Wednesday, 3 June 2015

South Korea MERS outbreak

Ministry of Health (MOH): Updates on Measures Againsts MERS-CoV

* Koreans told to 'rest easy' over MERS
Government says danger has now passed, with no new cases of virus since July 4
The Straits Times, 29 Jul 2015

SEOUL • South Korea has declared it is effectively out of danger from Middle East respiratory syndrome (MERS). This comes more than two months after the first case was reported and began spreading in hospitals to kill 36 people.

The outbreak grew to become the largest outside Saudi Arabia, infecting 186 people and, at its peak, putting nearly 17,000 in quarantine. It was traced to a man who returned from a business trip to the Middle East in May.

"It is the assessment of the government and the medical community that the public can rest easy," Prime Minister Hwang Kyo Ahn said yesterday.

Twelve people remain hospitalised and under treatment for MERS, although only one is still testing positive for the virus, the Health Ministry said, adding that no new cases have been reported since July 4. The virus has an incubation period of about two weeks.

The outbreak dealt a major blow to an already-weakened South Korean economy, knocking second-quarter growth to its worst in more than six years as it closed thousands of schools, kept consumers at home and scared away tourists.

The schools have reopened and shoppers are back in the stores, but officials are keen to repair the lingering damage to sentiment.

Seoul plans to spend up to 30 billion won (S$35 million) on campaigns to lure back travellers, including free promotional tours and concerts by big-name K-pop stars.

The government has also announced a 22-trillion-won stimulus package, much of which is aimed at supporting businesses hurt by the MERS crisis.

Earlier this month, the Bank of Korea cut its 2015 economic growth forecast for the third time this year, from 3.1 per cent to 2.8 per cent.

Citing sluggish exports and weak domestic consumption - exacerbated by the MERS outbreak - the central bank has kept its benchmark interest rate unchanged at a record low of 1.5 per cent.

MERS is linked to the same family of coronaviruses that triggered a deadly outbreak of severe acute respiratory syndrome (SARS) in 2003.

Mr Hwang said it was too early to declare the outbreak over, but urged the public to return to normal daily life. A Health Ministry official said: "We still have many arrivals from the Middle East, so there is always a possibility that new patients can come in."

Screening stations in airports will continue to operate.


Spread of MERS: Man visited 3 hospitals
High infection rates in South Korea partly due to popularity of big hospitals
The Straits Times, 10 Jun 2015

SEOUL - At first, doctors thought the 68-year-old man might have simple pneumonia.

He coughed and wheezed his way through three hospitals before officials figured out, nine days later, he had something far more serious and contagious. Along the way, health officials said, the man infected dozens who then became potential carriers themselves and infected dozens more and counting.

The original diagnosis that missed what became South Korea's first case of the Middle East respiratory syndrome, or Mers, was possibly caused by incomplete information from the patient about his travels.

The World Health Organisation acknowledged Mers is not easy to identify early because its symptoms are similar to respiratory infections like the common cold. But it is especially problematic in South Korea because of peculiarities in the hospital system, health experts say.

Patients jostle, cajole and name-drop to get referrals into the biggest hospitals, which they believe attract the best doctors. Family members and outside caregivers commingle with the sick in crowded emergency wards. They often stay with the patients in their rooms and do much of the nursing work - wiping sweat, emptying bedpans, changing sheets and exposing themselves to infections.

"Our crowded hospital environment is a weakness," said Dr Cho Sung Il, a professor of epidemiology in the Graduate School of Public Health at Seoul National University.

As of yesterday morning, the South Korean authorities had confirmed at least 95 Mers cases and were monitoring more than 2,500 people under quarantine. At least seven patients have died.

So many patients seek medical care at large hospitals that securing a bed in a mega-hospital in Seoul for a relative or friend has become a test of a person's networking ability. The two hospitals where the vast majority of Mers cases have occurred are among the biggest in their cities.

"Many people want to check into famous hospitals, some even waiting in their emergency rooms until a bed gets available," said Dr Kim Woo Joo of the Korean Society of Infectious Diseases, head of the government's epidemiological study of the Mers outbreak. "This is a very Korean thing."

South Korea has become known for the largest caseload of Mers outside of Saudi Arabia, where the disease first emerged in 2012.

