MERS Outbreak 2015—What Researchers Are Saying About the Virus Spreading Throughout The Far East

The Middle East Respiratory Syndrome (MERS) outbreak in the Republic of Korea has claimed its first two fatalities. The World Health Organization (WHO) and the nation's government officials are working to prevent its spread and cope with the outbreak.

Officials announced the closing of 230 South Korean schools on Wednesday the virus continues to spread. Contact tracing had revealed thirty cases in South Korea at the time of this writing. This outbreak is the most serious seen outside the Middle East to date.

Experts have yet to see any sustained human-to-human transmission. In the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002 and 2003, the virus was able to mutate and spread easily and rapidly; the result was the death of about 800 people worldwide.

First seen in humans in 2012, MERS is a relative of SARS; both are caused by similar coronaviruses. However, the MERS death rate of 36 percent is much higher according to WHO figures. There have been at least 470 MERS deaths, most in the Middle East and Saudi Arabia in particular. There is no vaccine or cure for MERS.

"There are a lot people worried about the situation," said South Korean President Park Geun-hye to top officials and ministers at an emergency meeting. "Everything must be done to stop any further spread."

As of Monday officials suspected there were 99 people infected; test results are pending. 1,364 people had been isolated in state-run quarantine centers and homes as they were monitored for symptoms.

Korea's management of MERS has been effective, according to WHO. They confirmed their index case in a 68-year-old Korean national on May 20, and notified WHO that day. The index case patient had recently traveled in the Middle East and was asymptomatic on his return flight on May 4. He became symptomatic on May 11, and as he sought care in five medical centers exposed a number of medical personnel. In fact, most of the confirmed cases are healthcare professionals, patients, and patient visitors.

However, many Koreans have their doubts. "A lot of fear we see now is rooted in the distrust of the government and what it says," says Yu Min-yeong, head of a Seoul crisis management consulting firm.

And there are several indications that the response should have been more vigilant; the index case wouldn't likely have been seen in multiple locations had there been a higher level of screening.

"We apologize for the inappropriate initial responses," Moon Hyung-pyo, the minister of health and welfare, said during a news conference on Tuesday. "We were too relaxed."

WHO says that these infections were spurred by exposure times as short as 5 minutes to a few hours. Unfortunately, since multiple people in several locations cared for the index patient, further cases are expected. The Korean Ministry of Health confirms that the most recent cases represent third generation transmission to people with no direct exposure to the index patient.

One confirmed case traveled against advice-advice based in part on an exposure history in Korea-on May 26. The penalty he faces for traveling against advice is a fine of up to 3 million won, or $2,700. He was symptomatic during his trip and arrived in Guangdong, China after stopping in Hong Kong. By May 29, China had isolated him at a Huizhou hospital, confirmed the presence of MERS, and notified WHO.

WHO recommends consistent application of approved infection prevention and control protocols and the adding of droplet precautions in healthcare settings. WHO does not yet call for travel or trade restrictions, or special screening at points of entry. However, there is a ban on overseas travel set by South Korean border control authorities for everyone isolated for possible infection.

"There is no reason for people to panic, and nothing so far that suggests to me that the virus has changed to become more dangerous," said Dr. Allison McGeer, an expert on infection control at Mount Sinai Hospital in Toronto.

Experts believe that MERS might be transmitted from dromedary camels to humans. Symptoms include shortness of breath, fever, and cough; the illness can be fatal.