Mers in Thailand: Cautious optimism as no new cases reported (Updated Sunday)

The Mers news this Sunday morning seems generally good, good enough for the Bangkok Post to headline it's story "Mers spread seems to be contained".

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Sunday morning

Cautious optimism as no new cases reported

The Mers news this morning seems generally good, good enough for the Bangkok Post to headline it's story "Mers spread seems to be contained".

It is important to remember that while Middle East Respiratory Syndrome is a deadly disease and one which requires extreme vigilance on the part of health officials, the number of people infected world-wide is not huge. In its latest report, the World Health Organisation says it has been notified of 1,334 laboratory-confirmed cases of infection since September 2012, included at least 471 deaths.

Here are excerpts from this morning's Bangkok Post story plus excerpts from online stories.

Mers spread seems to be contained

POST REPORTERS

All 175 people who were potentially exposed to Middle East Respiratory Syndrome are unlikely to have contracted the infection, Public Health Minister Rajata Rajatanavin said yesterday.

His assurance was based on the results of tests for the Mers virus conducted on three relatives of the 75-year-old man from Oman who was confirmed as the first Mers case in Thailand.

The relatives were closest to the man as they travelled from Oman to Bangkok but so far tests have not shown positive and their general condition was fine, the minister said. They were the most likely to contract the virus, so chances were good that the other 175 people at risk will be free of the virus.

Dr Rajata yesterday visited Bamrasnaradura Infectious Diseases Institute where the Omani Mers patient was being treated.

The patient’s condition had improved, he said. He had regained consciousness, was less dependent on the respirator, showed better lung X-ray results, and his appetite had increased.

Nakhon Ratchasima public health office chief Wichai Kattiyawittayakul said he had isolated three members of a Thai family who were on the flight to monitor their condition.

Dr Wichai said the three are a father, a mother and their 6-year-old son. The parents took the boy for treatment at Pak Chong Nana Hospital after he developed flu-like symptoms. Initial diagnosis showed he had a normal flu, but health authorities followed strict preventive guidelines by isolating them and their blood samples will be sent for testing today.

Meanwhile, the woman from Buriram who sat near the Omani man on the plane has been located and quarantined. Surachai Piragsa reports

Authorities have located a Buri Ram resident who sat near the Omani man confirmed as having Thailand's first case of Mers on a flight to Bangkok.

Health workers on Saturday examined Chaluay Amatsena, 38, at her home in Chalerm Phrakiat district of the northeastern province. Initial tests showed she had no symptoms of the virus that has killed 24 people in South Korea.

As of late Saturday, the number of people in Thailand potentially exposed to Mers had reached 175.

Relatives of the woman said a team of health officials went to her house on Saturday morning before taking her to Chalerm Prakiat Hospital, where she would be held for 14 days as a precautionary measure.

Finally, Reuters reports even better news from South Korea:

South Korea's health ministry said that no new cases of Middle East Respiratory Syndrome (Mers) had been recorded, for the first time in 16 days, and there were no more deaths.

Latest: The news is not quite as good as first reported. This morning three new cases were reported in South Korea, but no deaths. As usual, two of the latest victims are medical workers who had treated Mers patitents.

Saturday afternoon

Rumours of a Mers case in Chiang Mai are false

Social media rumours that a man in Chiang May who had just returned from South Korea had tested postitive for Mers have been proven false.  The man has a bad cold, said Surasing Vissarutrat, deputy chief of the Chiang Mai Provincial Health Office.  If you think about it, it would be very difficult to get Mers in South Korea even if you wanted too with all the safety precautions health officials are taking.

Saturday morning update

As of Saturday morning there was still no indication that the Mers virus had spread beyond the 75-year-old victim and possibly two family members who have been isolated. Attempts continue to find and monitor those who may have come in contact with the man.

