Although the World Health Organization in mid-June said that the Middle East respiratory syndrome (MERS) outbreak in South Korea is not an international public health emergency, it stated that it “is a wake-up call and that in a highly mobile world, all countries should always be prepared for the unanticipated possibility of outbreaks of this and other serious infectious diseases.” Japan needs to learn take steps to prevent a domestic outbreak based on the assumption that efforts to quarantine travelers suspected of being infected with the virus at ports of entry cannot be 100 percent effective.
The MERS coronavirus was first discovered in Saudi Arabia in 2012. Common symptoms include a high fever, coughing and shortness of breath following an incubation period ranging from two days to three weeks. Pneumonia is also common among MERS patients. The virus is spread through coughing and sneezing, but it is believed to not be as infectious as the influenza virus.
More than 1,300 people, mainly in the Middle East, are reported to have been infected with MERS and the WHO places the disease’s fatality rate at around 36 percent. But the true fatality rate could be lower because some infected people may not even be aware that they have the virus as their symptoms are mild or nonexistent.
In South Korea, the number of infected people topped 160 within a month after the first case — a man returning from the Middle East — was discovered on May 20. As of Sunday, the number of people infected hit 182 and the death toll reached 32. The rapid spread of the infection initially triggered fears of a mutation of the virus, which the WHO later denied. Instead, the outbreak has been blamed on slow action on the part of the South Korean government and hospitals due to their lack of awareness of the danger posed by MERS. Secondary infections are believed to have been facilitated by inadequate isolation of patients and insufficient protection of medical staff, failure to disclose the names of hospitals where the infection spread among patients, the practice of patients seeking care at multiple hospitals, and relatives and friends of hospitalized patients visiting them in large numbers.
Although the WHO does not see a need to impose travel restrictions, people who visit countries where MERS cases have been reported should frequently wash their hands and avoid close contact with people who exhibit symptoms of MERS, such as coughing.
People arriving in Japan from South Korea and the Middle East are asked at their ports of entry whether they suffer from symptoms such as a high fever, coughing or sneezing. Given that more than 10,000 people travel daily between Japan and South Korea, however, it is possible that some people infected with the virus won’t develop symptoms until after they pass through quarantine. Medical institutions who treat MERS patients should take sufficient precautionary measures to ensure against the spread of infection inside their facilities.
The health ministry advises people who suspect they may have contracted MERS to refrain from going directly to hospitals and instead call a public health center and follow its instructions. This procedure is key to preventing the infection from spreading. The ministry and local governments should take further steps to enlighten people about the importance of this procedure.