A man has tested positive for MERS-CoV in Abu Dhabi, the World Health Organization reports. So far, the 28-year-old is the only case to test positive out of 108 close contacts identified, but the WHO is urging vigilance.

MERS‐CoV is a coronavirus first identified in the Middle East in 2012 after the virus made its way into humans from bats via camels. It’s one of a number of zoonotic viruses (those that jump from animals into people) that health authorities keep close tabs on.

The WHO was notified of the confirmed case by the United Arab Emirates’ health surveillance body on July 10, 17 days after the young man tested positive in hospital on June 23.

In light of the case, WHO “re-emphasizes the importance of strong surveillance” for acute respiratory infections and has urged health authorities to “carefully review any unusual patterns.”

“No secondary cases have been detected to date,” WHO’s July 24 statement reads, although the organization expects additional cases will be reported from the Middle East or other countries where the virus circulates in animal hosts.

According to the WHO, the man had not recently traveled outside of the UAE before his diagnosis on June 23, and has no known history of direct contact with dromedary camels, the usual source of MERS infections.

“WHO continues to monitor the epidemiological situation and conducts risk assessments based on the latest available information,” the statement reads.

Health authorities identified 108 close contacts of the patient, who was admitted to hospital on June 8. The 108 contacts, all healthcare workers, were monitored for 14 days post-contact, and all tests have so far come back negative.

The man presented to a private medical clinic several times between June 3 and 7, complaining of vomiting and pain when urinating and in his right flank.

As his condition worsened, the man was admitted to hospital, and then to intensive care, where he is receiving supportive treatment.

There is currently no vaccine or specific treatment for MERS, the syndrome caused by MERS-CoV. A typical presentation of MERS is fever, cough, and shortness of breath.

At least 94 MERS-CoV cases (including this current case) and 12 related deaths have been reported to WHO from the UAE since July 2013.

Globally, labs have confirmed a total of 2,605 MERS-CoV cases since 2012, including 936 associated deaths as of July 2023.

Infections have been detected in the US, Philippines, Netherlands, and South Korea in recent years.

While news like this is a reminder of the global threat zoonotic viruses increasingly pose to humans, it also shows that infectious disease alert systems are working as designed, albeit a little slowly.

Sensibly, researchers keep scrutinizing how these systems could work better. Because as we know from the COVID-19 pandemic and outbreaks before it, what happens next – how authorities respond and continue to monitor the situation – is critical.

MERS-CoV is the virus that emerged after SARS-CoV-1 in 2003 and following the 2009 swine flu pandemic; but before the 2014-2016 West Africa Ebola and 2016 Zika virus outbreaks.

Despite this slew of zoonotic viruses and evidence of human activity intensifying spillover risk, experts warn we’re not doing enough to prepare for the next pandemic.

“Even with widespread evidence, investment in public health pandemic data systems within the health sector continues to be overlooked by most governments globally,” a group of public health researchers wrote in a 2022 systematic review of early warning systems used around the world to detect infectious disease outbreaks.

“Such preparedness appears significantly urgent with the unprecedented pandemic era of current and emerging public health threats,” they conclude.