Update: Bhutan’s surveillance for Middle East respiratory syndrome coronavirus (MERS- CoV) will continue until the World Health Organisation (WHO) declares the situation safe, public health director Dr Pandup Tshering said.

Bhutan was on red alert zone after Thailand confirmed a case of MERS-CoV on June 18. WHO had then urged countries in the region to step up vigil and review preparedness to respond to the disease.

On July 3, the Bamrasnaradura Infectious Diseases Institute in Thailand discharged the 75-year-old man after he was confirmed to have fully recovered from the disease, the Thai media reported.  The 176 people who had been in contact with him had also been cleared of the virus, according to the Thai health officials. The man had travelled to Thailand for medical treatment.

Given its large number of tourist arrivals and its position as a regional medical hub, Thailand’s heath authority has noted that the country was still at risk and that screening measures would continue to prevent a possible spread even through the patient had fully recovered.

“We have to get WHO’s advise and until then our surveillance would be on,” Dr Pandup Tshering.

Starting June 23 until yesterday, the health authority at Paro international airport has collected around 650 health declaration forms from all incoming Bangkok passengers.

The health declaration forms were introduced to facilitate contact tracing or follow up for 14 days, according to health officials.

Soon after the case was confirmed in Thailand, the health ministry notified all dzongkhags to intensify its surveillance for influenza like illness (ILI) and severe acute respiratory illness (SARI) in all hospitals and BHUs.

For travellers, the health ministry sent a total of 49 notifications to ministries, organisations and commissions on MERS – CoV in Thailand and made public announcements on health declaration forms.

The health ministry had also worked on its plan of action should Bhutan report a case of MERS.

According to the public health department, it would step up and triage all acute respiratory illness/ influenza like illness in hospitals. Triage is the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.

Health officials would trace and follow all close contacts for 14 days and identify a health team in each hospital for treatment. Isolation rooms for patients and referral facilities such as ambulance for MERS at the airport would be identified for treatment. Facilities to quarantine suspects for 14 days would also be identified.

To control infection, all staff would be trained on disinfection of premises, ambulances and aircraft while a screening area outside the airport terminal would also be established.

In an earlier interview, international health regulations (IHR) focal person, Dr Karma Lhazeen said, “It’s not as infectious as Ebola and doesn’t spread as fast but MERS has come closer to home than Ebola.”

Since May 20 this year, a total of 175 cases of MERS and 27 deaths were reported in South Korea.

According to the health ministry, it’s not yet clear how MERS-CoV is transmitted and therefore, it’s not possible to identify specific groups at risk.  The health ministry states that individuals at high risk of severe disease include those with diabetes, chronic lung disease, pre-existing renal failure or weak immune system.

By Sonam Pelden