Hong Kong Raises MERS Response Level To Serious, Issues Travel Alert

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In response to this weekend's doubling of MERS cases in South Korea, Hong Kong's CHP has activated the  SERIOUS response level of their MERS-CoV Preparedness Plan – one that is based in large measure on their Preparedness Plan for Influenza Pandemic launched in 2012 (see Hong Kong Updates Their Pandemic Preparedness Plan).

The Serious Response Level under the Government's Preparedness Plan for the MERS is activated ^new8 June 2015

As with their pandemic plan, this MERS plan has three response levels; Alert, Serious, and Emergency. Hong Kong activated their response plan at the Alert level on May 29th. 

The HK MERS-CoV Preparedness plan lists the following scenarios as justifying a SERIOUS response level. 

Serious Response Level

9. Serious Response Level corresponds to a situation where the risk of MERS causing new and serious impact to human health in Hong Kong is moderate. Generally, it depicts a moderate risk of local spread of the disease in Hong Kong. Examples of scenarios under this level include the following –

• confirmation of sporadic or a few small clusters of human case(s) caused by a MERS coronavirus in Hong Kong but without sustained human-to-human transmission;

• confirmation of MERS capable of efficient human-to-human transmission, spreading in an area that has insignificant trade and travel relationship with Hong Kong.

Although a MERS infected traveler passed through Hong Kong 10 days ago on his way to China, the CHP hasn't announced any local cases as of this writing, so this seems to be based on criteria # 2 above. 

The issuance of an `avoid unnecessary travel' alert for Korea (plus apparently characterizing their MERS outbreak as involving `efficient human-to-human transmission')  represents a major escalation over what we are hearing from the WHO, the South Koreans, and our own CDC (level 1 travel notice). 

Hong Kong is particularly proactive, however, in protecting public health as they were the hardest hit city in the world during the 2003 SARS epidemic (see SARS And Remembrance), which resulted in  a total of 1750 local cases and 286 deaths. 

Whether Hong Kong's response will be viewed as excessive or prescient will depend on how quickly the Koreans get control of their outbreak.