The Department of Health has asked physicians statewide to be on alert for Middle East Respiratory Syndrome after a deadly outbreak of the infectious disease hit South Korea.
“The risk of MERS-CoV (Coronavirus) infection for Hawaii residents is low; however, given the speed and frequency of global travel, we must continue to monitor for any potential cases and be prepared to manage them,” state Epidemiologist Sarah Park said in a letter Wednesday to health care providers.
The DOH has been monitoring emerging infectious pathogens such as MERS, first identified in Saudi Arabia in 2012, she said in the letter.
Infections primarily occur in the Arabian Peninsula but have spread to multiple countries including the United States in 2014. Most recently the virus hit South Korea, killing 27 people and infecting dozens of others. The current outbreak in South Korea is the largest outside the Middle East.
While the state doesn’t have a large Middle Eastern tourism market, annual visitor arrivals from Korea have grown, totaling 13,724 in April.
The Department of Health is asking health care providers to obtain a “detailed travel history when evaluating acute febrile patients with unexplained illness.” (“Febrile” means “feverish.”) The precautions are similar to those taken during the height of the Ebola outbreak in West Africa.
“There are no cases in Hawaii. We have worked closely with the military to ensure we have a coordinated effort in the event a case does emerge from South Korea,” said Toby Clairmont, director of emergency services at the Healthcare Association of Hawaii. “With the large number of military traveling between Korea and Hawaii, and the visitors, it’s something we need to remain vigilant about.”
The virus kills about 25 percent of people infected, and there is no antiviral medication or vaccine for it, Clairmont said.
“It’s transmitted a little easier than Ebola, but it’s not as deadly as Ebola,” he said, adding that the MERS virus can be transmitted through particles when someone sneezes or coughs directly on a person. “That’s why people that have been affected largely have been health care workers.”
Last week, Korea saw more than 100 cases and in excess of 5,000 people were quarantined, he added.
“It doesn’t pose a great threat to Hawaii, but we want to make sure if a suspect case does get here we work closely with DOH and the military to manage the case safely and effectively.”
The DOH letter said MERS should be considered in anyone who develops fever and symptoms of respiratory illness; and pneumonia or acute respiratory distress syndrome; and has traveled in or near the Arabian Peninsula or has been in a Korean health care facility with MERS cases within 14 days; or has been in close contact with someone infected. Other common symptoms include cough, headache and gastrointestinal problems.
People infected with MERS may have mild or no respiratory symptoms. However, many have developed severe acute respiratory illness, which has led to respiratory failure and death. Those with chronic conditions such as diabetes, lung disease or renal failure are more likely to have severe infection, DOH said. The incubation period for the disease ranges from two to 14 days.
“You should immediately report to DOH any patient you suspect as having MERS,” Park said in the letter. “To date, there has been no evidence for sustained human-to-human transmission in the community. Stringent adherence to basic infection control principles is critical to preventing disease transmission.”
