Thursday, May 21, 2015

South Korea: 2nd & 3rd MERS Cases Confirmed





The first imported MERS case reported in South Korea yesterday has expanded today into a local cluster as the patient’s wife, and another patient sharing his hospital room have now both tested positive.  Interestingly, today’s media reports adds Saudi Arabia and the UAE to the first patient’s travel itinerary, in addition to the original reports of Bahrain and Qatar.


Another 64 people – mostly family members and contacts of hospital workers who have been exposed – are also quarantined.


First this update from Reuters and a statement by the Korean CDC,  after which I’ll return with a bit more:


UPDATE 2-South Korea confirms third case of MERS virus; 64 isolated

* Wife of the first patient positive for MERS - officials

* Another who shared hospital room also confirmed

* All three in stable condition - doctors

* Another 64 people isolated (Updates with third case and adds ministry briefing, paragraphs 1-7)

By Meeyoung Cho

SEOUL, May 21 (Reuters) - South Korean health officials confirmed the country's third case of Middle East Respiratory Syndrome (MERS) on Thursday, with the two latest cases found in people who had been in contact with the first patient after he returned from the Middle East.

Authorities have also isolated as a precaution another 64 people who are family members or medical workers treating those three patients, said Yang Byung-guk, director of the health ministry's Korea Centers for Disease Control & Prevention.

Test results came back positive for a 63-year-old woman, the wife of the first proven case, as well as for a 76-year-old man who shared a hospital room with him, the health ministry said.

The first man was diagnosed with the disease on Wednesday after a trip to Bahrain, Saudi Arabia and the United Arab Emirates, where the disease broke out, Yang told a briefing.

(Continue . . . )


The South Korean CDC has issued the following somewhat syntax-challenged (translated) statement  along with a document (alas, in the Hanword .hwp format, which I’m unable to open) describing their heightened level of alert.


Middle East Respiratory Syndrome ( Homers ) related to response measures strengthened

- Add introduced to prevent the spread and strengthen the quarantine , isolation therapy , contact investigations, and active monitoring of symptoms, such as general measures implemented -

□ The government has 21 days ( Thursday 12) to hold a meeting with Merck's infectious disease specialist crisis management organized at Headquarters , the current infectious disease crisis situation assessment and to discuss the next steps crisis, comprehensive measures are " careful steps , " the But maintaining response was to strengthen actions preemptively .

○ The conference is the first confirmed cases last 5.15 from work 5.17 days to B in a hospital admission while trying , with one of the hospitalized elderly patients ( male , 76 years of age ) egeseodo genetic test results conducted in accordance As a follow up positive judgment is out ,

* 5.20 am from the same fever has been confirmed in epidemiological studies to date courses in the afternoon National hospitalized in isolation wards actions already completed power

○ The Conference Results 5 May 20 at " attention " crisis alert level is upgraded to keep but that close contact with the family and medical power doubts (64 people ) to immediately perform the isolation and ,

○ confirmed cases from contact up to one incubation period of 14 days, the daily monitoring through an additional symptoms to take proactive measures to identify whether the expression was .

□ The government further epidemiological investigation first patient outside Bahrain Middle East respiratory syndrome gukin Saudi Arabia , UAE and some have visited history was confirmed that ,

○ The domestic and international cases reported now in the Middle East respiratory syndrome to infection, all patients were on a straight ‧ , so indirectly associated with the Middle East ,

○ with camels known as a mediator hayeotgeona visit to the Middle East, to stay in contact after returning 14 days fever , cough and breathing difficulties such as respiratory symptoms or more visits to hospitals and medical personnel if you have the facts to inform also , who care for these patients, physicians also actively report was advised .


South Korea becomes the 14th nation outside of the Arabian peninsula to see an imported MERS case, yet secondary transmission of the virus outside of the Middle East has been rare.  As we saw in France and the UK back in 2013, and now in South Korea, nosocomial spread of the virus remains a risk.


Two weeks ago, in WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps, we looked at some of the glaring deficits in our understanding of how, and why MERS transmits the way it does. From that report:


Most importantly, they identified many knowledge gaps that need to be addressed to better understand the transmission dynamics of the virus among animals, between animals and humans, and from human to humans. These knowledge gaps include: the risk factors for transmission between camels and humans, the role of mild or asymptomatic cases in the infection transmission, the seasonal trend of the disease, the specific exposures that put the healthcare workers at highest risk illness, the underlying factors that are contributing into the transmissibility of the virus in healthcare settings, and the behaviors that put certain groups of people at higher risk of illness, etc. 


While this year’s outbreak of MERS in the Middle East has been considerably more subdued than last year, we continue to see evidence that the virus is actively circulating in the region.  

With Ramadan now less than a month away – followed in September by the annual Hajj  (see CDC Traveler’s Advice: Umrah, The Hajj and MERS) – millions of religious pilgrims from around the world will visit the Holy Cities and the risks of seeing additional cases exported cannot discounted.


And while many countries will probably attempt to implement some sort of enhanced airport screening, as we’ve discussed often in the past (see Why Airport Screening Can’t Stop MERS, Ebola or Avian Flu), those efforts are unlikely to produce much in the way of solid results.


Making it important that – whenever possible – outbreaks of emerging viruses are quashed as quickly as possible at the source, before they can board an airplane and spread inexorably around the globe.  


A goal toward which, after nearly three years, we don’t seem to be making a lot of progress .

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