The Out­break Of Deadly Mers Dis­ease In Korea, No Medicine For Cure

The Global Digest (English) - - Contents - By Staff Cor­re­spon­dent

About MERS virus

MERS-CoV means Mid­dle East Res­pi­ra­tory Syn­drome Coro­n­avirus. Com­mon symp­toms: acute, se­ri­ous res­pi­ra­tory ill­ness with fever, cough, short­ness of breath, and breath­ing dif­fi­cul­ties; pneu­mo­nia; gas­troin­testi­nal symp­toms, in­clud­ing di­ar­rhea.

Mea­sures to pre­vent res­pi­ra­tory ill­ness: avoid close con­tact, when pos­si­ble, with any­one who shows symp­toms of ill­ness (cough­ing and sneez­ing); main­tain good hand hy­giene, other good pre­ven­tive mea­sures in­clude avoid­ing uncooked or un­der­cooked meats, un­washed fruits or veg­eta­bles, and drinks made with­out ster­il­ized wa­ter. If you be­come sick while trav­el­ling, you should avoid close con­tact with other peo­ple while you are symp­to­matic; use good res­pi­ra­tory hy­giene, such as cough­ing or sneez­ing into a sleeve or flexed el­bow, med­i­cal mask, or tis­sue, and throw­ing used tis­sues into a closed bin im­me­di­ately af­ter use.

MERS virus in South Korea

In mid-June 2015, the most crit­i­cal point of the spread of the MERS virus in South Korea. Prof. Ja­cob Lee said the MERS prob­lem was started from the 1st pa­tient’s de­lay in re­port­ing to hospi­tal, and when the same pa­tient moved from Saint Mary hospi­tal to dif­fer­ent hos­pi­tals spread­ing MERS. Con­firmed cases in Korea were the re­sult of trans­mis­sion within clin­ics and hos­pi­tals.

There were 24 hos­pi­tals in to­tal where con­firmed pa­tients had either vis­ited or stayed. Among them, six hos­pi­tals, in­clud­ing St. Mary’s Hospi­tal in Pyeong­taek and the Sam­sung Med­i­cal Cen­ter in Seoul, were iden­ti­fied as hav­ing in-pa­tients with MERS.

Cen­tral MERS Man­age­ment Task Force Min­istry of Health and Wel­fare held brief­ings on July 23, 2015. On July 23, there were 186 con­firmed cases, and among them, 138

pa­tients were dis­charged from the hospi­tal and 36 died. 12 pa­tients were hos­pi­tal­ized for treat­ment. Four of them were in crit­i­cal con­di­tion re­ly­ing on life sup­port, in­clud­ing ven­ti­la­tors and ECMO de­vices (ex­tra cor­po­real mem­brane oxy­gena­tion). Of the 12 pa­tients, 11 were tested neg­a­tive for the MERS virus two times, and eight were trans­ferred from neg­a­tive-pres­sure iso­la­tion rooms to gen­eral wards for con­tin­ued treat­ment.

A to­tal of 138 pa­tients were dis­charged from the hospi­tal. They re­ceived in­jec­tions of an­tibi­otics and an­tivi­ral drugs and other symp­tom-spe­cific treat­ments. Pa­tients were de­clared cured if they had no res­pi­ra­tory symp­toms or fever and tested neg­a­tive for MERS two con­sec­u­tive times. Among the 36 who died, 91.7 per­cent, or 33 of them, were cat­e­go­rized as high-risk, either be­cause of age or pre­ex­ist­ing chronic con­di­tions, in­clud­ing can­cer or di­a­betes as well as heart, lung and kid­ney dis­eases and im­mun­od­e­fi­ciency dis­or­der.

On the July 13th, Ac­cord­ing to Kwon Jun-Wook (Di­rec­tor Gen­eral of Pub­lic Health Pol­icy), There were no new pa­tients or deaths in the pre­ced­ing 2 weeks. No ad­di­tional cases of MERS were re­ported for the 12 days as of July 13, the Min­is­ter of Health and Wel­fare also took charge of the Gov­ern­ment-wide Meet­ing for MERS Re­sponse. A to­tal of 14 health fa­cil­i­ties where con­firmed MERS cases were re­ported were des­ig­nated in­ten­sive man­age­ment hos­pi­tals.

