The World Health Organization (WHO) and the Republic of Korea to carry out Joint Mission for the MERS-CoV Outbreak

[Pathfinder]

The World Health Organization (WHO) and the Republic of Korea to carry out Joint Mission for the MERS-CoV Outbreak

News release



MANILA, 5 JUNE 2015 - In light of the recent outbreak of Middle East Respiratory Syndrome coronavirus (MERS-CoV), the World Health Organization and the Republic of Korea’s Ministry of Health and Welfare will conduct a joint mission to the Republic of Korea. The mission comes after close consultation between WHO and the Government.

The WHO team will be led by Assistant Director-General for Health Security Dr Keiji Fukuda. The team will be comprised of experts in epidemiology, virology, clinical management, infection prevention and control, as well as public health officers who have previously handled other MERS-CoV outbreaks in the Middle East.

The pressing objective of this joint mission is to gain information and review the situation in the Republic of Korea including the epidemiological pattern, the characteristic of the virus and clinical features. The team will also assess the public health response efforts and provide recommendations for response measures going forward.

Since the outbreak, WHO has been working closely with the Ministry of Health and Welfare and the Korea Centres for Disease Control and Prevention on response measures. WHO appreciates the Government's cooperation in sharing up-to-date information and facilitating the joint mission.

Based on current data and WHO’s risk assessment, there is no evidence to suggest sustained human-to-human transmission in communities and no evidence of airborne transmission. However, MERS-CoV is a relatively new disease and information gaps are considerable. The joint mission will bring us a step closer to gaining a better understanding of the nature of this virus.

WHO remains vigilant and is monitoring the situation. Given the lack of evidence of sustained human-to-human transmission in the community, WHO does not advise special procedures at points of entry, or travel or trade restrictions with regard to this event.

For further information, please contact:

Mr David Koch
Public Information Officer
WHO Regional Office for the Western Pacific
Telephone: +632 528 9991
Email: PIO@wpro.who.int

Ms Helena Humphrey
Risk Communications Officer
WHO Regional Office for the Western Pacific
Telephone: +632 528 9986
Email: humphreyh@wpro.who.int

http://www.wpro.who.int/mediacentre/...5/20150605/en/

[Pathfinder]

Posted : 2015-06-08 16:15
Updated : 2015-06-08 19:33

WHO team joins fight against MERS

By Kim Rahn

An international team of epidemiologists arrived here, Monday, to help fight the Middle East Respiratory Syndrome (MERS) epidemic.
...
The foreign delegation is comprised of experts in epidemiology, virology, clinical management, infection prevention and control from WHO headquarters, its Western Pacific Regional Office (WPRO), and experts from China and Hong Kong.

They are: Li Ailan, director of WPRO's division of health security and emergencies; Kidong Park, team leader of the WPRO's country support unit; Abdullah Assiri, infection prevention and control director of the Saudi Arabian Ministry of Health; David Hui, professor at the Chinese University of Hong Kong; Maria Van Kerkove, technical consultant for the global capacities, alert and response cluster of the WHO; Malik Peilis, director of the WHO H5 Reference Laboratory at the University of Hong Kong; and Martin Cetron, director of global migration and quarantine division at the U.S. Centers for Disease Control and Prevention.

Besides Lee, the Korean members are five professors and two officials from the Korea Centers for Disease Control and Prevention (KCDC).

The team will visit the KCDC headquarters in Osong, North Chungcheong Province, and Pyeongtaek St. Mary's Hospital in Pyeongtaek, Gyeonggi Province, where Korea's first MERS patient stayed and spread the virus.

At the hospital and other quarantine facilities, the members will gain information about how the virus spread.
...

http://www.koreatimes.co.kr/www/news/nation/2015/06/116_180430.html

[Pathfinder]

Joint mission to Republic of Korea on MERS-CoV begins well

News release

MANILA, 10 JUNE 2015 - A joint mission by the World Health Organization and the Republic of Korea's Ministry of Health and Welfare to review the situation regarding the outbreak of Middle East respiratory syndrome coronavirus (MERS CoV) in the Republic of Korea, has begun its work with an open and candid exchange of information and experience. Initial recommendations provided by the joint mission have been welcomed by the government.

The mission, which began yesterday in Seoul, is assessing the epidemiological pattern of MERS CoV in the Republic of Korea as well as the characteristics of the virus and clinical features. It is also reviewing the public health measures implemented to date.

Dr Keiji Fukuda, WHO Assistant Director-General for Health Security, who is co-leading the mission together with Dr Jong-Koo Lee, Director, Center for Global Medicine, Seoul National University, said that interactions in early discussions had been excellent. “The exchange of information and experience has included the provision of detailed information about the outbreak and the control measures that have been put into place, as well as discussion of existing challenges,” he said.

Dr Fukuda said that current efforts to control the outbreak and prevent further spread are being intensified. WHO has been working closely with the Ministry of Health and Welfare and the Korea Centres for Disease Control and Prevention on response measures since the outbreak began.

There have been 108 confirmed cases of MERS CoV (including 1 confirmed case in China) reported in the Republic of Korea so far, with 9 deaths. Whenever an emerging pathogen like the MERS virus appears in a new setting, for example, in a new country, a timely and thorough investigation is critical, particularly to assess whether the virus and its transmission are changing, and to ensure implementation of the most appropriate control strategies.

The evidence presented thus far suggests that the pattern of the outbreak in the Republic of Korea may be similar to MERS outbreaks that have taken place in health care facilities in the Middle East. However, the situation is rapidly evolving and investigations are ongoing.

