Plipat Tanarak, Buathong Rome, Wacharapluesadee Supaporn, Siriarayapon Potjaman, Pittayawonganon Chakrarat, Sangsajja Chariya, Kaewpom Thongchai, Petcharat Sininat, Ponpinit Teerada, Jumpasri Jaruphan, Joyjinda Yutthana, Rodpan Apaporn, Ghai Siriporn, Jittmittraphap Akanitt, Khongwichit Sarawut, Smith Duncan R, Corman Victor M, Drosten Christian, Hemachudha Thiravat
Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
World Health Organization Collaborating Centre for Research and Training on Viral Zoonoses, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Euro Surveill. 2017 Aug 17;22(33). doi: 10.2807/1560-7917.ES.2017.22.33.30598.
Thailand reported the first Middle East respiratory syndrome (MERS) case on 18 June 2015 (day 4) in an Omani patient with heart condition who was diagnosed with pneumonia on hospital admission on 15 June 2015 (day 1). Two false negative RT-PCR on upper respiratory tract samples on days 2 and 3 led to a 48-hour diagnosis delay and a decision to transfer the patient out of the negative pressure unit (NPU). Subsequent examination of sputum later on day 3 confirmed MERS coronavirus (MERS-CoV) infection. The patient was immediately moved back into the NPU and then transferred to Bamrasnaradura Infectious Disease Institute. Over 170 contacts were traced; 48 were quarantined and 122 self-monitored for symptoms. High-risk close contacts exhibiting no symptoms, and whose laboratory testing on the 12th day after exposure was negative, were released on the 14th day. The Omani Ministry of Health (MOH) was immediately notified using the International Health Regulation (IHR) mechanism. Outbreak investigation was conducted in Oman, and was both published on the World Health Organization (WHO) intranet and shared with Thailand's IHR focal point. The key to successful infection control, with no secondary transmission, were the collaborative efforts among hospitals, laboratories and MOHs of both countries.
2015年6月18日(第4天),泰国报告首例中东呼吸综合征(MERS)病例,患者为一名患有心脏病的阿曼人,于2015年6月15日(第1天)入院时被诊断为肺炎。第2天和第3天上呼吸道样本的两次逆转录聚合酶链反应(RT-PCR)检测结果均为假阴性,导致诊断延迟48小时,并决定将患者转出负压病房(NPU)。第3天晚些时候对痰液的后续检测确诊为中东呼吸综合征冠状病毒(MERS-CoV)感染。患者立即被转回NPU,随后被转至班拉史那拉朱拉传染病研究所。追踪到170多名接触者;48人被隔离,122人进行自我症状监测。无症状的高风险密切接触者在暴露后第12天的实验室检测结果为阴性,于第14天解除隔离。通过《国际卫生条例》(IHR)机制立即通知了阿曼卫生部(MOH)。阿曼开展了疫情调查,并在世界卫生组织(WHO)内联网上发布,同时与泰国的《国际卫生条例》联络点进行了共享。两国医院、实验室和卫生部之间的合作努力是成功控制感染且无二代传播的关键。