A recent MERS outbreak in South Korea—the largest outside of Saudi Arabia, where the disease first emerged in 2012—is likely to grow, according to the World Health Organization (WHO).
MERS, or Middle East Respiratory Syndrome, has infected at least 25 people in South Korea and killed two, the organization said Tuesday, June 2.
“Doctors have diagnosed five new cases not yet confirmed by the WHO, bringing the total to 30 cases,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who is working with doctors in South Korea to help treat patients.
South Korean officials have isolated 680 people to limit the spread of the disease, which spreads when sick people cough.
There have been at least 1,154 lab-confirmed cases of MERS worldwide since 2012, along with 431 deaths—a mortality rate of 37 percent.
MERS belongs to the same family of viruses as SARS, or Severe Acute Respiratory Syndrome, which was first identified in 2003. Symptoms, according to the Centers for Disease Control and Prevention, include fever, cough, and shortness of breath.
The first MERS case in South Korea was confirmed May 20 in a 68-year-old man who had traveled to four Middle Eastern countries. He developed symptoms earlier that month, and sought care at two outpatient clinics and two hospitals, WHO said.
Doctors did not isolate the man, who did not report exposure to MERS. He was present to a number of medical staff, hospital patients, as well as family members and visitors. Health officials are seeking more information about how he was exposed during his travels to the Middle East.
“The patient infected some patients in the same room, as well as others on the same ward of the hospitals. Some patients became infected after being exposed to the man for as little as five minutes,” the WHO said. “Other patients may have spread the virus at other hospitals before they were diagnosed.”
Another man infected with MERS symptoms traveled to China from South Korea on May 26, against his doctor’s orders, and was diagnosed at a Chinese hospital three days later.
South Korea’s Ministry of Health confirmed that there have been three generations of MERS spread—from the initial patient to a second, and then to a third patient with no contact from the original patient.
Given how many people were exposed, “further cases can be expected,” the WHO confirmed. People are more likely to spread the disease when they are very sick and coughing.
The first MERS case in the US, a health professional who had traveled to Saudi Arabia, was diagnosed last year, the CDC said.
“Doctors have long known that coronaviruses such as MERS spread easily in hospitals,” said Dr. Osterholm. “Hospitals helped to spread the SARS outbreak in Toronto in 2003, as sick patients waited in crowded emergency departments.”
“The current South Korean outbreak underscores the need to develop a vaccine against MERS,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, in Houston.
Information about coronaviruses, such as why some people are more contagious than others, is still being discovered. During the 2003 SARS outbreak, doctors called highly infectious people “super spreaders” because they infected dozens of people, while other patients never infected anyone.
“These people may have more of the virus, or their coughs may be more efficient at spreading it,” Osterholm said, noting that it will be more difficult to tell if the South Korean MERS outbreak is spreading any more quickly than usual. In past outbreaks in Saudi Arabia, world health officials often received information long after patients had been treated.
Health officials have been quick to notify international authorities of new developments, allowing people to follow the outbreak “in real time,” Osterholm added.
“There is a lot more transparency here than on the Arabian peninsula,” he said. “Because South Korea has an advanced medical system, it is better positioned to contain the MERS outbreak [here] than in developing nations.”
“The fact that MERS has spread around the world is not surprising…It could very easily come to America. Very easily. Any flight could contain someone who was infected in the Middle East. The question is, ‘Where is it going to spread to next?’”
(With reports from USA Today)