Researchers have traced Mers to a virus believed to have jumped from camels to humans. The virus can be spread by breathing the same air as an infected and coughing person in close proximity.

The hospital odyssey of the first infected patient began after May 11, when he developed a fever and visited a clinic in his home town of Asan, south of Seoul, on May 12, 14 and 15.

Perplexed doctors, not knowing he had visited Saudi Arabia and the United Arab Emirates in early May, sent him to a bigger hospital, St Mary's, in Pyeongtaek,near Seoul. With no improvement, he went to Seoul, visiting a relatively small hospital there on May 17, where X-rays suggested pneumonia. The next day, he was referred to the big Samsung Medical Centre. Doctors suspected he had Mers, learnt of his Middle East visit, isolated him and confirmed their correct diagnosis on May 20.

Dr Kim said St Mary's crowded conditions had been ideal for the virus to spread. So far, 37 St Mary's patients have been confirmed as having caught the virus. One of the patients later checked into the emergency ward of the Samsung hospital in Seoul, infecting at least 35 people.

It was only on Sunday that the government revealed the names of all 24 hospitals the confirmed cases had visited - 21/2 weeks after the first case was discovered. They have since added five more to the list.


As an additional precautionary measure for the early detection of MERS-CoV cases from South Korea, we have begun...
Posted by Ministry of Health on Tuesday, June 9, 2015

With the ongoing MERS-CoV outbreak in South Korea, all our hospitals have been reminded to remain vigilant and to stand...
Posted by Ministry of Health on Wednesday, June 3, 2015

South Korea sets up task force to tackle MERS outbreak
1,364 quarantined, 690 schools shut; President urges efforts to ease alarm
By Chang May Choon, South Korea Correspondent In Seoul, The Straits Times, 4 Jun 2015

PRESIDENT Park Geun Hye has launched a special task force to combat the widening Middle East respiratory syndrome (MERS) outbreak and urged greater efforts to ease growing public alarm, which prompted the closure of almost 700 schools.

As of yesterday, there were 30 confirmed patients, including two who died on Monday, and 398 suspected cases, including an air force officer from Osan Air Base in Gyeonggi province and a hospital doctor in Seoul. Health officials said 1,364 people were quarantined, up from 791 on Tuesday.

The World Health Organisation (WHO) has warned that the outbreak is likely to grow. The first patient, a 68-year-old man who had travelled to Bahrain, visited four hospitals and clinics before he was finally diagnosed with MERS on May 20.

With rumours swirling on social media about which hospitals to avoid, there are mounting calls for the government to reveal where the MERS patients are being treated and where people exposed to the virus are being isolated.

In an emergency meeting with officials yesterday, Ms Park also stressed the importance of transparency, calling on officials to reveal the causes and origin of the outbreak after thorough research.

"Many people are getting anxious," she said, adding that the government should discuss how to protect vulnerable people such as students and the elderly.

The Health Ministry has so far resisted calls to release a list of MERS-affected medical facilities. But it revealed yesterday that only 11 general hospitals and three clinics have dealt with confirmed MERS patients.

Of the 690 schools that were closed yesterday, 585 are in Gyeonggi province, where the first confirmed case was detected. The first MERS-related death - of a 58-year-old woman - was also registered in the province, which surrounds capital city Seoul. It is home to over 12 million people.

Among those who are quarantined, only 103 are staying at medical facilities, according to the Health Ministry. The rest are being isolated at home.

The WHO praised the South Korean authorities for the quality of reporting on MERS cases, which allowed almost real-time insight into how the disease spread.

"Aggressive contact tracing and testing for infection may help explain the rapid expansion of

the outbreak," it said in a statement from Geneva, adding that there was "no evidence of sustained transmission in the community".

It did not recommend any travel or trade restrictions.

Still, fears over the spread of the disease have grown.

Dermatologist Eun Lee, 37, has cancelled her six-year-old son's upcoming birthday party and stocked up on hand sanitisers and mouthwash.

"The situation is getting serious, so I'm going to avoid crowded places and general hospitals," she told The Straits Times. "We will just stay at home during the weekend."

