Thailand confirms patient from Oman as first MERS case

* Ministry of Health (MOH) advisory on MERS-CoV

MERS in Thailand

The Straits Times, 19 Jun 2015

BANGKOK/SEOUL - Thailand confirmed its first case of Middle East respiratory syndrome (MERS) yesterday, becoming the fourth Asian country to register the deadly virus this year.



Public Health Minister Rajata Rajatanavin told a news conference that a 75-year-old businessman from Oman, who had travelled to Bangkok for medical treatment for a heart condition, had tested positive for MERS.

"From two lab tests, we can confirm that the MERS virus was found," Mr Rajata said. "The first day he came, he was checked for the virus. The patient... contracted the MERS virus."

The health minister said 59 others were being monitored for the virus, including three of the man's relatives who travelled with him to Bangkok.

MERS is caused by a coronavirus from the same family as the one that triggered China's deadly 2003 outbreak of severe acute respiratory syndrome (Sars).

The vast majority of MERS infections and deaths have been in Saudi Arabia, where more than 1,000 people have been infected since 2012, and about 454 have died.

Last month, a MERS outbreak erupted in South Korea, resulting in 23 deaths so far. A total of 165 people have been infected and 6,700 people are in quarantine.

The daily number of new cases has dropped to single digits this week compared to as many as 23 last week. Three were reported yesterday - the lowest number since June 1.

All of the infections known to have occurred in South Korea have taken place in healthcare facilities. Three hospitals have been at least partially shut and two have been locked down with patients and medical staff inside.

China and the Philippines have also reported one MERS case each this year. The Philippines reported its first MERS case when a pregnant nurse travelled home from Saudi Arabia in February.

China also registered a case when a South Korean man, the son of a patient in Seoul, was confirmed to have been infected after travelling to Huizhou, in Guangdong province, last month.

Experts in South Korea have criticised President Park Geun Hye's government for its response to the outbreak.

"There are doubts whether the quarantine and monitoring are being carried out thoroughly for the thousands of people who have been placed in isolation," said the vice-president of the Korean Medical Association, Dr Kang Cheong Hee. "The authorities must take tougher measures to make sure that both confirmed patients and suspected virus carriers do not mingle with other ordinary people."

REUTERS, AGENCE FRANCE-PRESSE

* Be prepared to deal with MERS in Singapore: PM Lee

Singapore not screening visitors from Thailand yet
By Chong Zi Liang, The Straits Times, 20 Jun 2015

TRAVELLERS arriving from Thailand are currently not being screened at Changi Airport for symptoms of the Middle East respiratory syndrome (MERS) because the country has only one such case and the situation there is contained, Health Minister Gan Kim Yong said yesterday.

But Singapore will continue to monitor developments closely and if necessary, other measures would be introduced, Mr Gan told reporters after attending the annual general meeting of the Chinese Development Assistance Council, which he chairs.

Passengers arriving from MERS-affected countries such as South Korea and those in the Middle East are, however, being screened, he added.

Thailand confirmed its first case of MERS on Thursday - a 75-year-old businessman from Oman.

In South Korea, the outbreak that began last month has infected 166 people and killed 24, as of yesterday. It appears to be levelling off.

Mr Gan forewarned that with today's global travel patterns and transport connections, it is a question of when, and not if, MERS will hit Singapore.

But he assured Singaporeans that hospitals here are prepared and have been practising procedures and protocols to handle MERS patients. "Our hospitals have been reminded repeatedly to make sure they are ready."

Reminders and updates have also been sent to general practitioners as they are usually the first point of contact for patients, he added.

It is important that Singaporeans keep abreast of the latest MERS developments in the region and other parts of the world "so that we are always alert as, sooner or later, MERS will arrive", Mr Gan said.

#Factually takes a closer look at the MERS-CoV outbreak around the world and how Singapore is dealing with it.
Posted by Gov.sg on Friday, June 19, 2015

We have received a number of questions about the ongoing #MERS outbreak in the Republic of #Korea:What are the MERS...
Posted by World Health Organization (WHO) on Wednesday, June 17, 2015

More than 80 exposed to MERS virus in Thailand
Not clear if all who came into contact with first patient have been traced
By Tan Hui Yee, Thailand Correspondent In Bangkok, The Straits Times, 20 Jun 2015

MORE than 80 people in Thailand have been exposed to the Middle East respiratory syndrome (MERS) virus, the health authorities revealed, as the kingdom rushed to stem any panic from its first such case.

