WHO SEARO Statement On Thailand's Imported MERS Case

MERS Exported Cases As of October 2015 - Credit ECDC

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While MERS activity has been on the decline the past few months, last summer in Our Global Game Of Whac-A-MERS we looked at the ongoing threat of seeing MERS infected travelers arriving unannounced anywhere in the world.  

As the ECDC map above illustrates, while MERS cases have all originated from the Arabian peninsula, its prolonged (up to 15 day) incubation period allows those exposed ample time to board a plane and unknowingly transport the virus globally (see Why Airport Screening Can’t Stop MERS, Ebola or Avian Flu).

In Korea, a single introduction last May led to 185 additional infections, and 36 deaths, spread across a dozen or more medical facilities.  By contrast, the following month a single infected traveler arrived in Thailand, and was quickly diagnosed and isolated, preventing further spread.

Once again Thailand is dealing with an imported MERS case (see yesterday's Thailand Reports 2nd Imported MERS Case From Oman), and while it is too soon to know if they have contained the threat, they appear to have acted quickly once again.

First a statement from WHO SEARO (South-East-Asia Regional Office), then I'll be back with a bit more on containing the spread of MERS.

Thailand confirms MERS CoV in traveler, WHO cautions against continued risk of importation

SEAR/PR/1618

New Delhi, 24 January 2016: Thailand today confirmed Middle East respiratory syndrome coronavirus (MERS CoV) disease in a traveler, the second such case in the country in the last seven months, as WHO cautioned other member states in its South-East Asia Region against the continuing risks and the need to remain vigilant.

“The new case of MERS CoV is a reminder of the continued risk of importation of the disease from countries where it still persists. All countries need to further enhance surveillance for severe acute respiratory infections, focus on early diagnosis, and step up infection prevention and control procedures in health-care facilities to rapidly detect any case of importation and effectively prevent its spread,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region, said.

A 71-year -old national from Oman, who arrived in Bangkok, Thailand for treatment on 22 January, and was admitted to a private hospital, tested positive for MERS CoV. He has since been transferred to the Bamrasnaradura Infectious Disease Institute. Measures are being taken to trace all those who could have been in his contact during his journey to Thailand, and within Bangkok.

This is the second MERS CoV case in Thailand and in the WHO South-East Asia Region. Earlier, on 18 June 2015 another Omani national who arrived in Bangkok for treatment, was tested positive for MERS CoV.

In the recent past, countries in the WHO South-East Asia Region have been reviewing and strengthening preparedness to respond to MERS CoV.

WHO has been strongly advocating for strengthening health systems and ensuring strict infection control measures are in place in countries to respond to infectious diseases such as MERS CoV.

In the Region, WHO is supporting Ministries of Health to build capacities and strengthen preparedness as required under the International Health Regulations (2005) to effectively detect and respond to outbreaks and other hazards.

MERS CoV is caused by a virus. Typical symptoms include fever, cough and shortness of breath. Pneumonia is common, but not always present. Gastrointestinal symptoms, including diarrhea, have also been reported.

Due to the risks of seeing imported MERS, Ebola, or Avian flu cases, last summer TFAH Issue Brief: Preparing The United States For MERS-CoV & Other Emerging Infections, looked at the steps that governments, healthcare facilities, and public health departments around the world need to take in order to prepare for the arrival of MERS and other Emerging infections.


While most imported MERS cases around the world have been quickly identified and isolated, in Eurosurveillance: Estimating The Odds Of Secondary/Tertiary Cases From An Imported MERS Case, we looked at modeling that put the odds of seeing at least one secondary case derived from an imported MERS case at 22.7%, while the odds of seeing at least one tertiary case is 10.5%.  

Based on their models they calculated the odds of seeing at least 8 cases as the result of a single importation at a non-trivial 10.9%.

 
Reason enough to take calls for better surveillance, diagnosis, and infection control for MERS (and other emerging infectious diseases) seriously.