HONG KONG — Infectious disease specialists from around the world
began probing South Korea's outbreak of Middle East respiratory syndrome
coronavirus amid criticism that officials took too long to implement
infection-control measures.
Nearly a month after MERS-Cov arrived
in a traveler returning from Qatar, Acting Prime Minister Choi Kyung
Hwan said Tuesday the government will begin an aggressive response to
end the outbreak this week. One patient under quarantine orders from
South Korea flew to Hong Kong and traveled to Huizhou and Shenzhen while
sick, risking spreading the infection in southern China.
"They
missed opportunities to contain the virus at the very beginning," said
Leo Poon, an associate professor at the University of Hong Kong's School
of Public Health. The first infected "patient was not diagnosed with
MERS for a long time, which means he had opportunities to shed MERS for
quite a while and could have infected more people in that period."
An
eight-person team convened by the World Health Organization began
studying on Tuesday how 95 people were infected with the virus -- seven
of them fatally -- and will offer recommendations to contain the
epidemic, said Alison Clements-Hunt, a WHO spokeswoman in Manila.
"This mission should bring us a step closer to having a better understanding of the nature of the virus," she said.
Mission participants, invited by South Korea's health
ministry, include Keiji Fukuda, WHO's assistant director-general for
health security; Abdullah Assiri, a health official from Saudi Arabia;
Martin Cetron, director of global migration and quarantine at the U.S.
Centers for Disease Control and Prevention; and Malik Peiris, director
of the University of Hong Kong's School of Public Health.
The
health ministry added 8 new MERS-CoV cases Tuesday, after reporting 23
on Monday and 22 on Sunday. That suggests government infection-control
efforts are working, Clements-Hunt said. With more than 2,500 people
being monitored for symptoms, more infections are likely. It may take as
long as 14 days for symptoms to appear after exposure to the virus, she
said.
"Infection control has dramatically improved," said Michael
Osterholm, director of the University of Minnesota's Center for
Infectious Disease Research and Policy in Minneapolis, who has had
discussions with South Korean investigators though isn't part of the
mission.
Health officials need to continue tracking down and checking everyone in contact with an infected person, he said.
While
the South Korean response to MERS-CoV is "very encouraging," the
initial response was mishandled, said Benjamin Neuman, a virologist at
the University of Reading's School of Biological Sciences.
"It
took 11 days from the announcement of the first case until the major
effort to find and isolate contacts of infected people got under way,"
Neuman said. "Eleven days is a long time for a virus like MERS -- enough
time to infect a second wave of cases and begin a third, as we have
seen."
WHO was notified on May 20 by South Korea of its first
MERS-CoV case -- which occurred in a 68-year-old man who'd traveled to
Bahrain, United Arab Emirates, Saudi Arabia and Qatar from April 18 to
May 4, according to a May 24 statement. The man fell ill on May 11,
sought medical care the following day, was hospitalized on May 15 and
discharged two days later.
That evening, he sought treatment in
the emergency room of another hospital and was tested positive for
MERS-CoV three days later, when he was transferred to another facility
for isolation. The following day, someone in contact with the man at
home and a patient who shared his hospital room were confirmed to have
the virus also, setting off the outbreak in South Korea.
All of
the cases in South Korea have been linked to exposure to MERS-CoV in a
hospital or clinic, suggesting the virus is spreading among patients and
health-care workers rather than more broadly in the community.
Patients
were treated in more than 20 South Korean hospitals, which weren't
immediately identified by authorities so as to alert doctors to patients
potentially exposed to the virus, Poon said.
"If that information
had been shared, people there would have been on higher alert and
health-care workers could have paid particular attention to potential
cases," he said.
Previous MERS-Cov outbreaks were all subdued by
implementing WHO guidelines around infection control and finding and
monitoring everyone in contact with infected people, WHO's Clements-Hunt
said.
The mission will assess South Korea's infection control
measures and determine whether guidelines need to be amended, she said,
adding that the first case in South Korea wasn't picked up straight away
and that doctors, epidemiologists and lab technicians there hadn't seen
the virus before.
After some initial problems, the government is
now complying with WHO guidelines and will make changes to its public
health response procedures, said Song Dae Sub, a professor of pharmacy
at Korea University in Seoul, who is assisting the investigation.
Regulations
for managing infectious diseases in hospitals will be "amended
extensively," he said, adding that, unlike China, which has battled
highly pathogenic bird flu and SARS, South Korea hasn't had as much
experience with emerging pathogens.
"It seems to have taken the
country by surprise," said Raina MacIntyre, head of the school of public
health and community medicine at the University of New South Wales in
Sydney. "This highlights the need for countries to have good
preparedness plans in place and not just ones that sit in a ministerial
office -- it needs to be communicated right down to the people working
on the front line."
_ With assistance from Sam Kim and Heesu Lee in Seoul.
No comments:
Post a Comment