Here's more information on how Bamrungrad Hospital, the private hospital where the 75-years-old Mers patient was first admitted, screens its patients and how the elderly man was quickly isolated and tested for the disease. As a precaution, 58 hospital staff have taken temporary leave and being closely monitored for signs of Mers.

From Bangkok Post reporters Paritta Wangkiat, Ariane Kupferman-Sutthavong & Patsara Jikkham

The hospital has rolled out its toughest safety measures to prevent Mers from spreading to other patients, Dr Korpong Rookkapan, chief operations officer at Bumrungrad Hospital said. Bumrungrad Hospital has never before accepted any patients from overseas who posed a risk, he said, adding that the hospital has been on alert for the Mers virus since 2012.

Walk-in patients will be submitted to a triaging procedure, he said.

Dr Mondej Sookpranee, of the hospital's Infectious Diseases Department, said a team of doctors is on hand to question patients and observe their symptoms from the moment they step into the hospital.

"Their role is to find out whether these patients fit the criteria which would place them in risk groups," Dr Mondej explained.

If this is the case, they will be further examined in an isolation room that has a separate air filtration system from the remaining hospital buildings.

"The medical team overseeing those risk groups won't be looking after other patients either," he said.

Regarding the 75-year-old man from Oman, Dr Korpong said he walked into the hospital on Monday evening. The emergency room was empty at that time and the man and his family were quickly isolated after going through triaging.

He showed signs of fatigue and shortness of breath. An X-ray was performed but doctors could not diagnose whether the man had pneumonia or had suffered a heart attack, or both.

He only developed a fever over the next few days, Dr Korpong said.

Bumrungrad vice-president Dr Channit Thanphiphat. said the Public Health Ministry was immediately alerted last Monday about doctors' suspicions that the man had contracted Mers. The patient underwent four tests between Tuesday and Thursday, with the first positive result delivered on Wednesday.

Friday evening update

Thailand's first Mers patient, an Omani national, is still in a stable condition, officials at Bamrasnaradura Infectious Diseases Institute in Nonthaburi's Muang district said this morning. They have been able to reduce the amount of oxygen assistance he needs and his heart is still functioning well. Earlier in the day, officials said his family members had showed no sign of the disease, but now the Health Minister says that has changed. Two relatives are being tested and the final results won't be known for two days.

Meanwhile, one of the big problems with Mers is that it takes time to diagnose – in this case, several days – so that people who might have been exposed have scattered to many places around the country and even abroad. It is not that easy to find them. Here is an update on the current situation from our online reporters.

Tonight, the media is finally openly naming Bumrungrad Hospital as the private hospital where the Mers patient was admitted. Hospital officials say they are confident the hospital is Mers-free, but 58 staff members have been given temporary leave and are being closely monitored.

Hunt for Buri Ram man who sat near Mers patient

68 deemed at high-risk of Mers infection

Health officials are looking for a man from Buri Ram who sat near the Omani man now confirmed as having Thailand's first case of Middle East Respiratory Syndrome (Mers) on a flight to Bangkok.

The 75-year-old Omani has tested positive for the deadly virus.

Public Health Minister Rajata Rajatanavin said there were a total of 106 passengers and crew on the same flight as the Omani man. Their risk of infection ranged from high to low.

The ministry is focussing on passengers who sat in the same row, and the two rows in front and behind the infected man.

One of them is a native of Buri Ram. Health officials know his name, but have not been able to contact him.

The health ministry initially announced 59 people were in quarantine, but today it revised the number of people who had been in contact with the infected man to 161. Of these 68 were classed as being at high risk, including the three relatives of the Omani who accompanied him to Thailand.

Of the 68 in the high-risk group, 21 were passengers in the two rows in front and behind the infected man – his three relatives, a Buri Ram man, two foreigners who had left Thailand, and 15 foreigners still in Thailand.

The other 47 were health personnel at a Bangkok private hospital where the infected man went for treatment about his heart problem.

