Thursday, May 28, 2015

Korean MERS Cluster Rises To 7 - 1 Contact Reported In China

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Despite assurances last week from health authorities that the MERS virus`"has little risk" of spreading, Korea now holds the dubious distinction of having the most cases outside of the Middle East.

Overnight it was revealed that the number of confirmed cases had jumped to seven and that authorities had somehow allowed a `symptomatic' contact of two of the cases to travel by airplane to China. 

Although the details are available from the Korean CDC website, the machine translations are syntax-challenged and tedious to read.   We do have some English language alternatives, however, including Hong Kong's CHP.

28 May 2015

DH closely monitors two additional MERS cases in Korea

The Department of Health (DH) is today (May 28) closely monitoring two additional cases of Middle East Respiratory Syndrome (MERS) reported by Korea, and hence called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.

According to the health authority of Korea, the two latest patients (a 71-year-old male and a 28-year-old female) had contact with the male index case aged 68 confirmed on May 20. These are the sixth and seventh MERS cases in Korea.

The Centre for Health Protection (CHP) of the DH is seeking more information on the case from the World Health Organization (WHO) and the relevant health authority, and will remain vigilant and work closely with the WHO as well as overseas and neighbouring health authorities to monitor the latest developments.

"The cluster in Korea signifies that human-to-human transmission of MERS Coronavirus (MERS-CoV) in health-care settings and among close contacts can occur. The WHO has warned that failure in infection control and prevention measures in health-care settings could result in a large number of secondary cases. Nosocomial transmission can be stopped by strict adherence to basic infection control and prevention measures. The public and the health-care sector should pay special attention," a spokesman for the DH said. 
(Continue . . . )

The 71 year-old male patient was reported a roommate of the index case, while the 28 year-old female is described as a nurse who had contact with the index case.

Meanwhile, The Korea Times has a long report this morning detailing how a symptomatic contact  was allowed to board a plane and travel (albeit against medical advice) to China.

MERS phobia spreads to China
Health authorities take flak for poor control
By Jung Min-ho
The suspected patient was supposed to be under close monitoring because he showed clear indications of having contracted MERS, including a high fever. He was the son of the third man identified with the illness and the brother of the fourth, the KCDCP said.
Yet he had no problems passing through immigration inspections at Incheon International Airport and getting on a plane, which had 166 passengers on board. 
This highlights the KCDCP's ineptitude in handling cases of MERS, which the disease control center said "has little risk" of spreading further when it confirmed the first patient a week ago. Some worry that a MERS epidemic could break out in Korea.
"We should have checked more actively and broadly on family related issues. We are deeply sorry about that," KCDCP Director Yang Byung-kook told reporters.
(Continue . . . )

Korean authorities have provided the Chinese authorities with a list of 28 people who sat next to this contact on the plane, which carried a total of 166 passengers.  Chinese officials are now reportedly testing this individual for the MERS virus. 

While it is unlikely that - as suggested in the article above - that a `MERS epidemic' could break out in Korea, the events of the past week illustrate the dangers of underestimating a poorly understood virus. 

As with SARS, this virus seems to favor hospital transmission, but there is much we don't know about how else it is spread, including the role of asymptomatic carriage.

This is a topic we've broached often, most recently in WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps.

With the yearly influx of religious pilgrims to Saudi Arabia expected for Ramadan (June 17th-July 17th this year) now only 3 weeks away, this importation of the MERS virus and its subsequent spread has public health agencies on guard around the globe.

Stay tuned. 

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