Saturday, July 30, 2016

Thailand Reports `Probable' Imported MERS Case

Updated: Monday 8/1/16

There are new reports that the suspected case has tested negative and awaits a second test before being declared `cleared of MERS'.  

Whether that means he was never infected, or has simply cleared the virus, is uncertain at this time.  Hopefully follow up serological testing will be done to confirm or rule out a MERS infection.


For the third time in just over a year Thailand is reporting an imported MERS case, who is now in isolation (along with his family and a Taxi driver) at Bamrasnaradul hospital.

According to press reports (there's nothing yet on the MOH website), the patient is an 18 year old Kuwaiti male who entered the country on Monday with two older relatives.   

He developed flu-like symptoms on Tuesday and tested positive for MERS on Wednesday.  His condition has improved, and he (and his contacts) will remain in isolation for 14 days. 

According to the Bangkok Post report (below) this case is considered `probable' because one lab returned a positive lab result, while several others were inconclusive. 

Other than being identified as Kuwaiti, we aren't provided with any information about this patient's recent travel history, or possible exposures.  Kuwait, which has only reported 4 cases in the past 4 years, last reported a MERS case in September of 2015.

New probable Mers case found

 30 Jul 2016 at 16:06 

A Kuwaiti man has been identified as a probable Mers case in Thailand although testing has not been conclusive, according to the Public Health Ministry.

The 18-year-old man entered the country on Monday with his father and grandmother and all of them are now hospitalised, said Ammuay Gajeena, director general of the Disease Control Department said at a news briefing on Saturday afternoon.

The purpose of their visit was to have the grandmother treated for knee-related complications.

When the man started to show flu symptoms a day later, the private hospital treating his grandmother took a sample of his body fluid to be tested for Middle East Respiratory Syndrome (Mers) at the facility's laboratory.

The test came positive on Wednesday and the hospital informed the ministry which immediately admitted him to the state-owned Bamrasnaradura Infectious Disease Institute.

(Continue . . . .)

For details on Thailand's two earlier imported MERS cases, you may wish to revisit:

WHO SEARO Statement On Thailand's Imported MERS Case

Thailand Discharges Their First (and Only) MERS Case

Thailand, which is a major medical tourism destination and gets many patients from the Middle East, has managed to quickly identify and contain three MERS cases.

But as we saw last year in Eurosurveillance: Estimating The Odds Of Secondary/Tertiary Cases From An Imported MERS Case - while most imported cases won't result in extended outbreaks - the odds of seeing at least 8 cases as the result of a single imported case was estimated at non-trivial 10.9%.

A reminder that on any given day, in any given hospital, a MERS, Ebola, or Avian flu patient can walk in the door.  For more on how hospitals can prepare, you may wish to revisit  TFAH Issue Brief: Preparing The United States For MERS-CoV & Other Emerging Infections.

1 comment:

Maura said...

Hey Mike-- ICYMI, this case has now tested negative on the second, final round of testing at 4 labs, as have his father and grandmother. All three have been released from isolation and quarantine, respectively, and flew home yesterday.

Love your blog and keep up the good work!