South Korea MERS outbreak spreads: 25 cases, 2 dead
Schools close, tourists cancel tours and organisations move to adopt preventative measures
By Chang May Choon, South Korea Correspondent In Seoul, The Straits Times, 3 Jun 2015

THE Middle East Respiratory Syndrome (MERS) outbreak has claimed its first two victims in South Korea, prompting schools to close and tourists to cancel tours over growing fears of the virus spreading.

Six more people were diagnosed yesterday, bringing the total number of MERS cases to 25, as the government vowed to step up efforts to contain the outbreak - the largest outside the Middle East.

This includes the first recorded tertiary infections - two people who caught the virus not from the first patient but a secondary patient.

More than 750 people who had contact with MERS patients, including medical staff, have been quarantined so far, at home or medical facilities.

According to the health ministry, a 58-year-old woman and a 71-year-old man died on Monday after having close contact with the first MERS patient, a 68-year-old man who tested positive for MERS on May 20 after a trip to Bahrain.

Health officials said both were already unwell and were being treated in hospital where they caught the MERS virus. The woman, who died in a hospital in Gyeonggi province, had asthma, while the man had suffered from chronic obstructive pulmonary disease.

Meanwhile, the South Korean man who brought MERS to China is being treated in southern Guangdong province and his condition is stable, according to local media reports.

At an emergency ministerial meeting yesterday, acting prime minister Choi Kyung Hwan promised that the government will mobilise all its medical resources to combat MERS and allay public concerns.

The World Health Organisation (WHO) will be sending a team of epidemiologists to help the country cope with the outbreak, Korea Times reported. It added that they will depart for Seoul once they receive confirmation from the health ministry, and will start analysing the virus to see how closely it is related to the one first detected in Saudi Arabia in 2012.

With fear spreading faster than the virus, some organisations have taken it upon themselves to adopt preventive measures.

In Gyeonggi province, a primary school located near the hospital where the 58-year-old woman died decided to close yesterday, due to rising concern from parents. Another 35 primary schools will close from today, and schools have been advised to cancel outdoor activities as a precaution.

Ssangyong Motor sent some workers home after an employee was diagnosed with MERS on Monday, while Hyundai Motor advised its employees to refrain from going to the Middle East.

The tourism sector was also hit, with about 1,300 people from Taiwan and another 300 from China cancelling their trips, according to reports.

Singaporean Grace Teo, 33, a civil servant who is set to fly to Seoul on June 15 with her family and friends, said she is following the news every day as she is worried about exposing her three-year-old daughter to MERS.

"When I saw the news this morning that two people have died, my heart sank," she told The Straits Times, adding that she will give herself another week to make a decision.

[Update] The Ministry of Foreign Affairs in Singapore (MFA) has released a travel notice in light of the recent MERS...
Posted by Korea Tourism Organization (Singapore) on Wednesday, June 3, 2015

South Korea MERS outbreak: Some holidaymakers worried but not cancelling plans
By Cheryl Faith Wee, The Straits Times, 3 Jun 2015

Reports of the deadly Middle East respiratory syndrome (MERS) in South Korea have some holidaymakers worried. But, for now, most will go ahead with their June vacation plans.

Travel agencies here said some customers have asked how safe it is to visit South Korea. But there have been no cancellations at agencies such as Chan Brothers Travel and CTC Travel.

Said Chan Brothers' marketing communications executive Rebecca Chia: "We remind our travellers to maintain vigilance and adopt health precautions such as avoiding close contact with people who are coughing. We are closely monitoring the situation."

South Korea recorded its first case of the MERS virus last month. Since then, the number of infected South Koreans has jumped to more than 20, with two fatalities as of yesterday. The virus has infected more than 1,100 people and killed more than 400 worldwide.

But despite concerns, demand for travel to South Korea has not dampened. This month, Chan Brothers has several groups, of 20 to 40 people each, departing for the country daily.

Hong Thai Travel has about 500 people going there this month, while CTC Travel has about 600.

S. Korean dies of MERS-like symptoms
Park slams Seoul govt's response to MERS cases
She urges all-out action as S. Korean woman suspected to have MERS dies
By Chang May Choon, South Korea Correspondent In Seoul, The Straits Times, 2 Jun 2015

A 58-YEAR-OLD South Korean woman suspected of contracting Middle East respiratory syndrome (MERS) has died, as President Park Geun Hye criticised the government's poor initial response and urged officials to go all out to contain the spread of the virus.