The initial recommendations made today by the joint mission are:

• Infection prevention and control measures should immediately be strengthened in all facilities across the country.
• All patients presenting with fever or respiratory symptoms should be asked about: contact with a MERS patient; visits to a health care facility where a MERS patient has been treated; and history of travel to the Middle East in the 14 days before symptom onset. Any patient with positive responses should be promptly reported to public health authorities and managed as a suspected case while the diagnosis is being confirmed.
• Close contacts of MERS cases should not travel during the period when they are being monitored for the development of symptoms.
• Strong consideration should be given to re-opening schools, as schools have not been linked to transmission of MERS-CoV in the Republic of Korea or elsewhere.

The joint mission will end its in-country visit on Saturday 13 June 2015.

For further information, please contact

Dr Margaret Harris
Communications Officer
Mobile: +41 796 036 224
E-mail: harrism@who.int

Ms Alison Clements-Hunt
Communications Officer
Tel (direct): +632 528 9985
Mobile: +63 920 9135092
E-mail: PIO@wpro.who.int

http://www.wpro.who.int/mediacentre/.../201506010/en/

[Commonground]

• Revised high-level messages-R.docx

<Korea-WHO Joint Mission on MERS CoV>
High-level messages
Assessment

* High-level messages, Korea-WHO Joint Mission on MERS CoV

• This outbreak in the Republic of Korea, which started with the introduction of MERS-CoV infection into the country by a single infected traveller, was amplified by infection in hospitals and movement of cases within and among hospitals.

• A combination of older and new cases continues to be reported, but the epidemic curve shows that the number of new cases occurring each day appears to be declining. This decline has coincided with much stronger contact tracing, monitoring and quarantine, suggesting that disease control measures are working. These measures are greatly facilitated by expanded laboratory testing. However, several weeks will be required to confirm the impact of the measures and whether the outbreak is fully controlled.

• Several factors appear to have contributed to the initial spread of this virus.
  • The appearance of MERS-CoV was unexpected and unfamiliar to most physicians
  • Infection prevention and control measures in hospitals were not optimal
  • Extremely crowded Emergency Rooms and multi-bed rooms contributed significantly to nosocomial infection in some hospitals.
  • The practice of seeking care at a number of medical facilities(?doctor shopping?) may have been a contributing factor
  • The custom of having many friends and family members accompanying or visiting patients may have contributed to secondary spread of infection among contacts.

• The rapid increase in numbers of cases has led to much speculation as to whether there may be new contributing factors to transmission. It is too early to draw definitive conclusions at this time, but certain observations can be made:
  • There is no strong evidence at present to suggest that the virus has changed to make the virus more transmissible.
  • Thus far, the epidemiological pattern of this outbreak appears similar to hospital-associated MERS-CoV outbreaks that have occurred in the Middle East. However, this Mission has not been able to determine whether environmental contamination, inadequate ventilation, or other factors have had a role in transmission of the virus in this outbreak. There is a compelling need for further investigation.

• While there is no evidence at present of ongoing community transmission of MERS-CoV in the Republic of Korea, continued monitoring for this possibility is critical. Because the outbreak has been large and complex and more cases can be anticipated, the Government should remain vigilant and continue intensified disease control, surveillance, and prevention measures until the outbreak is clearly over.

High Level Recommendations for Government

1. Infection prevention and control measures should immediately be strengthened in all health care facilities across the country.

1. All patients presenting with fever or respiratory symptoms should be asked 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 before symptom onset. Any patient with positive responses should be promptly reported to public health authorities and managed as a suspected case while the diagnosis is being confirmed.

1. Close contacts of MERS cases should not travel during the period when they are being monitored for the development of symptoms.

1. Strong consideration should be given to re-opening schools, as schools have not been linked to transmission of MERS-CoV in the Republic of Korea or elsewhere.

1. The most important steps needed to stop further cases involve continued implementation of basic public health measures by all health authorities. These include:
   1. early and complete identification and investigation of all contacts
   2. robust quarantine/isolation and monitoring of all contacts and suspected cases
   3. full implementation of infection prevention and control measures; and
   4. prevention of travel, especially internationally, of infected persons and contacts

1. Local governments must be fully engaged and mobilized in the national fight against this large and complex outbreak.

1. In parallel with disease prevention and control measures, steps should be taken to strengthen domestic and international confidence and trust. The most important actions involve improving risk communications. The Ministry of Health and Welfare should provide regularly updated information (in Korean and English) on the epidemiological situation, investigations, and disease control measures.

1. Additional staff (for ?surge capacity?) are urgently required for the response and to provide relief for staff already working on the outbreak.

1. Selected hospitals should be designated for safe triage and assessment of suspected MERS cases. This will require trained personnel, facility management, and communication with the public.

1. Comprehensive research studies designed to close critical gaps in knowledge, including sero-epidemiological studies, should be completed and the results widely communicated as quickly as possible.

1. The Republic of Korea should ensure that it is able to optimally respond to future outbreaks. In particular, it should strengthen the medical facilities needed to deal with serious infectious diseases, including increased numbers of negative-pressure isolation rooms; consider how to reduce the practice of ?doctor shopping?; train more infection prevention and control specialists, infectious disease experts, laboratory scientists, epidemiologists, and risk communication experts; and invest in strengthening public health capacities and leadership, including at Korea Centers for Disease Control and Prevention (KCDC).

• Revised high-level messages-R.docx