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MERS-CoV Outbreak in South Korea

We the North
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Ontario’s Chief Medical Officer of Health (CMOH) has released updated information on Middle East Respiratory Corona Virus (MERS-CoV) as a result of the recent outbreak of the virus in South Korea. The memo contains links to additional updates and resources.

What is MERS-CoV?

MERS-CoV is a viral respiratory disease first identified in Saudi Arabia in 2012. Caused by a type of coronavirus (the same virus family that causes the common cold and SARS), the illness does not seem to pass easily from person-to-person. However, human-to-human transmission has occurred following close contact with sick persons especially when caring for them. To date, approximately 36% of reported patients with MERS have died. There are no cases in Canada.

What is happening in Korea?

In May, a person returned to South Korea from the Middle East where the virus continues to circulate. After the person returned, he developed MERS-CoV which wasn’t diagnosed until a number of other people had been exposed. Some of those ill people have infected others. As of June 10, there were 108 confirmed cases (107 in Korea, 1 in China) and 9 of those cases have died. There are more than 3,400 contacts being followed who are either in quarantine or isolation.

What guidance is the CMOH providing?

The Ontario government has not changed the case definition of MERS-CoV to include travel to South Korea, but wants to alert the health care system of these developments. The CMOH and the Provincial Infectious Diseases Advisory Committee (PIDAC) continue to recommend that workers use respiratory precautions and don fit-tested, seal-checked N95 respirators and other personal protective equipment (PPE) when in a room with a patient under investigation or being treated for MERS-CoV and when transporting such patients. In addition to N95 respirators, PPE includes gloves, gowns and eye protection. Airborne Infection Isolation Rooms (AIIR), if possible, are also recommended for confirmed cases and patients under investigation for MERS-CoV.
 
OPSEU is pleased that the Ontario guidance on infection control precautions and PPE goes beyond that of Public Health Agency of Canada (PHAC) or WHO – which are recommending only droplet precautions.
 
When you click on the links within the CMOH memo, it is a bit confusing because you first land on a May 2014 update and you have to click within it to get to the latest update (March 2015). Here is the link:
http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/guidance.aspx#1   

What should Joint Health & Safety Committees do?

This outbreak in Korea provides an excellent opportunity for Joint Health & Safety Committees, infection prevention and control practitioners and employers to review and update if necessary, their health and safety and infection prevention and control policies and procedures, especially screening procedures for acute respiratory infections. The CMOH memo provides a link to PIDAC resources which provide more information on surveillance for acute respiratory infections. 

Resources

The latest health and safety and infection control information from the Ministry of Health & Long Term Care is here:
http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/guidance.aspx#1     
 
A description of the current situation can be found on the World Health Organization website: http://www.wpro.who.int/outbreaks_emergencies/wpro_coronavirus/en/