Treat­ment and Preven­tion

Con­firmed pa­tients were treated safely at those hos­pi­tals equipped with neg­a­tive pres­sure iso­la­tion wards so that there was no chance of con­ta­gion to the pub­lic. In the ini­tial stage, the mon­i­tor­ing of those who were quar­an­tined in their homes was some­what in­suf­fi­cient. The Gov­ern­ment swiftly es­tab­lished a sys­tem to match each per­son un­der quar­an­tine with a pub­lic health cen­ter of­fi­cial or a pub­lic ser­vant from lo­cal gov­ern­ments. Track­ing of pa­tients’ lo­ca­tions us­ing their mobile phones was also car­ried out through con­sul­ta­tions with the min­istries con­cerned.

The Min­is­ter said ‘He hoped peo­ple would un­der­stand that all th­ese mea­sures were in­evitable for the pro­tec­tion of fam­i­lies and neigh­bors. In an­nounc­ing tech­ni­cal med­i­cal is­sues, the par­tic­i­pa­tion of civil­ian ex­perts were to be ex­panded. He asked all peo­ple to take ap­pro­pri­ate per­sonal hy­giene pre­cau­tions and to play their part in the coun­try’s ef­forts.’ Such as, early and com­plete iden­ti­fi­ca­tion of all con­tacts; quar­an­tine or iso­la­tion and mon­i­tor­ing of all con­tacts and sus­pected cases; full im­ple­men­ta­tion of in­fec­tion, preven­tion and con­trol mea­sures; preven­tion of travel, es­pe­cially in­ter­na­tion­ally, of in­fected per­sons and con­tacts.

In­fec­tion man­age­ment mea­sures at med­i­cal fa­cil­i­ties were strength­ened, which pre­vented the fur­ther spread of the dis­ease. Ap­prox­i­mately 287 hos­pi­tals were des­ig­nated MERS-free hos­pi­tals, where pa­tients with se­vere res­pi­ra­tory con­di­tions were ad­mit­ted and treated en­tirely un­der quar­an­tine. All med­i­cal fa­cil­i­ties and emer­gency rooms were checked for proper record keep­ing on who had passed through. Hospi­tal rooms, med­i­cal per­son­nel and other resources nec­es­sary for quar­an­tine and treat­ment of con­firmed MERS pa­tients were se­cured. Hos­pi­tals treat­ing con­firmed MERS pa­tients and hos­pi­tals treat­ing sus­pected MERS pa­tients were des­ig­nated by city and prov­ince and quar­an­tine rooms were made avail­able. Spe­cial­ized per­son­nel were dis­patched, along with nec­es­sary med­i­cal equip­ment, to treat con­firmed pa­tients. Eight fa­cil­i­ties were pro­vided with a to­tal of 116 per­son­nel and equip­ment such as portable neg­a­tive pres­sure con­tain­ment sys­tems and Level-D pro­tec­tive gear.

Mea­sures were taken to com­pen­sate those af­fected in the re­sponse to the out­break. Med­i­cal fa­cil­i­ties re­ceived com­pen­sa­tion for di­rect and in­di­rect losses and other as­sis­tance. Those un­der home quar­an­tine were pro­vided with sub­si­dies for liv­ing ex­penses and cost of treat­ment. As­sis­tance was pro­vided for funeral ar­range­ments for the de­ceased. The Vice Min­is­ter of Cul­ture, Sports and Tourism told re­porters, that the gov­ern­ment in­creased

the bud­get for the tourism re­cov­ery pro­gram to about 13 bil­lion Won. To that end, the nec­es­sary bud­get would be promptly dis­bursed us­ing the dis­as­ter man­age­ment fund and re­serve fund.

A re­vised In­fec­tious Dis­ease Con­trol and Preven­tion Act was pro­mul­gated on July 6, strength­en­ing the author­ity of dis­ease con­trol per­son­nel and epi­demi­ol­o­gists work­ing in ac­tual sit­u­a­tions, in­creas­ing the num­ber of epi­demi­ol­o­gists, and strength­en­ing the na­tional dis­ease man­age­ment sys­tem to en­able quicker re­sponses.

Avoid Mis­un­der­stand­ing

MERS is not trans­mit­ted through the air. There has been no sus­tained trans­mis­sion within the com­mu­nity, thor­ough con­tain­ment of the virus is pos­si­ble. Ex­perts have said that the MERS virus, sim­i­lar to the com­mon flu, can be con­tained and pre­vented from spread­ing into the com­mu­nity through ap­pro­pri­ate quar­an­tine mea­sures and ad­e­quate per­sonal hy­giene pre­cau­tions.

