Results of national surveillance and response on patients under investigation (PUIs) of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Korea, 2018

Ryu Boyeong, Kim Eun Kyoung, Shin Seoung Hwan, Jin Yeo Won, Lee Jia, Lee Jeong Heon, Kim Jia, Kim Ji Yeon, Kim Hyo Jin, Shin Hee Yeong, Lee Ki Yong, Lee Ah Kyung, Choi Seona, Choi Choro, Choe Han Saem, Kim Tae Hun, Jeong Mi Jin, Park Se Woong, Moon Sangjun, Park Youngjoon, Lee Sangwon, Jung Seonghoon
Task Force Team for MERS-CoV Preparedness and Response, KCDC

There have been continuous reports of Middle East respiratory syndrome Coronavirus (MERS-CoV) infection in the Middle East in recent years, with 2,279 confirmed cases and 806 deaths since its first notification in Saudi Arabia. For the early detection and rapid implementation of control measures for MERS-related cases, the Republic of Korea (ROK) enhanced its MERS surveillance and response system after the 2015 domestic MERS outbreak. This report describes the results of national surveillance and response on patients under investigation (PUIs) for MERS-CoV infection in ROK, 2018. A total of 378 cases was classified as PUIs for MERS-CoV infection among 2,225 reported cases. Of those, the number of self-reported cases who called the KCDC 1339 Call Center or their local public health centers was higher than that of cases notified by healthcare providers, with 202 cases (53.4%) and 143 cases (37.8%), respectively. Thirty-two cases (8.5%) were identified at a port of entry. Males (56.9%) and Koreans (87.8%) were predominant in the cases. Two hundred and thirty-three cases (61.6%) had a history of traveling to the UAE, 38 cases (10.1%) to Israel, and 33 cases (8.7%) to Saudi Arabia. Most PUIs cases were classified as having low epidemiological risk. The most common symptoms were fever and cough (93.1% and 75.9%, respectively), and pneumonia was observed in 35 cases (9.3%). Laboratory testing confirmed one MERS-CoV infection in September. There were also cases with respiratory viral infections, such as influenza (131 cases, 37.8%) and rhinovirus (65 cases, 17.2%). In 2018, one MERS imported case was detected through ROK’s national MERS surveillance and response system, with no additional cases. The system should be continuously tested and improved for effective preparedness and response of MERS patients.

Keywords: Middle East Respiratory Syndrome Coronavirus, National surveillance, Patient under investigation, Respiratory virus, Korea