Press Release

DH closely monitors additional MERS cases in KSA

23 November 2014

The Department of Health (DH) is today (November 23) closely monitoring five additional cases (including two deaths) of Middle East Respiratory Syndrome (MERS) reported to the World Health Organization (WHO) by 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.

According to the WHO, the five cases involve four men and one woman with comorbidities. Details of the cases are as follows:

1. A 42-year-old female nurse, who had exposed to a confirmed case;
2. A 60-year-old man who had received dialysis in the same room used to dialyse a confirmed case. The patient passed away on October 15;
3. An 82-year-old man who had no contact with animals but resides in an area with heavy presence of camel farms. In addition, the patient has a history of raw camel milk consumption in the 14 days prior the onset of symptoms;
4. A 44-year-old man who has frequent contact with animals but he has no history of contact with camels or consumption of raw camel products in the 14 days prior to the onset of symptoms; and
5. A 70-year-old man who had contact with animals but had no history of contact with camels or consumption of raw camel products in the 14 days prior to the onset of symptoms. The patient died on October 28.

Contact tracing of household contacts and healthcare contacts is ongoing for these cases.

The aforementioned five cases, including two deaths, had already been included in the total numbers of cases and deaths in the MERS disease outbreak news of the WHO issued on November 7. Therefore, globally, the total number of laboratory-confirmed MERS cases notified to the WHO remains 909, including at least 331 related 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 as well as overseas and neighbouring health authorities to monitor the latest developments.

"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," a spokesman for the DH urged.

"Scientific studies have 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 boundary control points is firmly 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 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 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 said.

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. 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 pages below for more information and health advice:

• The CHP's MERS page (This link will open in a new windowwww.chp.gov.hk/en/view_content/26511.html);
• The MERS page of the DH's Travel Health Service (This link will open in a new windowwww.travelhealth.gov.hk/english/popup/popup.html); and
• The WHO's latest news (This link will open in a new windowwww.who.int/csr/don/archive/disease/coronavirus_infections/en).

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