The woman, who had physical contact with the first confirmed patient, was admitted to a hospital in Gyeonggi province and died of symptoms similar to MERS yesterday afternoon, according to health officials.

An investigation is being planned to determine her exact cause of death.

As of yesterday, there were 18 confirmed MERS cases in South Korea - the highest outside the Middle East - and one in China.

The Chinese authorities are still trying to locate 10 people who had contact with a 44-year- old South Korean man who brought MERS into the country, the official Xinhua news agency reported. He is being treated at a hospital in the southern city of Huizhou and the health authorities said he is in a stable condition.

There are now 67 people quarantined in China - including three who were tracked down yesterday - and 18 in Hong Kong.

Those in China had travelled on the same bus as the South Korean man, while those in Hong Kong were seated near him on a flight from Seoul.

South Korea's Health Ministry came under fire yesterday for its slow response to the first case reported on May 20 and for failing to contain the outbreak.

More than 680 people who had close contact with MERS patients, including medical staff, have been isolated and are being kept under observation.

In a regular meeting with her aides, Ms Park said that the government's initial response was "insufficient" and stressed the need to step up efforts to prevent infectious diseases from spreading, especially across borders.

She asked for a joint task force to be set up, so as to "find the reason for the high rate of transmission".

The government has since imposed a temporary ban on people who have been exposed to MERS leaving the country.

Health and Welfare Minister Moon Hyung Pyo has apologised for the MERS outbreak.

He also said this week would be a "critical turning point" for MERS - seeing whether it will continue to spread or subside.

All the cases detected so far are linked to Patient Zero - a 68-year-old man who tested positive for MERS on May 20, after a trip to Bahrain.

Of the three latest cases reported yesterday, two were patients in the same hospital as Patient Zero.

The third person came into contact with Patient Zero while caring for his hospitalised parent.

First identified in Saudi Arabia in 2012, MERS is a respiratory disease that spreads through close contact and causes flu-like symptoms. In severe cases, it can cause respiratory failure.

There is no treatment or vaccine for the disease. MERS has infected more than 1,100 people and killed more than 400, mostly in the Middle East.

MERS fears spread to China as result of carelessness
The Straits Times, 1 Jun 2015

SEOUL - Fears of the deadly Middle East respiratory syndrome (MERS) have spread from South Korea to China on a combination of carelessness among individuals and medical staff, as well as the bungling of initial response by the South Korean government.

As of yesterday, the number of South Koreans infected with the deadly viral disease jumped to 15 after it recorded its first case of the virus in a 68-year-old man on May 20, according to the Ministry of Health and Welfare.

The first patient has infected 14 people, including a 44-year-old man who went to China against the advice of doctors, as the first patient had "belatedly" notified doctors of his travel to Saudi Arabia.

Health officials have come under fire for allowing the man to travel to China.

South Korea's health minister apologised yesterday for failing to halt the outbreak, vowing "utmost efforts" to curb the disease's spread.

Minister Moon Hyung Pyo said: "We apologise for causing concern and anxiety among people due to... our initial judgment on the contagiousness of MERS."

Urging the public not to panic, he added that this week would be a "critical period" to contain the spread of MERS, which has symptoms such as flu-like aches.

The man who went to China had flown to Hong Kong before travelling by bus to the Chinese city of Huizhou, where he is being treated under quarantine. The Hong Kong authorities said last Saturday 18 plane passengers who sat close to the man have been sent to a quarantine camp.

The passengers were seated within two rows of the man, but had yet to show any symptoms, the Associated Press reported. Another 17 passengers are being monitored.

The man's colleagues have been or are also expected to be examined or quarantined.

Mr Moon said the hospital where the first outbreak was reported has been closed and all patients were being treated in quarantine.

The 14 others who acquired the virus from Patient Zero were other patients in the same hospital as the man, relatives of the patients or hospital staff with whom he came into contact.

MERS has infected more than 1,100 people and killed more than 400 worldwide, with most cases in the Middle East. There is no known cure or vaccine for it.



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