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Crowd control? Public health experts worry that the annual hajj could increase the incidence of MERS.

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WHO Convenes Emergency Committee on MERS Virus

The World Health Organization (WHO) is convening an emergency committee to determine whether the novel coronavirus that emerged in the Middle East last year constitutes a "public health emergency of international concern." Keiji Fukuda, Assistant Director-General for Health Security and Environment at the WHO, announced the move at a press conference today in Geneva.

Fukuda said the committee would be drawn from a roster established under International Health Regulations and include experts in public health, epidemiology, virology and related fields. It is expected to meet for the first time by telephone on Tuesday.

A declaration by the panel of a global crisis would give the WHO power to issue temporary recommendations on travel restrictions or other ways to control the spread of Middle Eastern Respiratory Syndrome (MERS) virus, which has infected 79 people and killed 42 of them. The only other such panel was convened in 2009 to combat the H1N1 flu pandemic.

Mike Osterholm, director at the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, applauded the WHO's move. "It is a very important step in realizing this poses a potential global threat," he said. The number of cases has held steady this spring, with the WHO counting 19 in April, 21 in May, and 22 in June. But many cases do not seem to be connected to any other cases. "There is either an animal reservoir that is widespread and we are not aware of it, or there is substantial unrecognized human-to-human transmission of this virus," Osterholm says. "Either way, this is a problem."

The panel will convene the day after the start of the Islamic holy month of Ramadan. Many Muslims undertake a small pilgrimage called Umrah during that time. The annual, and much larger, hajj pilgrimage occurs in October, bringing millions of visitors to Saudi Arabia, where most of the infections have occurred. Matthew Frieman, a coronavirus researcher at the University of Maryland School of Medicine in Baltimore, says the WHO's timing is "precisely right" because of the increased opportunities in the months to come for the virus to spread. Christian Drosten, a virologist at the University of Bonn Medical Centre in Germany, says the WHO needs to decide before October whether travel restrictions are needed.

Medical experts have criticized the Saudi government for being slow to share data on new cases. But Reinhard Burger, president of the Robert Koch Institute, the German center for disease control, says establishing the emergency committee is more about being prepared and getting together all the information available than trying to apply political pressure. He said many experts learned about an outbreak of MERS in a Saudi hospital only when a paper on it appeared in the New England Journal of Medicine. "That there were more hospital-acquired infections than we thought would have been good to know earlier," Burger says. "To learn that from reading a journal was very unusual."