The deadly disease, which was first identified in Saudi Arabia three years ago, has killed 24 and infected 166 people in South Korea since it was detected there last month, although the authorities there said the outbreak appeared to be levelling off.

Singapore's Health Minister Gan Kim Yong said yesterday that travellers from Thailand were not being screened at Changi Airport for MERS symptoms as the country had only one such case and the situation was contained. He added, however, that developments were being monitored closely.

Thailand's Ministry of Public Health revealed that the MERS virus was detected in a 75-year-old man from Oman on Thursday. Yesterday evening, it said in a press statement that 85 people had come into contact with him.

It was not clear though whether all 85, including a taxi driver, airline passengers and medical staff, have been traced and quarantined.

The man landed in Bangkok on Monday and sought treatment that night at Bangkok's Bumrungrad International Hospital for a cough, later running a fever. The private hospital kept him and his relatives in isolation quarters before they were moved to the state-run Bamrasnaradura Infectious Diseases Institute just outside Bangkok on Thursday.

The hospital called a press conference yesterday, saying it had quarantined 58 staff members.

Meanwhile, the MERS patient is "a little bit better", Dr Sopon Mekthon, director of the Health Ministry's disease control department, told The Straits Times. "He is out of the respirator."

Tests on the patient's two sons turned out negative yesterday.

Passengers at Bangkok's Suvarnabhumi Airport had to go through thermoscan machines yesterday and health warning cards were issued on flights connected to high-risk areas for MERS.

The airport is a major aviation hub for the region, while the city is one of the world's top tourism destinations.

Singaporeans, meanwhile, are not rushing to call off trips to Bangkok. Instead, they are monitoring the situation and are hopeful that it will not be a repeat of the South Korean case, travellers, travel agencies and airlines told The Straits Times. Hundreds of Singaporeans have cancelled their trips to South Korea.

Dynasty Travel has a number of clients going to the popular shopping destination over the National Day weekend. "We're keeping our fingers crossed," said its director of marketing communications Alicia Seah.

CTC Travel yesterday received some calls from concerned customers travelling to Chiang Mai in northern Thailand. "They are still monitoring the situation as the departures are mainly in August and September," said a spokesman.

Graphic designer Jason Fu, 26, does not plan to cancel his two upcoming holidays to Bangkok next month and in September for now. "I'll wait and see. The public should not be paranoid," he said.

Additional reporting by Melissa Lin

'Patient Zero' moved from exclusive hospital
Man from Oman and relatives shifted to state-run infectious diseases centre
By Tan Hui Yee, Thailand Correspondent In Bangkok, The Straits Times, 20 Jun 2015

THE first person to test positive for the deadly Middle East respiratory syndrome (MERS) in Thailand initially refused to be put in isolation, said the hospital which treated him.

The 75-year-old man from Oman turned up at Bangkok's exclusive Bumrungrad International Hospital on Monday night without a prior appointment, accompanied by two relatives. He was tired and coughing, but not feverish, said the hospital.

Hospital staff ushered him into an isolation room within its emergency ward, said infectious diseases specialist Mondej Sookpranee.

His temperature started rising to about 38 deg C, and a chest X-ray heightened doctors' suspicions that he was suffering from MERS.

"They refused to be in the isolation room, but we insisted," Dr Mondej told The Straits Times. "We knew the effect of letting them go."

At least two separate tests were conducted on the man's phlegm sample at different laboratories before Thai health authorities publicly confirmed the country's first MERS case.

Some 55 hours after the patient and his relatives were first confined in Bumrungrad's isolation quarters, they were moved to the state-run Bamrasnaradura Infectious Diseases Institute in Nonthaburi, a province just outside the capital.

Bumrungrad is one of the most well-known private hospitals in Asean's second-largest economy, both of which draw medical tourists from all over the world.

The hospital serves 1.1 million patients every year, including over 520,000 foreign patients. Some 20 per cent of its patients come from the Middle East.

Last year, the publicly-listed hospital earned the most revenue from patients from Myanmar, the United Arab Emirates and Oman.

Thai health authorities initially refused to name Bumrungrad on Thursday when they announced the nation's first MERS case.

But the word got out anyway, prompting the hospital to hold a press conference yesterday to quash speculation of a cover-up.

