Press Release

Three patients with respiratory symptoms and travel history under CHP investigation

16 May 2014

The Centre for Health Protection (CHP) of the Department of Health (DH) is today (May 16) investigating three suspected cases of Middle East Respiratory Syndrome (MERS) and called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.

The first case is a female patient aged 29 in Pamela Youde Nethersole Eastern Hospital (PYNEH) whose nasopharyngeal aspirate tested negative for MERS Coronavirus (MERS-CoV) upon preliminary laboratory testing by the CHP's Public Health Laboratory Services Branch (PHLSB).

She presented with myalgia on May 6 and subsequently developed cough, sore throat and runny nose. She attended PYNEH yesterday (May 15), was admitted early this morning and is now in stable condition. Investigations revealed that she had travelled to Dubai from April 24 to 26 during which she rode a camel on April 25. The patient then travelled to Europe and returned to Hong Kong via Dubai on May 14. Her two travel collaterals have remained asymptomatic.

The other two cases are a woman aged 58 and her daughter aged 26 who have presented with fever, cough and sore throat since May 10 and May 4 respectively. They were admitted to Caritas Medical Centre today and are now in stable condition. Their respiratory specimens have been taken for the PHLSB's preliminary testing.

Preliminary investigations indicated that they had travelled to Europe from April 29 to May 6 with both transits at Dubai. They had no contact with animals or sick persons and did not visit health-care facilities there. One of their travel collaterals had cough and sore throat on May 15 and consulted a private doctor in stable condition. The other collateral has remained asymptomatic.

"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 health-care 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 test 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 report their travel history to the doctor. HCWs 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 markets with camels;
• 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 foods 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 visits to health-care 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 WHO (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).