So far all 21 close contacts of a South Korean man who was diagnosed as having MERS-CoV after returning from a business trip to Kuwait are asymptomatic, the World Health Organization (WHO) said today in a statement that covered investigation findings and its assessment of the risk of spread.
The case, announced by South Korea on Sep 8, marked country's first imported case in 3 years and the second MERS-CoV (Middle East respiratory syndrome coronavirus) case exported in recent weeks from the Middle East. The other involves a Saudi resident whose illness was detected in the United Kingdom following exposure to camels in his home country.
In 2015, South Korea's first imported MERS-CoV case sparked an outbreak that spread through hospitals, sickening 186 people, 36 of them fatally. The event prompted sweeping changes throughout South Korea's health system, and a WHO official said earlier this week that quick detection of the new case has probably averted another massive outbreak, though it wouldn't be surprising to see some secondary infections.
Two hospital visits in Kuwait
The new WHO report added a few more details about the illness of the 61-year-old man, who is currently in stable condition at Seoul National University hospital. The agency said the man began experiencing diarrhea on Aug 28, which got worse on Sep 3. He visited a local hospital in the city of Mangaf in Kuwait on Sep 4 and Sep 6.
On Sep 7, he flew back to South Korea via Dubai and immediately went to a general hospital in Seoul with symptoms that included diarrhea and fever. The medical team found that the man had pneumonia and, because of his travel history, suspected MERS-CoV. He was immediately transferred to Seoul National University Hospital, where he was isolated and tested positive for the virus.
The 21 close contacts that the South Korea health ministry is monitoring include family members, airline passengers who sat near the patient, flight attendants, and others in Seoul, including four healthcare workers. All are in home quarantine and will be monitored by local health officials for 14 days after exposure to the patient.
According to a Korea Herald story that cited the Korea Centers for Disease Control and Prevention (KCDC), all 19 of the South Koreans who shared living quarters with the sick man while in Kuwait have tested negative for the virus. It added that 10 people in South Korea who reported symptoms have also tested negative.
Korean health officials are still trying to find 10 people who arrived in Seoul on the man's flight from Dubai, according to the Korea Herald report.
Meanwhile, the WHO report said 435 other contacts have been identified and were or are under passive surveillance.
An epidemiologic investigation of the man's exposures and travel history in Kuwait is under way, the WHO said, adding that it is working with South Korea, the United Arab Emirates, and Kuwait to track the patient's movements to identify any other potential contacts.
WHO: No change in overall risk
The new Korean case doesn't change the WHO's overall risk assessment, it said, emphasizing that the virus doesn't spread easily from person to person without close contact, such as providing unprotected care to an infected person. The WHO also said more cases linked to the South Korea case might be reported, but those wouldn't change the overall global risk from the case, which it says is low.
The WHO also said it expects more MERS-CoV cases to be reported from the Middle East, along with sporadic exported cases in people who are exposed to animals, animal products, and other sick people, such as those in healthcare settings. "Human-to-human transmission can be stopped with adequate infection prevention and control measures," the WHO noted.
The total number of MERS cases reported to the WHO as of August is 2,249, including 798 deaths.
Sep 12 WHO statement
Sep 12 Korea Herald story
Sep 10 CIDRAP News story "South Korea reports MERS in Kuwait business traveler"