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Update on MERS-CoV: The latest development of the MERS-CoV outbreak in South Korea

​Currently there is a minor outbreak of Middle East Respiratory Syndrome (MERS) in South Korea.

 

With 185 cases reported from WHO, 36 of which are fatalities, this is, however, the largest outbreak of MERS since the discovery of the disease in the Middle East region in 2012. Globally, WHO have registered 1368 cases, with at least 489 related fatalities. 

 

From 13-17 June 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia noti-fied WHO of five additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.
 
On 18 June 2015, the National IHR Focal Point of Thailand notified WHO of the country’s first confirmed case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
 
On May 20, the Republic of Korea (South Korea) reported its first laboratory-confirmed case of Middle East respiratory syndrome (MERS). All transmission has been linked to healthcare facilities where MERS-CoV patients were treated.
 
It appears that all detected cases to date can be linked to the first case which was reported in the begining of May 2015, where a Korean business traveller brought the virus from the Middle East.
 

According to WHO, the number of daily reported cases, which is the most accurate picture of whether the outbreak is slowing down, appears to be declining.

 

Description of the disease
A Corona virus causes MERS, hence the disease is also referred to as MERS-CoV. MERS is a potentially deadly disease affecting the respiratory systems. 3-4 out of 10 infected people die. It is mostly patients with underlying diseases, e.g. cancer and Chronic Obstructive Pulmonary Disease (COPD), who belong to the group at risk.

 
Typical symptoms of MERS are:
  • Fever
  • Cough
  • Shortness of breath
In addition, gastrointestinal symptoms, including diarrhoea and nausea/vomiting may also occur. For many people with MERS, more severe complications can follow, such as pneumonia and kidney failure.

The incubation time (the time from infection to actual illness) of MERS, is usually 5 to 6 days, but it can range from 2-14 days.

All patients presenting with fever or respiratory symptoms should be questioned about contact with a MERS patient; visits to a healthcare facility where a MERS patient has been treated; and history of travel to the Middle East in the 14 days prior to symptom onset. Any patient with positive responses should be promptly reported to the public health authorities and managed as a suspected case while the diagnosis is being confirmed.
 
Transmission
The disease is considered to spread via an infected person’s respiratory secretions, i.e. through coughing.

According to CDC (Center of Disease Control – US), close physical contact, such as nursing or living with an infected person can also be a source of infection of MERS. Cases have been reported of transmission of MERS within healthcare settings, such as hospitals.
 
Until more is understood about MERS-CoV, patients with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of se-vere disease from MERS‐CoV infection. Therefore, these people are advised to avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.
 
Food hygiene practices should be observed. People are advised against drinking raw camel milk or camel urine, or eating meat that has not been properly cooked. WHO does not advise special screening at points of entry with regard to this event nor does it cur-rently recommend the application of any travel or trade restrictions.
 
People who have been in close contact with MERS CoV-infected patients, should not travel during the period when they are being monitored for the development of symptoms.

Prevention and treatment

There is no vaccine to prevent MERS.
 
However, some general preventive precautions can easily be taken in order to protect yourself to some extent against MERS:
 
  • Wash your hands often with soap and water for 20 seconds. If soap and water are not avaible, use an alcohol-based hand sanitizer.
  • Cover your nose and mouth with as tissue when coughing or sneezing.
  • Avoid touching your eyes, nose and moth with unwashed hands.
  • Avoid physical contact, e.g. kissing and sharing tabelware, such as cups or eating utensils, with infected people.
  • Clean and disinfect frequently touched surfaces and objects, such as door handles.

If infected, no specific anti-viral treatment targeting MERS exits. Treatment is to relieve symptoms and in more severe cases support of vital functions.

 
If infected or suspicion of infection seek medical attention as soon as possible.

 

Travel safety
Currently, neither CDC nor WHO recommend the application of any travel or trade re-strictions, i.e. special screening at points of entry.


At this time, no further precautions, besides the above, need to be taken when travelling in South Korea. Thus, it is still safe travelling to and within the country.

 

South Korea is a highly developed country with excellent medical care. The quality of medical facilities in Seoul, Pusan and Daegu is especially high. In rural areas, however, medical facilities may be harder to locate and of lower quality.
There might also be variations in the level of English proficiency, with lower levels outside larger cities. Travellers should be aware that most doctors and hospitals expect direct payment for healthcare services.

Recommended Korean clinics and hospitals
In the need of medical attention, Falck Global Assistance is recommending the following clinics and hospitals in South Korea:
 
Seoul
National Medical Center
Address : 245 Uljiro, Jung Gu, Seoul
Tel : +82 2 2265 9131
 
Busan
Busan National University
Address : 179 Gudongno, Seo-Gu, Busan
Tel: +82 51 240 7000
 
Daegu
Yeungnam University Hospital
Address : 170 Hyunchungno, Nam-Gu, Daegu
Tel: +82 53 623 9001

Falck Global assistance is closely monitoring the situation and keep the website up-dated. For any further enquiries, please contact Falck Global Assistance.
 
Falck Global Assistance is ready to assist you before, during and after your travel. Contact our emergency response centre at +45 7025 0405.
 
For other enquiries, please contact Medical Director, Thy Andresen at +45 4019 4874.
​Falck Global Assistance is a part of Falck Group that offers worldwide rescue services.

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Falck Global Assistance, Sydhavnsgade 18, DK-2450 Copenhagen | CBR: 38049399 | email: globalassistance@falck.com | tel: +45 70 25 04 05