The Min­is­ter asked for co­op­er­a­tion to en­sure that ex­ces­sive con­cerns did not pro­duce un­nec­es­sary con­fu­sion. The po­lit­i­cal sec­tor and lo­cal gov­ern­ments were also ex­pected to put their con­fi­dence in the Gov­ern­ment, so they would be able to re­spond to­gether with com­po­sure, and he said he was con­fi­dent the coun­try would be able to suc­cess­fully over­come the sit­u­a­tion. He asked also for co­op­er­a­tion from the Korean peo­ple to en­sure that ex­ces­sive vig­i­lance did not cause an un­due slump in eco­nomic ac­tiv­ity. He hoped the peo­ple would not be mis­led by un­founded ru­mors to the con­trary.

Re­search ac­tiv­ity

A joint mis­sion con­firmed that the virus was clus­tered around health fa­cil­i­ties and found no ev­i­dence that it was cir­cu­lat­ing in the com­mu­nity. “How­ever, con­tin­ued mon­i­tor­ing for this was crit­i­cal,” said Dr. Fukuda.

The mis­sion, com­prised of ex­perts in epi­demi­ol­ogy, risk communications, virol­ogy, clin­i­cal man­age­ment, in­fec­tion preven­tion and con­trol, as well as pub­lic health spe­cial­ists, iden­ti­fied sev­eral rea­sons why the virus, which ar­rived in the coun­try with a sin­gle in­fected trav­eller, was able to go on to in­fect large num­bers of peo­ple in a rel­a­tively short time. Th­ese in­cluded: The fact that the MERS-CoV was un­ex­pected and un­fa­mil­iar to most physi­cians in the Re­pub­lic of Korea; Sub-op­ti­mal preven­tion and con­trol mea­sures in some hos­pi­tals, re­lated in part to over­crowd­ing in emer­gency rooms and pa­tients in rooms with many beds; The pos­si­ble im­pact of habits and cus­toms such as so­called “doc­tor-shop­ping”, where pa­tients seek care at a num­ber of med­i­cal fa­cil­i­ties, as well as vis­its to hos­pi­tal­ized pa­tients by many friends and fam­ily mem­bers.

Epi­demi­o­log­i­cal re­search and anal­y­sis was con­ducted as part of MERS re­sponse and erad­i­ca­tion ef­forts. Rel­e­vant test spec­i­mens, clin­i­cal data and other re­search find­ings were col­lected and stored.

In­ter­na­tional co­op­er­a­tion

On June 8, the Min­istry of For­eign Af­fairs and other min­istries be­gan a joint as­sess­ment with the World Health Or­ga­ni­za­tion on the cur­rent sit­u­a­tion. In­ter­na­tional co­op­er­a­tion was car­ried out trans­par­ently with spe­cial­ized or­ga­ni­za­tions such as the WHO and the U.S. Cen­ters for Dis­ease Con­trol. The Korea-WHO MERS Joint Mis­sion pre­sented its find­ings on June 13. In part­ner­ship with WHO and the U.S. CDC, a com­pre­hen­sive as­sess­ment of Korea’s sys­tem for pre­vent­ing the spread of new in­fec­tious dis­eases was car­ried out June 22-July 1.

In Manila, 13 June 2015 - A joint mis­sion by the World Health Or­ga­ni­za­tion and the Re­pub­lic of Korea’s Min­istry of Health and Wel­fare, “we know that there has been much anx­i­ety about whether the virus in the Re­pub­lic of Korea has in­creased its abil­ity to trans­mit it­self be­tween hu­mans,” said Dr Keiji Fukuda, WHO As­sis­tant Di­rec­tor-Gen­eral for Health Se­cu­rity who co-led the mis­sion with Dr JongKoo Lee, Di­rec­tor, Cen­ter for Global Medicine, Seoul Na­tional Univer­sity. “How­ever, based on avail­able se­quenc­ing stud­ies of this virus, it does not ap­pear to have changed to make it­self more trans­mis­si­ble.”

Min­istry of Cul­ture, Sports and Tourism Sec­ond Vice Min­is­ter Kim Jong (2nd L)

MERS virus was seen from

Mi­cro­scope in Korea

Paul Jen­nings (New Zealand) has been teach­ing English in uni­ver­si­ties in South Korea for seven years. He has a MA in TESOL. He also has been in­volved in vol­un­teer­ing and hu­man rights events over the past ten years, and is an As­so­ciate Editor at the Global Di­gest mag­a­zine.

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