Institutional Preparedness to Prevent Future Middle East Respiratory Syndrome Coronavirus-Like Outbreaks in Republic of Korea

Abstract

A year has passed since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea. This 2015 outbreak led to a better understanding of healthcare infection control. The first Korean patient infected by Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was diagnosed on May 20, 2015, after he returned from Qatar and Bahrain. Thereafter, 186 Korean people were infected with the MERS-CoV in a short time through human-to-human transmission. All these cases were linked to healthcare settings, and 25 (13.5 %) infected patients were healthcare workers. Phylogenetic analysis suggested that the MERS-CoV isolate found in the Korean patient was closely related to the Qatar strain, and did not harbor transmission efficiency-improving mutations. Nevertheless, with the same infecting virus strain, Korea experienced the largest MERS-CoV outbreak outside the Arabian Peninsula, primarily due to the different characteristics of population density and the healthcare system. We aimed to review the epidemiological features and existing knowledge on the Korean MERS outbreak, and suggest methods to prevent future epidemics.

Keywords: Awareness; Middle East respiratory syndrome coronavirus; Preparedness.

Figure 1. Epidemic curve of the Korean Middle East respiratory syndrome outbreak.

Adapted from Epidemiol Health 2015; 37: e2015033.

Figure 2. Phylogenetic analysis of the complete Middle East respiratory syndrome-coronavirus genomes using the maximum-likelihood method based on Tamura-Nei model implemented in MEGA5.

CH, China; EG, Egypt; FR, France; KR, Republic of Korea; OM, Oman; QT, Qatar; SA, Saudi Arabia; UAE, United Arab Emirates; UK, United Kingdom; US, United States; JR, Jorda. Adapted from Exp Mol Med. 2015;47:e181.