Thursday, June 12, 2014

Hong Kong Unveils Their MERS-CoV Preparedness Plan




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Hong Kong’s CHP (Centre for Health Protection) was created after the shellacking that city took from the SARS outbreak of 2003 (see SARS and Remembrance).  Since then, the CHP has become the very model of a modern, proactive and diligent public health system.


Over the years we’ve watched Hong Kong deal effectively with intrusions from  H7N9, H9N2, H5N1 and a variety of other imported infectious diseases, all whilst keeping the public – and outside public health interests – well informed along the way. 


With more than 7 million residents crammed into just 426 sq miles, the CHP takes infectious disease threats very seriously. Today, Hong Kong’s CHP unveiled their MERS-CoV Preparedness Plan – one that is based in large measure on their Preparedness Plan for Influenza Pandemic launched in 2012 (see Hong Kong Updates Their Pandemic Preparedness Plan).


As with their pandemic plan, this MERS plan has three response levels;  Alert, Serious, and Emergency.   Descriptions of each below come from the new plan:


Alert Response Level 

Alert  Response  Level  corresponds  to  a  situation  where  the  risk  of MERS  causing  new  and  serious  health  impact  in  Hong  Kong  is  low.  Generally,  it  depicts  the  existence  of  MERS  coronavirus  capable  of causing serious health outcome in humans  in  places outside Hong Kong and  the  transmissibility  to  human  has  not  been  sufficient  to  sustain community  level  outbreaks.   An  example  of  scenario  under  this  level includes the following –

  • confirmation of sporadic or clusters of human case(s) caused by MERS  coronavirus  in  areas  outside  Hong  Kong,  which  the transmissibility  to  human  has  not  been  sufficient  to  sustain community level outbreaks.

Serious Response Level

Serious Response Level corresponds to a situation where the risk of MERS causing new and serious impact to human health in Hong Kong is moderate.   Generally, it depicts a moderate risk of  local spread of the disease in Hong Kong.  Examples of scenarios under this level include the following –

  • confirmation of sporadic or a few small clusters of human case(s) caused  by  a  MERS  coronavirus  in  Hong  Kong  but  without sustained human-to-human transmission;

Emergency Response Level

Emergency Response Level corresponds to a situation where the risk of MERS causing new and serious impact to human health in Hong Kong is  high  and  imminent.   Generally,  it  depicts  a  high  risk  of community-wide transmission of the virus in Hong Kong.  An example of a scenario under this level is MERS infection locally acquired in Hong Kong or in a place with considerable level of trade and travel relationship
with  Hong  Kong  and  with  evidence  of  human-to-human  transmission sufficient to cause sustained community level outbreaks.


This 23 page PDF document outlines in detail the individual response steps mandated for each of these three scenarios. 


The CHP has also released a press statement, explaining this new plan, and reiterating their health advice - and admonitions to avoid camels - for anyone traveling to the Arabian peninsula (Excerpts follow):


12 June 2014

Preparedness Plan for Middle East Respiratory Syndrome launched 

The Government today (June 12) announced the launch of the Preparedness Plan for Middle East Respiratory Syndrome (MERS Plan). The Plan sets out the Hong Kong Special Administrative Region Government's preparedness and response plan in case of an outbreak of MERS, and is mainly based on the framework of the Preparedness Plan for Influenza Pandemic launched in 2012 (Influenza Plan 2012).


In the MERS Plan, a three-tier response level, namely, Alert, Serious and Emergency, is used, which is in line with the Influenza Plan 2012. The MERS Plan also includes comprehensive response measures, clear command structures, and mechanisms for the activation and standing down of response levels.

In accordance with the MERS Plan, the Alert Response Level is activated with reference to the current epidemiological situation. The MERS Plan has been uploaded to the CHP's MERS page (


Recent scientific studies supported the premise that camels served as the primary source of MERS Coronavirus (MERS-CoV) infecting humans. The virus appears to pass from an infected person to another in close contact as observed among family members, patients and health-care workers (HCWs). However, so far there is no evidence of sustained human-to-human transmission in the community. Currently, there is no vaccine against MERS available. Treatment is mainly supportive and there is no effective antiviral treatment recommended for MERS at the moment.

"As the summer vacation is just round the corner, we strongly advise travel agents organising tours to the Middle East not to arrange camel rides and activities involving camel contact, which may increase the risk of infection. Furthermore, travellers are reminded to avoid going to farms, barns or markets with camels, and avoid contact with animals (especially camels), birds, poultry or sick people during travel," the spokesman added.

Travellers returning from the Middle East who develop respiratory symptoms should wear face masks, seek medical attention and report their travel history to the doctor. HCWs should arrange MERS-CoV testing for them. Patients' lower respiratory tract specimens should be tested when possible and repeat testing should be undertaken when clinical and epidemiological clues strongly suggest MERS.

Travellers are reminded to take heed of personal, food and environmental hygiene:

  • Avoid going to farms, barns or markets with camels;
  • Avoid contact with animals (especially camels), birds, poultry or sick people during travel;
  • Wash hands regularly before and after touching animals in case of visits to farms or barns;
  • Do not consume raw or undercooked animal products, including milk and meat, or foods which may be contaminated by animal secretions, excretions (such as urine) or products, unless they have been properly cooked, washed or peeled;
  • Seek medical consultation immediately if feeling unwell;
  • Avoid visits to health-care settings with MERS patients;
  • Wash hands before touching the eyes, nose and mouth, and after sneezing, coughing or cleaning the nose; and
  • Wash hands before eating or handling food, and after using the toilet.

The public may visit the DH's Travel Health Service

( or the WHO's latest news ( for more information and health advice.

Tour leaders and tour guides operating overseas tours are advised to refer to the CHP's health advice against MERS (

Ends/Thursday, June 12, 2014

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