Wednesday, September 12, 2018

WHO Update & Risk Assessment: MERS-CoV In South Korea

Credit WHO


Four days ago we saw the South Korean CDC Confirm An Imported MERS-CoV Case, bringing back memories of their 2015 multi-hospital epidemic which saw 186 people infected and 37 deaths.
Fortunately, this time it appears that that index patient was isolated relatively quickly, and no additional cases have been reported - although a large number of contacts are still being monitored.
Today the World Health Organization has published their first summary and risk assessment on this imported case, which indicates the infected traveler had been sick for more than a week when he few back to South Korea, and had visited at least two hospitals in Kuwait in the days before his departure.

Due to its length I've only posted some excerpts.  Follow the link below to read it in its entirety.

Middle East respiratory syndrome coronavirus (MERS-CoV) infection – Republic of Korea

Disease outbreak news
12 September 2018

On 8 September 2018, the International Health Regulations (IHR 2005) National Focal Point (NFP) of the Republic of Korea notified WHO of a laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV).

The case is a 61-year-old male Korean national who visited Kuwait on business from 16 August through 6 September 2018. He returned to Korea via Dubai.

On 28 August, while in Kuwait, he experienced diarrhoea. On 3 September his symptoms worsened and he visited a local hospital in Mangaf, Kuwait on 4 and 6 September. On 7 September, he returned to Korea and presented to a general hospital in Seoul with diarrhoea and fever. A diagnosis of pneumonia was made, and due to his travel history, MERS was suspected. He was immediately isolated, transferred to the Seoul National University Hospital where he was immediately placed in an isolation ward. The patient is currently in a stable condition.

A sputum sample was collected and tested positive for MERS-CoV by RT-PCR on 8 September at the laboratory of Seoul Provincial Institute of Public Health and Environment. Viral isolation is being performed.
Public health response

The Ministry of Health in the Republic of Korea is closely monitoring 21 individuals who had close contact with the patient: family members, individuals who were seated near the patient during travel, flight attendants, close contacts while in Seoul and four health care workers. All identified contacts have been placed in quarantine at home and are currently asymptomatic; they will be monitored by local public health centres for 14 days after exposure to the patient. In addition, up to 435 individuals, including the passengers on the flight, were or are under passive surveillance.

Health authorities in the Republic of Korea have been in contact with the Ministry of Health in Kuwait. The epidemiological investigation of the patient’s exposures and travel history in Kuwait is ongoing.

WHO is working with Ministry officials in the Republic of Korea, Kuwait and United Arab Emirates and providing technical advice and guidance for investigations in the three Member States to determine the patient’s movements, exposures and to minimize the occurrence of secondary infections.
WHO risk assessment

The virus does not pass easily from person to person unless there is close contact, such as providing unprotected care to an infected patient. Infection with MERS-CoV can cause severe disease resulting in high rates of morbidity and mortality. Community-acquired human infections with MERS-CoV have occurred from direct or indirect contact with infected dromedary camels. MERS-CoV can also transmit between humans, through unprotected contact with an infected person. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings. Human-to-human transmission can be stopped with adequate infection prevention and control measures.

The notification of a confirmed case in the Republic of Korea does not change WHO’s overall global risk assessment for MERS. As a result of comprehensive contact tracing and testing of high risk contacts, additional cases may be identified in relation to this one case. Additional infections identified as part of the ongoing public health response will not change the overall global public health risk, which is low.

WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and that sporadic cases will continue to be exported to other countries by individuals who have acquired the infection after exposure to infected animals, animal products or human cases (for example, in a health care setting). To date, no cases have been associated with Hajj.

WHO continues to monitor the epidemiological situation and conduct risk assessments based on the latest available information.
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