The MoH has taken measures to prevent its entry into the country

Health: The recent confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Thailand has put Bhutan on the red alert zone and pushed the country to step up its surveillance efforts.

The health ministry and World Health Organisation (WHO), has accordingly initiated preparatory measures to prevent MERS-CoV from entering Bhutan, a press release from the health ministry states.

MERS is a viral respiratory disease caused by a coronavirus, which was first identified in Saudi Arabia in 2012. “A typical case of MERS includes fever, cough and or shortness of breath,” the health ministry’s press release states. “Pneumonia is a common finding on examination and gastrointestinal symptoms, including diarrhea, have also been reported.”

Coronaviruses are a large family of viruses that can cause diseases ranging from common cold to Severe Acute Respiratory Syndrome (SARS). “The virus does not appear to pass easily from person to person unless there is close contact, such as providing unprotected care to an infected patient,” the WHO stated.

Starting yesterday, the health authority at Paro International airport started collecting health-screening forms from all incoming Bangkok passengers.  The health desk collected 82 forms from Druk Air passengers and 57 from Tashi Air passengers.

The preparedness measures include activation of the ministerial (high) level committee, preparedness measures at the point of entry at Paro airport, public notifications and introduction of mandatory health screening for every incoming passenger from Bangkok.

Heath officials at Paro airport said they distributed the forms to be given to passengers on June 21.   While passengers flying in from Bangkok are cooperating in filling up the forms, other passengers from Delhi, Kolkata and Dhaka aren’t as willing, because the form mentions only Thailand.

“They say the form specifically mentions passengers coming in from Thailand and refuse to fill the health declaration forms,” a health official at the airport said.

The health declaration form states, “…the ministry of health, royal government of Bhutan mandatorily requires all passengers coming from Thailand by all modes of transport to fill in the form.”

The issue was raised with the health ministry and it was decided that forms would be collected only from passengers flying in from Bangkok, although the initial instruction was to make all passengers fill in the form.

“The health ministry requests all incoming passengers to fill up the health declaration form on arrival and hand over the form to the health desk at the Paro international airport,” the press release states.

Surveillance system for influenza like illness (ILI) and severe acute respiratory illness (SARI) in all hospitals and BHUs has also been intensified. “The department of public health has also done an assessment of screening facilities at Paro airport, surveillance, prevention and treatment facilities at JDWRH and Paro district hospital,” the press release stated.

While WHO doesn’t recommend the application of any travel or trade restrictions at this point, it has requested people travelling to affected countries to take precautionary measures.

National international health regulations (IHR) focal person, Dr Karma Lhazeen said the preparedness measures already exist and that the declaration forms are for contact tracing. “It’s not as infectious as Ebola and doesn’t spread as fast but MERS has come closer to home than Ebola,” she said.

Since the first case was confirmed on May 20 in the Republic of Korea, the total reported cases stands at 167 including one in China and another in Thailand.

While the health ministry has already alerted the districts since June 5, the ministry on June 19 issued an office order for some 30 officials to intensify and carry our MERS-CoV prevention activity at the earliest. “The officials mentioned are to make themselves available whenever requested,” the office order stated.

Sonam Pelden