Press Release

DH closely monitors additional overseas MERS cases reported to WHO

14 June 2014

The Department of Health (DH) is today (June 14) closely monitoring additional cases of Middle East Respiratory Syndrome (MERS) reported to the World Health Organization (WHO) by the United Arab Emirates (UAE), Iran and the Kingdom of Saudi Arabia (KSA), and hence called on the public to stay alert and maintain good personal, food and environmental hygiene during travel.

UAE

According to the WHO, the male patient aged 36 is a butcher who works in a slaughter house for camels and sheep. The case was identified and laboratory confirmed upon a general screening in slaughter houses.

Iran

The female patient aged 35 is a nurse assistant who is a close contact of the first confirmed patient in Iran.

KSA

A total of 402 laboratory confirmed MERS cases (including 114 deaths) were reported to the WHO between April 11 and June 9, and 109 of them are healthcare workers (HCWs) (including four deaths). Patients' age ranged from nine months to 94 years old and the median was 46 years old. About 58.3 per cent of cases with information reported are male. Some 44.5 per cent reported severe disease while 28.6 per cent were asymptomatic or had mild illness.

In addition, another 113 cases were identified by KSA through retrospective review and were reported to the WHO on June 3, pending further information.

To date, 697 laboratory confirmed MERS cases have been reported to the WHO globally, including at least 210 deaths.

The Centre for Health Protection (CHP) of the DH is seeking more information on the cases from the WHO and the relevant health authorities. The CHP will remain vigilant and work closely with the WHO and overseas and neighbouring health authorities to monitor the latest developments.

"Persons with pre-existing major illnesses, including chronic diseases such as diabetes, renal failure, chronic lung disease and immunodeficiency, are more likely to develop severe infections for MERS if exposed to the virus. Pilgrims should consult a healthcare provider before travelling to review the risk and assess whether making the pilgrimage is advisable," a spokesman for the DH advised.

"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. In addition, travellers are reminded to avoid going to farms, barns or markets with camels, and avoid contact with animals, especially camels, birds, poultry or sick people during travel," the spokesman added.

"Recent scientific studies supported the premise that camels served as the primary source of MERS Coronavirus (MERS-CoV) infecting humans. A study further suggested that human MERS-CoV infections could be transmitted through close contact with infected camels," the spokesman explained.

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 CHP's Public Health Laboratory Services Branch is capable of detecting the virus. No human cases have been recorded so far in Hong Kong," the spokesman said.

"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 added.

Early identification of MERS-CoV is important, but not all cases can be detected in a timely manner, especially mild or atypical cases. 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 undertaken 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 consume raw or undercooked animal products, including milk and meat, or foods which may be contaminated by animal secretions, excretions (such as urine) or products, unless they have been properly cooked, washed or peeled;
• Seek medical consultation immediately if feeling unwell;
• Avoid visits 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 WHO's latest news (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).