Sunday, June 07, 2015

Korea:The MERS Hospital List

# 10,159

Overnight South Korea's Acting Prime Minister Choi Kyung-hwan announced a list of hospitals where MERS cases are either receiving treatment or had `passed through'.

While the number of `affected  facilities' has jumped dramatically (from the 6 we already knew about) to 24, only six actually have MERS cases admitted.

The South Korean government has come under increasing pressure to release the names of affected facilities, but has waited more than two weeks to do so.  The list below comes from the Korean Observer report Government discloses names of 24 MERS-affected hospitals.

Hospitals with MERS patients 
Samsung Medical Center in Gangnam, Seoul where one of its doctor was diagnosed with MERS and apparently contacted over 1,500 people
365 Seoul Open Clinic in Cheonho, Seoul
Pyeongtaek St. Mary’s Hospital, in Pyeongtaek, Gyeonggi Province
Asan Seoul Clinic in Asan, South Chungcheong Province
Daecheong Hospital in Daejeon
Konyang University Hospital in Daejeon

While we don't have any specifics on how these 18 second-tier hospitals came to be affected, they appear to have experienced potential exposure to MERS when a subsequently identified case visited or passed through their facility.

So far, none of these hospitals appear to have reported infections. 

Other MERS effected hospitals 

Asan Medical Center in Songpa, Seoul
Yeouido St. Mary’s Hospital in Seoul
Hanaro Clinic in Seoul
Yoon Chang-ok Internal Medicine Clinic in Pildong, Seoul
Pyeongtaek Pureun Hospital in Pyeongtaek, Gyeonggi Province
Pyeongtaek 365 Yonhapheo Clinic (Clinics Alliance) in Pyeongtaek, Gyeonggi Province
Pyeongtaek Good Morning Hospital in Pyeongtaek, Gyeonggi Province
The Good Samaritan Bagae Hospital in Pyeongtaek, Gyeonggi Province
Pyeongtaek Yeonsei Hub Family Medicine in Pyeongtaek, Gyeonggi Province
St. Vincent Hospital in Suwon, Gyeonggi Province
Hallym University Medical Center in Hawseong, Gyeonggi Province
Medihols Hospital in Bucheon, Gyeonggi Province
Bucheon St. Mary’s Hospital in Bucheon, Gyeonggi Province
St. Mary’s Hospital Family Medicine Clinic in Seongdong-gu, Seoul (It was wrongfully identified as a Gunpo clinic by the ministry)
Osan Korea Hospital in Osan, Gyeonggi Province
Cheonan Dankook University Hospital in Cheonan, South Chungcheong Province
Choi Sun-yong Internal Medicine Clinic in Sunchang, North Jeolla Province.
Daecheon Clinic in Daecheon, South Chungcheong Province

According to this Korean Observer article, the government's finance Minister (Choi) is quoted as saying all cases so far are related to hospital exposures, and that no community transmission has been detected.

Choi said there’s no immediate plan to upgrade the MERS alert level from the current “watch” to “warning.” 
“The government has determined that MERS has not yet spread through communities,” he said. “So far, every case has been confined to hospitals. We won’t raise the alert level, but we’d like to inform you that we’re taking all the steps intended for a much higher level of warning.”

As long as transmission remains hospital-related, experience has shown that enhanced infection control protocols can bring these outbreaks under control. Even very large nosocomial outbreaks - such as we saw last year in Jeddah, Saudi Arabia - eventually burn out.

Things would become considerably more problematic if cases were to begin emerging from the community. Something we've not seen announced in Korea yet, but which remains a distinct possibility. 

On a more positive note - unlike in the Middle East - Korea doesn't have an indigenous dromedary population to harbor and continually reseed the virus into the community. That should help limit the risks of seeing any long-term endemicity.

This  Korean MERS outbreak illustrates how easily an exotic and potentially deadly virus can travel halfway around the world and greatly impact another region.   

While we've been lucky with our two imported MERS cases in the United States, and Canada was fortunate that their imported H5N1 and H7N9 cases did not spread, the truth is - no nation on earth can claim to be immune to this sort of incident.

Stay tuned . . .

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