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The clinical and virological features of the first imported case causing MERS-CoV outbreak in South Korea, 2015.
BMC Infect Dis. 2017 07 14; 17(1):498.BI

Abstract

BACKGROUND

In 2015, the largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outside the Middle East occurred in South Korea. We summarized the epidemiological, clinical, and laboratory findings of the first Korean case of MERS-CoV and analyzed whole-genome sequences of MERS-CoV derived from the patient.

CASE PRESENTATION

A 68-year-old man developed fever and myalgia 7 days after returning to Korea, following a 10-day trip to the Middle East. Before diagnosis, he visited 4 hospitals, potentially resulting in secondary transmission to 28 patients. On admission to the National Medical Center (day 9, post-onset of clinical illness), he presented with drowsiness, hypoxia, and multiple patchy infiltrations on the chest radiograph. He was intubated (day 12) because of progressive acute respiratory distress syndrome (ARDS) and INF-α2a and ribavirin treatment was commenced. The treatment course was prolonged by superimposed ventilator associated pneumonia. MERS-CoV PCR results converted to negative from day 47 and the patient was discharged (day 137), following rehabilitation therapy. The complete genome sequence obtained from a sputum sample (taken on day 11) showed the highest sequence similarity (99.59%) with the virus from an outbreak in Riyadh, Saudi Arabia, in February 2015.

CONCLUSIONS

The first case of MERS-CoV infection had high transmissibility and was associated with a severe clinical course. The patient made a successful recovery after early treatment with antiviral agents and adequate supportive care. This first case in South Korea became a super-spreader because of improper infection control measures, rather than variations of the virus.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, 04564, Republic of Korea.Korea Centers for Disease Control and Prevention, Cheongju, 28159, Republic of Korea.Division of Pediatric Allergy & Pulmonology, Department of Pediatrics, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, 35015, Republic of Korea.Korea Centers for Disease Control and Prevention, Cheongju, 28159, Republic of Korea.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, 04564, Republic of Korea.Center for Infectious Diseases, National Medical Center, Seoul, 04564, Republic of Korea.Korea Centers for Disease Control and Prevention, Cheongju, 28159, Republic of Korea.Korea Centers for Disease Control and Prevention, Cheongju, 28159, Republic of Korea.Center for Infectious Diseases, National Medical Center, Seoul, 04564, Republic of Korea. simply.gayeon@nmc.or.kr.Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Medical Center, Seoul, 04564, Republic of Korea. ssabana777@gmail.com.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28709419

Citation

Lee, Ji Yeon, et al. "The Clinical and Virological Features of the First Imported Case Causing MERS-CoV Outbreak in South Korea, 2015." BMC Infectious Diseases, vol. 17, no. 1, 2017, p. 498.
Lee JY, Kim YJ, Chung EH, et al. The clinical and virological features of the first imported case causing MERS-CoV outbreak in South Korea, 2015. BMC Infect Dis. 2017;17(1):498.
Lee, J. Y., Kim, Y. J., Chung, E. H., Kim, D. W., Jeong, I., Kim, Y., Yun, M. R., Kim, S. S., Kim, G., & Joh, J. S. (2017). The clinical and virological features of the first imported case causing MERS-CoV outbreak in South Korea, 2015. BMC Infectious Diseases, 17(1), 498. https://doi.org/10.1186/s12879-017-2576-5
Lee JY, et al. The Clinical and Virological Features of the First Imported Case Causing MERS-CoV Outbreak in South Korea, 2015. BMC Infect Dis. 2017 07 14;17(1):498. PubMed PMID: 28709419.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The clinical and virological features of the first imported case causing MERS-CoV outbreak in South Korea, 2015. AU - Lee,Ji Yeon, AU - Kim,You-Jin, AU - Chung,Eun Hee, AU - Kim,Dae-Won, AU - Jeong,Ina, AU - Kim,Yeonjae, AU - Yun,Mi-Ran, AU - Kim,Sung Soon, AU - Kim,Gayeon, AU - Joh,Joon-Sung, Y1 - 2017/07/14/ PY - 2017/01/12/received PY - 2017/06/29/accepted PY - 2017/7/16/entrez PY - 2017/7/16/pubmed PY - 2017/10/11/medline KW - Complete genome KW - Genetic analysis KW - Index case KW - Korea KW - Middle East respiratory syndrome Coronavirus SP - 498 EP - 498 JF - BMC infectious diseases JO - BMC Infect Dis VL - 17 IS - 1 N2 - BACKGROUND: In 2015, the largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outside the Middle East occurred in South Korea. We summarized the epidemiological, clinical, and laboratory findings of the first Korean case of MERS-CoV and analyzed whole-genome sequences of MERS-CoV derived from the patient. CASE PRESENTATION: A 68-year-old man developed fever and myalgia 7 days after returning to Korea, following a 10-day trip to the Middle East. Before diagnosis, he visited 4 hospitals, potentially resulting in secondary transmission to 28 patients. On admission to the National Medical Center (day 9, post-onset of clinical illness), he presented with drowsiness, hypoxia, and multiple patchy infiltrations on the chest radiograph. He was intubated (day 12) because of progressive acute respiratory distress syndrome (ARDS) and INF-α2a and ribavirin treatment was commenced. The treatment course was prolonged by superimposed ventilator associated pneumonia. MERS-CoV PCR results converted to negative from day 47 and the patient was discharged (day 137), following rehabilitation therapy. The complete genome sequence obtained from a sputum sample (taken on day 11) showed the highest sequence similarity (99.59%) with the virus from an outbreak in Riyadh, Saudi Arabia, in February 2015. CONCLUSIONS: The first case of MERS-CoV infection had high transmissibility and was associated with a severe clinical course. The patient made a successful recovery after early treatment with antiviral agents and adequate supportive care. This first case in South Korea became a super-spreader because of improper infection control measures, rather than variations of the virus. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/28709419/The_clinical_and_virological_features_of_the_first_imported_case_causing_MERS_CoV_outbreak_in_South_Korea_2015_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2576-5 DB - PRIME DP - Unbound Medicine ER -