Press Release

Two patients with respiratory symptoms and travel history test negative for MERS-CoV

5 May 2014

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (May 5) investigating two 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.

The first case was notified by Ruttonjee Hospital (RH) last night (May 4) and involved an 86-year-old man. The patient presented with fever and cough with sputum since April 30. He was admitted to RH for treatment under isolation yesterday. The clinical diagnosis is pneumonia. He is now in stable condition.

Initial investigations by the CHP revealed that the patient had travelled to Europe from April 17 to 26. Two flights in his trip transited at Dubai but he only stayed at the airport. He had no contact with animals or patients and did not visit healthcare facilities there. His home contact has remained asymptomatic.

The second case was notified by United Christian Hospital (UCH) last night and involved a 50-year-old woman. The patient noticed an increase in cough and sore throat during her trip to Dubai from April 5 to 11. Her condition improved after self-medication. She attended UCH yesterday and was subsequently admitted for treatment under isolation. She was febrile upon admission. Her current condition is stable.

Initial investigations by the CHP revealed that the patient had taken a photo with a camel on April 7 but she had no direct contact with the animal. She had no contact with patients and did not visit healthcare facilities in Dubai. Her home contact has remained asymptomatic.

The respiratory specimens of the two patients were negative for MERS-CoV upon preliminary laboratory testing by the CHP's Public Health Laboratory Services Branch (PHLSB).

"We strongly advise travel agents organising tours to the Middle East not to arrange camel rides and activities involving camel contact which may increase the risk of infection," a spokesman for the DH remarked.

"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. Healthcare 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 report their travel history to the doctor. Healthcare workers should arrange MERS-CoV testing for them. Patients' lower respiratory tract specimens should be tested when possible and repeat testing should be done when clinical and epidemiological clues strongly suggest MERS.

Travellers are reminded to take heed of personal, food and environmental hygiene:

• Avoid going to farms, barns or camel markets;
• Avoid contact with animals (especially camels), birds, poultry or sick people during travel;
• Wash hands regularly before and after touching animals in case of visits to farms or barns;
• Do 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;
• Seek medical consultation immediately if feeling unwell;
• Avoid visit to healthcare settings with MERS patients;
• Wash hands before touching the eyes, nose and mouth, and after sneezing, coughing or cleaning the nose; and
• Wash hands before eating or handling food, and after using the toilet.

The public may visit the CHP's MERS page (This link will open in a new windowwww.chp.gov.hk/en/view_content/26511.html), the DH's Travel Health Service (This link will open in a new windowwww.travelhealth.gov.hk/english/popup/popup.html) or the latest news of the World Health Organization (This link will open in a new windowwww.who.int/csr/don/archive/disease/coronavirus_infections/en/) for more information and health advice.

Tour leaders and tour guides operating overseas tours are advised to refer to the CHP's health advice against MERS (This link will open in a new windowwww.chp.gov.hk/en/view_content/26551.html).