As of yesterday, 58 staff from Bumrungrad who had been in contact with the patient were kept in quarantine. They will be there for 14 days.

"We designated an area in the hospital to keep them. We don't let them go home," said Dr Mondej. Some of its staff have been told to wear masks, but not "hospital wide" because the "the contamination has been limited", he said.

Bumrungrad's shares dropped 6.05 per cent in value on the Thai stock exchange yesterday.

Asked if the hospital was wary the MERS case would taint its name, Dr Mondej replied: "The reputation would be tainted only if we ignored the situation... But we did not. We even did more than we should do."

He was referring to the isolation of the patient and his relatives.

Thai PM calls for calm over MERS case
Disease control measures in place, says government
The Straits Times, 19 Jun 2015

BANGKOK - Prime Minister Prayut Chan-o-cha has asked Thais not to panic after the health authorities confirmed the first case of Middle East respiratory syndrome (MERS) in the kingdom in a 75-year- old businessman from Oman who travelled to Bangkok as a medical tourist.

"(The man) is from a Middle Eastern country. The (test) results confirmed that he has Middle East respiratory syndrome," said Thai Public Health Minister Rajata Rajatanavin, adding that the patient had arrived in the kingdom with his family three days ago.

A Thai government spokesman later told reporters the man was from Oman and had travelled to a central Bangkok hospital for treatment for a heart problem.

After being tested for MERS, he was moved to the Bamrasnaradura Infectious Diseases Institute in Nonthaburi province on the outskirts of the Thai capital yesterday morning.

Dr Rajata said that besides the man and his three family members, two taxi drivers and dozens of medical staff and personnel the man had come into contact with have also been quarantined.

Passengers seated two rows in front of and behind him have also been contacted by health officials, Dr Rajata added.

The ministry did not disclose what airline the man flew in on.

"We are confident that we can control the outbreak," government spokesman Sunsern Kaewkamnerd said in a statement. He added that "disease control" measures were in place.

He said the Prime Minister had advised people to follow the information given out by the Ministry of Public Health to safeguard themselves against the disease.

Earlier, Thailand's Disease Control Department said it was screening travellers at 67 points of entry into the country. "We are checking 67 ports, including land, sea and air," said Mr Sophon Mekthon, secretary-general of Thailand's Disease Control Department.

"We have told all hospitals in Thailand to be on alert. Those who come back from the Middle East and South Korea must be checked thoroughly," he added.

Earlier yesterday, World Health Organisation (WHO) chief Margaret Chan expressed guarded optimism over South Korea's ability to contain the MERS outbreak in the country. The organisation had earlier described the spread of the disease as a "wake-up call".

"Our current assessment of the MERS situation in South Korea... is the government is now on a very good footing," she told reporters in Seoul, adding that the situation does not constitute an international public health emergency.

"The MERS outbreak will be brought under control... although it may take a little longer than everyone would like to see," said Ms Chan, who is in South Korea for a previously scheduled conference.

She said the government had admitted it got off to a "slow start" but that its efforts strengthened "very quickly and systemically and very significantly", resulting in a decline in new cases.

The good news is that scientists have not detected any genetic change in the virus, she said.

Ms Chan's comments came as South Korea's Health Ministry reported three more deaths and three more cases.

The WHO said on Wednesday that a lack of awareness about the virus among health workers and the public was a major contributing factor to its rapid spread in South Korea.

According to an earlier WHO statement, MERS cases have been reported in four Asian countries before Thailand - South Korea, China, the Philippines and Malaysia - since the virus first surfaced in Saudi Arabia in 2012.

More than 6,700 people were being held in quarantine in South Korea yesterday, in a bid to halt the spread of the virus. Around 4,500 others have already been released from isolation.

AGENCE FRANCE-PRESSE, REUTERS

* Thailand taking no chances in preventing spread of MERS
It outlines measures for medical tourists visiting country and pilgrims heading to Saudi Arabia
The Straits Times, 24 Jun 2015

BANGKOK - Thailand is taking no risks with the recent outbreak of Middle East respiratory syndrome (MERS), and has outlined several measures to prevent the spread of the disease.

For instance, medical tourists from countries affected by MERS who are travelling to Thailand will be required to undergo tests for the virus one week before they enter the country, said the Thai Health Ministry on Monday.

