Thursday, June 11, 2015

ECDC: Updated Rapid Risk Assessment On MERS

# 10,186

The ECDC has released an updated Rapid Risk Assessment on MERS, and while the threat to the EU remains unchanged, it does provide us with some of the best charts, graphics, and background on Korea's outbreak that we've seen.

First the press release, followed by a link to the new assessment, and a few select excerpts.

ECDC updates its rapid risk assessment as MERS-CoV cluster evolves in South Korea

11 Jun 2015
The cluster of Middle East respiratory syndrome coronavirus (MERS-CoV) continues to evolve in South Korea, where 107 confirmed cases and nine deaths have been reported as of 10 June 2015 and since the first case was diagnosed on 20 May 2015. While it is the largest cluster of MERS-CoV seen outside of the Arabian Peninsula, it follows the pattern of transmission in Saudi Arabian hospitals when extended nosocomial transmission was observed, and is thus not unexpected. 
ECDC’s latest assessment continues to conclude that the current MERS-CoV outbreak poses a low risk to the EU. It highlights the importance of rapid consideration of MERS-CoV and strict adherence to infection control measures in healthcare settings, as well as suggests raising travellers’ awareness of the presence of MERS-CoV in the Middle East and in South Korea. 
Risk to travellers to South Korea 

The outbreak so far does not represent an increased risk of infection for travellers or visitors to South Korea. However, EU citizens travelling to the Middle East and South Korea need to be aware of the presence of MERS-CoV in these areas, especially in healthcare facilities, as continued exposure in affected healthcare facilities cannot be excluded. Travellers who have visited healthcare facilities in the Middle East and South Korea who develop respiratory symptoms up to 14 days after return should seek medical attention, indicating their travel history.
Surveillance and infection control of paramount importance 

ECDC risk assessment once again reasserts the importance of international surveillance for MERS-CoV cases among travelers. Rapid efforts to contain nosocomial clusters in the Middle East and South Korea are vital to prevent broader transmission.
Rigorous implementation of infection prevention and control measures in hospitals is essential to interrupt transmission and prevent clusters of infection. Detecting rare imported cases early on is a challenge that highlights the need for adequate infection prevention and control measures for all patients showing symptoms of acute respiratory infection. 
Continued investigation needed

Additional information on clinical presentation, further details on epidemiological features of the cluster, and knowledge of MERS-CoV genetic sequences are required to confirm our current conclusions. In addition, more details on the potential exposure in the community of the index case would help to elucidate the potential source of the infection and the cause of the high number of secondary cases.
Rapid risk assessment on severe respiratory disease associated with Middle East respiratory syndrome coronavirus (MERS-CoV). 17th update, 11 June 2015 

You'll want to download and examine the entire document, but I've cherry picked a couple of the graphics to give you an idea of the depth of analysis it provides.  First is a side by side comparison of the Saudi and Korean case demographics.

So far the Korean cases have been slightly younger, and not quite as heavily skewed towards males, as we've seen in Saudi Arabia.   Young cases remain remarkably absent from both demographics.

This next graphic shows the distribution of cases by date and presumed place of exposure.

Highly recommended. 

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