Results of national surveillance of Middle East respiratory syndrome coronavirus infection among Hajj pilgrims and response of patients under investigation in the Republic of Korea from 2016-2018

Shin SeungHwan, Ryu Boyeong, Jin Yeowon, Park Youngjoon
Task Force for MERS-CoV Preparedness and Response, KCDC

 Hajj is the annual Islamic pilgrimage to Mecca in Saudi Arabia that is attended by millions of   pilgrims every year. Since it is a mass gathering, the risk of respiratory disease outbreak and transmission is high. The purpose of this surveillance report was to prevent the inflow and transmission of Middle East respiratory syndrome (MERS) coronavirus by Hajj pilgrims and improve the “2019 MERS Special Management Plan for Islamic Pilgrimages”, which was designed based on domestic conditions by estimating risks and suggesting precautions for each period such as before departure, during the pilgrimage, and after return from overseas. To prevent domestic importation of MERS from Islamic pilgrimages, various methods for increasing awareness were used, such as publishing press releases and leaflets. Moreover, the Korea Centers for Disease Control and Prevention call center (1339) was available to receive reports from anyone who developed suspected symptoms of MERS, including fever and respiratory symptoms, within 2 weeks of returning to the Republic of Korea. From 2016 to 2018, a total of 1,078 domestic Hajj pilgrims were surveyed including 330, 448, and 300 pilgrims in 2016, 2017, and 2018, respectively. Among them, 954 pilgrims (88.4%) returned within the control period that is 4 weeks from the end of the Islamic pilgrimage. Out of this group, 23 pilgrims were classified as suspected MERS cases, but they were later confirmed negative for MERS based on diagnostic testing. Through the “MERS Special Management Plan for Islamic Pilgrimages” from 2016?2018, MERS suspected cases were detected and controlled in the early stages. However, communication with people whose first language is not Korean was challenging. Therefore, in addition to the current standard operating procedures, complementary steps should be taken for response in the field, such as providing information and interpretation services in multiple languages.

Keywords: Middle East respiratory syndrome, Hajj, Enhance management, Early detection