MOH’s Crisis Preparedness in Facing MERS-CoV

Ministry of Health (MOH) constantly strengthens its preparedness and response to MERS-CoV infection at all levels of the Ministry including at the international Points of Entry. MOH has also continued surveillance activity at the points of entry to screen travellers from countries affected by MERS-CoV.

The Ministry is continuously vigilant and has been implementing temperature monitoring at all key points of entry. Travellers detected with fever will be examined by the health team at the airport. If a traveller arrives from a MERS-CoV infected country and fulfils the criteria of a Patient Under Investigation (PUI) MERS-CoV case definition, they will be referred to the hospital for further investigation and management. If they are not suspected as PUI MERS-CoV, they will be given a Health Alert Card to remind them to seek immediate medical advice if they subsequently develop symptoms such as fever, cough and breathing difficulty within 14 days of arriving in Malaysia. It is important that they mention their recent travel history to the attending doctor.

The Malaysian health system’s preparedness and response has been tested before when we were able to diagnose the first case of MERS-CoV in April 2014 and took prompt preventive and control measures through the existing surveillance, notification system and the expansion of laboratory capacities to test for the virus nationwide through multi-sectoral collaboration. Since 2013 till today, 801 cases have been notified to MOH Malaysia as PUI MERS-CoV, 799 cases tested as negative and only one case tested as positive (that was in April 2014), while one result is still pending.

Regarding the current situation in Republic of Korea, based on WHO’s report, the ongoing cluster is resulting from an imported case with travel history to the Middle East and the subsequent human-to-human transmission is similar to healthcare setting outbreaks in the Middle East. Adequate infection prevention and control measures have ended transmission in previous outbreaks.

To date, all cases were epidemiologically linked to the index case suggesting only one generation of spread and transmission appears to have occurred before isolation of the index case. Currently, there is no evidence of sustained human-to-human transmission in the community, and no evidence of airborne transmission.

Contact tracing and monitoring by health authorities from the Republic of Korea and China are ongoing. Timely information sharing of cases with the World Health Organization is also occurring.

Therefore, Malaysia is at the utmost preparedness and response in facing MERS-CoV and other emerging infectious disease with our previous experience in handling the first case of MERS-CoV in Malaysia; continuous enhanced preparedness and response including ongoing surveillance; increased laboratory capacity for detection of virus; strengthened clinical management and infection prevention and control (IPC); public health intervention; and continuous awareness on MERS-CoV to travellers, Malaysian pilgrims and public. MOH Malaysia will continue to monitor the MERS-CoV situation and is constantly in communication with WHO for the latest updates. We will review our preparedness and response from time to time accordingly.

Datuk Dr Noor Hisham Abdullah

Director General of Health Malaysia

2 June 2015