Abstract
Although there were some positive viewpoints from international press and academia that the Republic of Korea (hereafter South Korea) successfully controlled the Middle East Respiratory Syndrome (MERS) outbreak in 2015, the domestic point of view towards the MERS response in South Korea was critical. As people in the world's 11^th^ largest economy, South Koreans criticized the failure of hospitals' initial response to the MERS index case and the lack of a proper control strategy for secondary and tertiary cases. To contain the MERS outbreak, South Korea implemented mainly three MERS control and intervention strategies: quarantine and isolation system, temporary closure of schools and cancelation of public events, and share of correct knowledge of MERS from trustworthy authorities, such as central and local governments and non-governmental organizations (NGOs). The traveler tracking system, the health care delivery system, and the Infectious Disease Prevention Act should be strengthened or amended. The establishment of bioethics and adherence to the World Health Organization (WHO)'s guidelines are also recommended to prevent possible future outbreak.
Highlights
The objective of this study is to analyze the Middle East Respiratory Syndrome (MERS) epidemic in South Korea in a critical view: 1) how MERS initially imported in South Korea; 2) how the index case spread the virus and what the consequences were; 3) what kinds of interventions were implemented to control MERS; 4) what lessons we learned from the MERS outbreak; and 5) what interventions would be recommended to control a future disease outbreak
5 it is essential for hospitals to strengthen biosafety and infection prevention/control procedures, such as enhancing early detection and prompt triage and isolating patients through strict safety control policies, to efficiently stop transmission of MERSCoV. 5-6 The 2015 MERS outbreak in South Korea began with a single 68-year-old patient who often traveled to the Middle East for his greenhouse building business
There was no exact data to count the total number of closed schools, it is estimated that more than 2,400 schools, including 22 universities canceled classes to protect students from the MERS outbreak. 16, 17 A joint South Korean-World Health Organization (WHO) mission said that it was unnecessary to put students in their homes because MERS was hospital-associated and schools were not linked to the transmission of the virus
Summary
The diagnostic pathway to MERS-CoV infection requires laboratory diagnosis through a real time reverse transcriptase PCR (rRT-PCT) or serological tests 3-4 at a tertiary general hospital, either with a referral slip from a primary or secondary hospital or through emergency medical services. Detecting MERS patients in a timely manner is challenging because symptoms of MERS-CoV infection are non-specific and the spectrum of illness caused by MERSCoV is not firmly defined, which requires clinical judgement from healthcare providers. 5-6 The 2015 MERS outbreak in South Korea began with a single 68-year-old patient (the index case) who often traveled to the Middle East for his greenhouse building business. The total number of quarantined individuals was 16,752 10, and the MERS outbreak caused the loss of US$ 18 billion in gross domestic product (GDP), equivalent to 1.31% of the annual average. 4 residents of South Korea criticized the government and hospitals harshly, saying that they failed to detect the index case and conduct an initial epidemiologic investigation as expeditiously as possible. Voluntary quarantine at home or in an isolated area was strongly recommended for those who were exposed to the disease
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