By Kim Hyun-bin
Fears of Middle East Respiratory Syndrome (MERS) outbreak has resurfaced for the first time in three years after a 61-year-old man contracted the virus during a business trip to Kuwait earlier this month.
The man came into contact with over 400 people including those on the plane, and had close contact with 21 of them _ flight attendants, passengers in the seats around him, immigration officials and medical staff. They are being monitored and have to report to the quarantine authorities about their everyday condition, according to the Korea Centers for Disease Control and Prevention (KCDC).
Unlike the first outbreak in 2015, which resulted in 38 deaths and infections of 186 people, the second outbreak has been well contained so far, with most of those coming into close contact testing negative for the disease.
The first outbreak had a far worse outcome as the government lacked knowledge about the disease and consequently the knowhow on suitable quarantine measures.
Since then, measures have been enhanced to help prevention of any future outbreaks of the virus.
To better inform the public, the Korean Society of Infectious Diseases (KSID) published a MERS white paper in 2015, which listed the rumors and facts of MERS after the first outbreak.
Is MERS an airborne virus?
No. MERS is not virally contagious. It is mostly spread through contact with an infected person's bodily fluids such as nasal discharges and coughs.
“If MERS was airborne, most of a patient's family members would also be diagnosed with the disease, but only 5 to 10 percent were infected _ an unrealistic figure if the virus could be transmitted through air. It would have infected their local community and spread rapidly through subways and buses,” said Kim Tae-hyung, a professor of the Division of Infection Diseases at the Soon Chun Hyang University Hospital.
However, in May 2015, the first rumors of MERS being airborne arose after a patient tested positive for MERS without any known close contact with the first patient.
The problem was the government's definition of “close contact” was poorly defined. In 2014, the government defined close contact as “people within a two-meter radius of a MERS patient for over an hour without any safety gear including masks, gloves and eye protection.”
The rule was made after reviewing the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) guidelines for SARS and H1N1 swine flu.
However, unlike the CDC and the WHO, the Korean government lacked information and data on preventing MERS and the government set the critical contact area as too small which led to infections outside their surveillance range.
After dealing with the first outbreak, the government erased the one-hour contact and replaced it with “anyone who has a fever over 37.5 degrees Celsius after encountering a MERS patient within a two-meter radius.”
“The CDC included other preventive options to halt the spread of the virus but the KCDC guidelines mainly focused on the one-hour contact within a two-meter radius without other detailed preventive options, which was a disastrous mistake,” according to the KSID.
How to prevent infection
Symptoms of MERS are fever, coughing, and respiratory difficulties. Patients may also suffer from an upset stomach, vomiting, and diarrhea.
After conducting a survey on 46 MERS patients who were allowed to select multiple criteria, 41 had fever, 16 constantly coughed, 11 had respiratory difficulties, followed by muscle pain and diarrhea.
The symptoms were noticeable between two to 14 days after infection. Before apparent symptoms, experts say the virus is not contagious.
The median incubation period for MERS with limited human-to-human transmission is approximately five days. However, the longest incubation period recorded by the KCDC was 14 days.
To prevent infection, health officials recommend washing hands routinely and not touching the eyes, nose, and mouth when hands are not sanitized. In addition, people are advised to make sure to cover their mouth and nose with a tissue when coughing and avoiding people with fever.
MERS is a coronavirus respiratory disease with a fatality rate of 20 percent to 46 percent, contracted through contact with infected camels and spread through close contact with a MERS-infected person.
The first MERS case was in Saudi Arabia, and spread to other countries. As of June, the WHO has reported 2,229 confirmed cases worldwide.