Thursday, July 09, 2015

Korea: Some MERS Policy News



# 10,310


The hard lesson that South Korea has learned over the past couple of months is that there is literally no place on earth that is immune to seeing imported cases of exotic emerging infectious diseases, and that the costs for not being prepared can be enormous.


The good news is, there have been no new cases reported since Sunday, although two more fatalities (total=35) have been announced.



We’ve a pair of new reports this morning discussing policy decisions South Korea has either made, or is trying to make, regarding this (and future) outbreaks.


Although a bit premature - with a streak of 4 days without a new case - thoughts are once again returning to when they might be able to declare this current outbreak over.  This from KBS News:


Gov't, WHO Setting Standard to Determine End of MERS Outbreak

Write : 2015-07-09 18:13:04 Update : 2015-07-09 18:22:02

South Korean health authorities and the World Health Organization (WHO) are in talks to set specific criteria to determine the end of the Middle East Respiratory Syndrome (MERS) outbreak.

With no new cases of the MERS infection reported for the fourth day on Thursday, the government's central MERS-response headquarters said that there is no set standard yet to determine the end of the epidemic.

Officials said they were continuing talks with the WHO to set the guidelines.

(Continue . . . )



The standard used in African nations dealing with Ebola outbreaks has been to multiply the maximum incubation period times 2, to come up with an appropriate timetable without new cases to declare an outbreak over.  Of course, as we saw in Liberia, even after 3 months without a new case, the virus can always be re-introduced into a region.


With MERS, the accepted incubation period is up to 14 days, so by that standard you’d have to go 28 days without a new case to declare an outbreak quashed. Whether that – or some other metric – will become the standard for MERS elimination is apparently still under discussion.


A second story this morning revolves around public notification of MERS cases.   

As you may recall, South Korea initially refused to provide the names and locations of hospitals affected by the MERS virus.  Despite strident local and international criticisms, it wasn’t until 2 weeks into the crisis that officials relented and released The MERS Hospital List.


Today, the media is reporting that Korean officials have reclassified MERS as a group 4 disease, one that requires immediate notification of the public.   This from the Korean Times.


MERS listed as notifiable disease

By Kim Se-jeong

The Ministry of Health and Welfare said Thursday that it has placed Middle East Respiratory Syndrome (MERS) on a list of communicable diseases whose occurrence must be immediately made public.

Health authorities are required to disclose relevant information to the public quickly in the case of the outbreak, such as hospitals and other establishments infected patients visited.

"MERS was included as a Group 4 infectious disease, which is those that break out overseas and are brought into the country," a ministry official said. Plague, yellow fever, dengue fever and Severe Acute Respiratory Syndrome (SARS) are also on the list.

(Continue . . . )


As we saw last fall with Ebola in Dallas and this summer with MERS in Korea, the challenges of dealing with poorly understood EIDs are often underappreciated, and the learning curve can be steep.   Far too often, we repeat the mistakes of the past, instead of learning from them.


We’ve been incredibly lucky that the EIDs that have emerged thus far have been less than fully human-adapted, and therefore not all that easily spread.  


How long our luck will last is anyone’s guess, but nature’s laboratory is running 24/7, so no one should assume it will last forever. 


These outbreaks, as tragic and disruptive as they are, should be viewed as opportunities to prepare – intelligently, and diligently – for the next big global health crisis. It is all but inevitable that a real pandemic contender will emerge.  It is just a matter of time. 


The only real question is.  Will we be ready?



A few recent blogs on pandemic preparedness include:


TFAH Issue Brief: Preparing The United States For MERS-CoV & Other Emerging Infections

Pandemic Planning For Business

NPM13: Pandemic Planning Assumptions

The Pandemic Preparedness Messaging Dilemma

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