A deadly disease that has been lying quietly is suddenly on the move again in Asia, sending health authorities scrambling to contain an outbreak that has seen at least 25 people infected with two deaths so far.
Authorities in South Korea are trying to contain an outbreak of the lethal Middle Eastern respiratory syndrome (MERS). Those infected include one patient who travelled to China.
The Korean MERS outbreak is the biggest ever outside the Arabian Peninsula and scientists are baffled at to how a single imported case could have led to such an alarming number of secondary infections.
Australia’s Department of Foreign Affairs and Trade (DFAT) has issued an alert over the outbreak, which began when a 68-year-old man returned to Korea from a business trip to four Middle Eastern countries and fell ill a week later. He was treated at several clinics and then diagnosed with MERS on 20 May.
MERS is a mystery and no vaccine exists. Dromedary camels and Egyptian tomb bats have been implicated in its spread.
The DFAT alert uses the disease’s full name and acronym: Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The deadly malady was first reported by the World Health Organization (WHO) in September 2012. Cases of MERS-CoV have been reported in several countries, including Saudi Arabia, Jordan, Qatar, Kuwait, Oman, the United Arab Emirates, Yemen, Lebanon and now the Republic of Korea (South Korea).
The DFAT advisory continues: “Other countries have also reported imported cases from returned travellers. All cases have either lived in or travelled to affected countries, or had close contact with travellers returning from these areas. Singapore and Hong Kong have screening arrangements in place at international airports for travellers arriving from MERS-CoV affected countries. There have been no cases in Australia to date.”
The following is from DFAT:
What are the symptoms and who is at risk?
MERS-CoV can cause a rapid onset of severe respiratory illness with a fatality rate of around 30%. There is no vaccine for MERS-CoV. Symptoms include fever, cough, shortness of breath and breathing difficulties. Some patients have reported a variety of other symptoms, including muscle pain, diarrhoea, vomiting and nausea.
Some patients have mild symptoms or are asymptomatic. Severe cases have most frequently occurred in people with underlying conditions that may have made them more susceptible to infection (including diabetes, kidney disease, hypertension, asthma and lung diseases, cancer, cardiovascular disease).
Reducing the risk of exposure
Dromedary camels are suspected to be the source of infection for sporadic cases, but the exact routes of direct or indirect exposure remain unknown. Person-to-person transmission has been documented, particularly in healthcare settings.
The WHO advises that people at potentially higher risk of severe disease due to MERS-CoV should take appropriate precautions when visiting farms, barn areas or market environments where camels are present in MERS-affected countries.
Appropriate precautions might include avoiding contact with camels, good hand hygiene, and avoiding drinking raw milk or eating food that may be contaminated with animal secretions or products unless they are properly washed, peeled or cooked.
All travellers should adhere to general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices when visiting a farm or barn in MER-CoV affected countries.
Seek immediate medical attention if you feel unwell with symptoms similar to MERS-CoV infection while travelling or on your return to Australia. Be sure to tell your healthcare provider that you have travelled to a region where MERS-CoV is known to occur. Avoid close contact with people who are ill with these symptoms.
Many confirmed cases have occurred in healthcare workers. The particular conditions or procedures that lead to transmission in hospital are not well known. However, lapses in infection control are known to be important in increasing the risk of infection in healthcare workers. Therefore, the WHO emphasises the importance of infection control strategies and practices in healthcare in affected countries, not only when caring for suspected MERS-CoV patients but also when caring for patients in all circumstances.
See the Australian Department of Health website for information about infection control measures for healthcare workers.
Edited by Peter Needham