral manner and allow other people to take intellectual property rights on a new disease?"

Fouchier, however, says the material transfer agreement, known as an MTA, is similar to other ones used within WHO's networks.

"There are no restrictions to the use of the virus for research and public health purposes. There are only restrictions for commercial exploitation and forwarding virus to third parties. Very common in all MTAs, including those of WHO," he said by email responding to questions from The Associated Press.

Any delays claimed by WHO are a misconception, he said.

"After the first identification of the virus, diagnostic tests were developed in collaboration with several public health laboratories, and these tests were distributed free of charge to everyone around the world who asked for them," Fouchier added. "We have not denied access to the virus to any research and public health laboratory with the appropriate facilities to handle this virus safely."

The World Health Assembly, the decision-making body of WHO, runs from May 20-28.

Indonesia has previously refused to share samples of the H5N1 bird flu virus, claiming that vaccines made from those samples would be too expensive for developing countries to afford. That dispute led to a protracted series of negotiations with WHO and others to ensure poor countries would have access to vaccines in a pandemic.

At the assembly, Fukuda said the new coronavirus has now claimed 22 lives worldwide out of 44 lab-confirmed cases, mostly in Saudi Arabia.

The latest fatal case involves a 63-year-old man in central Saudi Arabia with an underlying medical condition who died Monday, five days after being hospitalized with acute breathing problems. WHO officials say they do not believe it is related to the cluster of cases reported from the country's east.

"There is a huge amount that we do not understand about this virus or this situation," he said.

Four out of five of the 44 confirmed cases affected men, and the patients' average age is 56, said WHO officials, citing information that comes in part from Saudi health authorities. Patients have been between the ages of 24 and 94.

Saudi authorities have reported 10 deaths from 22 cases since an outbreak began at a health care facility in April in the country's east, WHO officials said.

Fukuda said evidence in some of the disease clusters points to limited transmission from person to person. Last week, WHO said it was worried about the people affected by "cases that are not part of larger clusters and who do not have a history of animal contact." WHO said those cases suggest the virus may already be spreading in the community.

Many health officials have been frustrated at the lack of detail coming out of Saudi Arabia about the virus and have complained there is not enough information about how cases are connected, their history and how they might have been exposed. Without that information, health officials will find it more difficult to track the virus' spread and how to prepare for a wider outbreak.

In a speech on Monday, Chan publicly praised China for its rapid sharing of information on the new bird flu, H7N9. She said nothing about Saudi Arabia and reminded countries of the importance of "fully transparent reporting to WHO."

Tunisia authorities have reported two confirmed cases, involving a brother and sister, and one probable case involving their 66-year-old father, who died in Tunisia on May 10, a week after returning from Saudi Arabia and Qatar, the officials said.

Countries where cases of infections were acquired within the country from an unknown source so far include Jordan, Saudi Arabia, Qatar and the United Arab Emirates, Fukuda said. Other countries where cases are associated with travel or contact with a returned infected traveler, he said, are so far known to be Germany, France, Tunisia and Britain.

"We do not know the full geographic spread of this virus," said Fukuda, who told the assembly that the incubation period seems to be anywhere from 2 ½ days to 14 days.

Explore further: SARS-like virus claims new life in Saudi

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