"The screening measure is part of efforts to control the spread of MERS," said Dr Supamit Chunsuttiwat from the Disease Control Department. Thailand receives more than a million medical tourists each year.

Thai officials also made it clear that hospitals cannot deny treatment to walk-in patients, even if they are suspected of being infected with MERS.

In the past week, at least two private hospitals were found to have sent suspected patients by taxi to Bamrasnaradura Infectious Diseases Institute, simply because they came from MERS-hit countries, said Health Service Support Department director-general Boonruang Triruangworawat. "We have issued warnings to the staff of these two hospitals because such actions are against the law," he said.

Thais travelling to Saudi Arabia for the Haj and Umrah pilgrimages have also been asked to take special precautions. The Tourism and Sports Ministry told six major tour operators to instruct clients on how best to take precautions against the disease.

More than 16,000 Thai Muslim pilgrims are expected to travel next month to Saudi Arabia, where MERS first broke out.

The pilgrims will be put under observation for 14 days when they return to Thailand.

The Thai authorities believe the MERS situation in the country is under control. There has been just one confirmed case of the virus and the patient, a 75-year-old medical tourist from Oman, is recovering.

Meanwhile, the heir to the South Korean business giant Samsung, Mr Jay Y. Lee, publicly bowed his head in apology for one of its flagship hospitals becoming an epicentre for MERS.

His apology came as officials reported three new cases but no additional deaths.

Samsung Medical Centre in Seoul has accounted for about half of all 175 confirmed cases of MERS in South Korea.

"Samsung Medical Centre has failed to control the infection and spread of the virus, causing great pain and concern to the people," said Mr Lee, who is vice-chairman of Samsung Electronics. He promised a thorough overhaul of the hospital.

The medical centre's position as one of the country's most prestigious hospitals has been undermined by the outbreak.

South Korea's health ministry, said two out of three new carriers came into contact with the virus at two different hospitals in Seoul, one of which was Samsung Medical Centre.

Of the 175 confirmed cases, 27 patients have died, 54 have recovered and have been discharged from hospital, while 94 patients are still being treated.

AGENCE FRANCE-PRESSE, THE NATION/ASIA NEWS NETWORK

* Thailand's first MERS patient 'free of virus'
The Straits Times, 30 Jun 2015

BANGKOK - There was some good news on the MERS front for Thailand and South Korea yesterday.

An Omani man who became Thailand's first case of the Middle East respiratory syndrome (MERS) has been declared free of the deadly virus, the Thai Health Ministry said yesterday.

The 75-year-old man, who had travelled to Bangkok for treatment of a heart condition and was then diagnosed with the virus, will remain in quarantine for the time being.

"In the last test results, we did not find the MERS virus in the patient," said Mr Surachet Satitramai, acting permanent secretary at the Public Health Ministry.

"His condition is much better but we still need to see if his other health conditions, including his heart condition, will have any effect on his recovery."

Mr Surachet said three of the man's relatives who travelled with him to Thailand were also free of the virus. The ministry is still monitoring 36 people who were exposed to the lone patient.

Thailand confirmed its first MERS case earlier this month, becoming the fourth Asian country to register the virus this year. Its status as a hub for medical tourism could be helping it contain the spread of MERS, government and health officials said last week.

In South Korea, officials yesterday reported no new MERS cases or deaths for the first time in nine days, but warned there was no indication yet that the outbreak had been brought under control.

The number of those infected with MERS remained unchanged for two days in a row at 182, the South Korean Health Ministry said. The death toll also remained unchanged from 32 on Sunday.

It is the first time that the country has reported no additional infections as well as no new deaths since June 20. The outbreak began on May 20 when a 68-year-old man was diagnosed after returning from a trip to Saudi Arabia.

The number of new patients has generally been in decline since the middle of this month, when it often jumped by double digits - with many of the new infections stemming from the Samsung Medical Centre in Seoul, the epicentre of the outbreak.

But officials remained cautious yesterday as they monitored developments at another hospital in eastern Seoul, where a MERS patient potentially came into contact with thousands of people before being diagnosed on June 22 and dying two days later.

"This week falls within the incubation period involving that case, so we are keeping a close eye on the situation and will do our best to prevent further spread of the virus," said senior Health Ministry official Kwon Duk Cheol.

REUTERS, AGENCE FRANCE-PRESSE