Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications

Abstract

Beginning with the index case that infected 28 others, an in-depth analysis was conducted. The average age was 55 years, which was a little higher than the global average of 50 years. As in most other countries, more men than women were affected. The case fatality rate was 19.9%, which was lower than the global rate of 38.7% and the rate in Saudi Arabia (36.5%). In total, 184 patients were infected nosocomially and there were no community-acquired infections. The main underlying diseases were respiratory diseases, cancer and hypertension. The main contributors to the outbreak were late diagnosis, quarantine failure of 'super spreaders', familial care-giving and visiting, non-disclosure by patients, poor communication by the South Korean Government, inadequate hospital infection management, and 'doctor shopping'. The outbreak was entirely nosocomial, and was largely attributable to infection management and policy failures, rather than biomedical factors.

Middle East respiratory syndrome

“…The clinical presentation of patients infected with MERS-CoV ranges from asymptomatic or mild upper respiratory illness to rapidly progressive pneumonitis, respiratory failure, acute respiratory distress syndrome, septic shock, and multiorgan failure with fatal outcome (figure 5). 2,10,11,[61][62][63][64][65][66][67][68][69][70] It is not possible to distinguish patients with a legitimate asymptomatic MERS-CoV infection from those who develop mild disease because reports to WHO provide signs and symptoms information only at the time of reporting. Many individuals remain asymptomatic whereas some go on to develop mild disease, which is why WHO classifies these individuals as mild or asymptomatic.…”

“…The signs and symptoms associated with MERS are non-specific, with or without multisystem involvement, and thus could be mistaken for other causes of respira tory tract or gastrointestinal illnesses. 2,10,11,[61][62][63][64][65][66][67][68][69][70] Therefore, the clinical diagnosis of MERS can be easily missed. Patients with MERS can typically present with fever, chills, rigors, headache, a non-productive cough, sore throat, arthralgia, and myalgia followed by dyspnoea.…”

“…2,10 Several outbreaks of human-to-human MERS-CoV trans mission have occurred, the largest outside the Middle East occurring in South Korea in 2015. 11,12 This outbreak was associated with substantial morbidity and mortality, as well as having substantial economic, social, and health security effects. 12 SARS-CoV-2 (initially named 2019-nCoV) was detected in December 2019 after sequencing of clinical samples from a cluster of patients in Wuhan, China who dev -eloped pneumonia of unknown cause.…”

MERS: an emerging disease of the 21st century

“…19 While, another paper by Kim et al discussed the MERS-CoV outbreak of South Korea revealing that the fatality rate was about 20%, almost half the global rate of 38.7% and significantly less than the rate recorded in Saudi Arabia (36.5%). 20 Also, the epidemic potential of this novel coronavirus was evaluated by Breban et al, where it was found that the reproduction number (R 0 ; defined as the mean count of infected individuals as a result of one diseased individual in a susceptible community) ranged between 0.60 and 0.69. This denoted that MERS-CoV is yet to possess a pandemic potential because its R 0 <1.…”

Factors associated with recovery delay in a sample of patients diagnosed by MERS‐CoV rRT‐PCR: A Saudi Arabian multicenter retrospective study

“…Early screening and diagnosis of MERS‐CoV could greatly promote proper control and clinical management of cases, which may reduce the risk of transmission and increase the chance of successful outcomes . This study provides more understanding of how long a period (in days) it may take to recover from MERS‐CoV infection.…”