There are 93 people deemed at medium to low risk – another 85 passengers on the same flight, of which 18 of them, including 12 cabin crew, have left Thailand. Two taxi drivers, one already accounted for, and six hotel staff.

Dr Rajata said currently the infected man's son had a low fever and his younger brother had a cough. Samples of sinus tissue and throat fluid had been taken from both of them and had been sent for laboratory testing. (Latest: Health officials say it will take two more days before conclusive lab results will be known.)

The two men were now in quarantine and being closely monitored. It was unlikely the virus would spread out of the ministry's Bamrasnaradura Infectious Disease Institution in Nonthaburi's Muang district.

The infected man was being kept in isolation. His condition was stable but he could not breathe unassisted.

Dr Rajata said the ministry was also still looking for a taxi driver, though he might be a low risk case as the length of his exposure to the Omani man was short  – a ride from the hotel to a private hospital.

Friday morning story

First MERS case confirmed in Thailand

Below is a more detailed story than the one I posted late last night. A big concern now, of course, is to keep the disease from spreading, so we will be following the story closely.

From the recent experience in South Korea, quickly finding, monitoring and possibly quarantining all those who came in contact with the Mers victim will be crucial. Fortunately, Mers is not spread through the air, so if the quarantine is effective, it should not spread into the surrounding community.

Nation's first Mers case strikes

Omani man, 75, quarantined after testing positive

Post Reporters

The Public Health Ministry has confirmed the first case of Middle East Respiratory Syndrome (Mers) virus infection in the country as medical authorities gave assurances they will do all they can to prevent the spread of the virus.

Public Health Minister Rajata Rajatanavin said Thursday a 75-year-old man from Oman has tested positive for the deadly virus.

The man, whose identity has not been revealed, was admitted to a private hospital on Monday for heart disease treatment.

This prompted hospital staff to take stringent measures to prevent any possible spread of the Mers virus. Samples of phlegm taken from the patient were tested several times before it was confirmed that the patient had contracted the virus.

The patient was transferred to the Public Health Ministry's Bamrasnaradura Infectious Diseases Institute in Nonthaburi's Muang district Thursday morning.

The man has now been quarantined at the institute. His condition remains stable, Dr Rajata said.

Upon the man's arrival at Suvarnabhumi airport, he had no fever, but he began coughing and had difficulty breathing when he was admitted to the private hospital, the minister said.

Dr Rajata said authorities are now monitoring 59 people suspected of coming into contact with the patient during and after his journey to Thailand on the aeroplane.

They include three of his family members who travelled with him, passengers who sat near him on the plane, cabin crew, medical staff at the private hospital and two taxi drivers.

The family members have been invited to stay at the institute, Dr Rajata said, adding that authorities will contact others to seek updates on their health condition.

Dr Rajata urged the public to remain calm because the patient has now been quarantined and is under close observation.

Prasert Thongcharoen, a professor emeritus who is an adviser to the Disease Control Department, said the patient is an Omani national and made a living as a fisherman there. Camels are thought to be carriers of the virus but there are none in his home town of Jalan.

The man told doctors he had avoided contact with camels, although he said he drank camel's milk, said Dr Prasert, who chairs a committee of experts on virology and epidemiology at the department. The man arrived in Thailand on Monday on Oman Air flight WY0815. His family checked into a hotel in Sukhumvit Soi 3.

Dr Prasert gave assurances that every effort will be made to contain the spread of the disease.

"We are confident we can prevent the disease from spreading," he said.

Thanarak Phaliphat, director of the Epidemiology Bureau under the Disease Control Department, said authorities will regularly telephone those who came into contact with the patient and will ask them to stop work temporarily.

Next week, authorities will visit each of them again and continue to monitor their condition for another two weeks, Dr Thanarak said.

Apichai Mongkol, chief of the Medical Sciences Department, said the private hospital that admitted the patient sent liquid samples from the patient for several lab tests at four different universities, before it was confirmed the man was infected with Mers.

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