28 April 2014
The Centre for Health Protection (CHP) of the Department of Health (DH) is today (April 28) investigating three suspected cases of Middle East Respiratory Syndrome (MERS) whose respiratory specimens were all negative for MERS Coronavirus (MERS-CoV), and called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.
Two of the cases involve a man aged 53 and his wife aged 52. The male patient presented with low grade fever, sore throat and runny nose on April 19 while his wife with underlying illness developed cough, fever, sore throat, headache and myalgia yesterday (April 27). They were both admitted to Princess Margaret Hospital today for management under isolation in stable condition. Both of their nasopharyngeal aspirates were tested negative for MERS-CoV upon preliminary laboratory testing by the CHP's Public Health Laboratory Services Branch (PHLSB).
They travelled to Tunisia from April 18 to 25 with transit in Dubai. They visited a zoo on April 19 and did not have direct animal exposure, but took a camel ride on April 20.
The remaining case is a man aged 56 with underlying illness. He presented with sore throat, headache, chills and rigor on April 22 and was admitted to Queen Elizabeth Hospital yesterday for management under isolation in stable condition. His nasopharyngeal swab was negative for MERS-CoV upon the PHLSB's preliminary laboratory testing.
He travelled to Venice on April 18 via Doha, and to Bari, Greece, Turkey, Istanbul and Croatia by cruise from April 19 to 26, during which he had no contact with animals or patients. He returned to Hong Kong yesterday.
Advice to travel industry
The DH's Port Health Office has issued letters to the travel industry and agents organising tours to the Middle East to draw their attention to the updated risk assessment by the World Health Organization (WHO).
"Recent studies showed that camels served as the primary source. We hence strongly advise travel agents, apart from ongoing precautionary measures, not to arrange camel rides and activities involving contact with camels, which may increase the risk of infection when travelling in the Middle East," a spokesman for the DH remarked.
Tour leaders and tour guides operating overseas tours are advised to refer to the CHP's health advice against MERS ( www.chp.gov.hk/en/view_content/26551.html ).
Advice to travellers
"Travellers, apart from avoiding contact with animals, especially camels, or visits to farms, barns or markets with camels, should not drink raw milk, or consume food which may be contaminated by animal secretions or products, unless they have been properly cooked, washed or peeled," the spokesman urged.
"As pre-existing major illnesses can increase the likelihood of medical problems, including MERS, during travel, in view of recent pilgrimage activities, pilgrims should consult a healthcare provider before travelling to assess whether it is medically advisable," the spokesman advised.
Locally, the DH's surveillance mechanism with public and private hospitals, practising doctors and at the airport is well in place. Suspected cases identified will be sent to public hospitals for isolation and management until their specimens are tested negative for MERS-CoV.
"MERS is a statutorily notifiable infectious disease and the PHLSB is capable of detecting the virus. No human cases have been recorded so far in Hong Kong," the spokesman stressed.
"The Government will be as transparent as possible in the dissemination of information. Whenever there is a suspected case, particularly involving patients with travel history to the Middle East, the CHP will release information to the public as soon as possible," the spokesman remarked.
Early identification of MERS-CoV is important, but not all cases can be detected in a timely manner, especially mild or atypical cases. Health-care workers (HCWs) should maintain vigilance and adhere to strict infection control measures while handling suspected or confirmed cases to reduce the risk of transmission to other patients, HCWs or visitors. Regular education should be provided.
Travellers returning from the Middle East who develop respiratory symptoms should wear face masks, seek medical attention and reveal their travel history. MERS-CoV should be tested for. Patients' lower respiratory tract specimens should also be diagnosed when possible and repeat testing should be done when clinical and epidemiological clues strongly suggest MERS.
Members of the public are reminded to take heed of personal, food and environmental hygiene:
The public may visit the CHP's MERS page ( www.chp.gov.hk/en/view_content/26511.html ), the DH's Travel Health Service ( www.travelhealth.gov.hk/english/popup/popup.html ) or the WHO's latest news ( www.who.int/csr/don/archive/disease/coronavirus_infections/en/ ) for more information and health advice.