Epidemiologic investigation of Middle East respiratory syndrome: Lessons learnt from Korea and China in new epidemics

Dear Sir,

Emerging Middle East respiratory syndrome (MERS) has become the big issue in public health. The concern is on the present epidemiologic investigation of MERS. The simple question is whether there is any pitfall. The recent publications on MERS in a Korean journal are very interesting.^[1],[2] Chang et al. discussed on MERS epidemiological investigation in Korea and noted that “efforts should be made to establish a methodology for rapid tracking of all possible contacts and elimination-based identification of the precise modes of transmission.”^[1] Leeet al. and Kiet al. also noted that “governmental authorities in Korea enforce preventive policies, foster the development of highly qualified personnel, and increase investment in the public health domain of infectious disease prevention.”^[2] Indeed, the situation of epidemic of MERS in Korea is considered serious. However, it is questionable whether we can accuse of the present public health system regarding this new emerging disease. In fact, as a new disease, it is usually the lack of knowledge and good system in any setting. For a new emerging disease, “a good surveillance system to monitor disease transmission dynamics is essential and needs to be implemented to combat the outbreak”^[3] and it is noted for “the research priorities on the development of appropriate combined disease monitoring systems and good policy to allocate available tools and technology in resource-limited settings for epidemic scenarios.”^[3] In the early phase of a new emerging disease outbreak, the diagnostic tool is usually lacking and this can be the problem that leads to uncontrolled widening of the outbreak.^[3] Indeed, the standards of epidemiologic investigation of MERS might not be different from other countries. However, the difference of success in control of disease might be due to the measure to combat the disease in the early outbreak phase. In China, where MERS was also detected in the similar period, very strict control is applied by governmental policies and this might be the key for success in disease control in China.^[4] The lessons learnt from Korea and China are very interesting. Nevertheless, the lessons are relevant to the previous surveillance system of the new epidemic. One might note that especially China’s situation is not comparable to that in Korea. In Korea, physicians at the first line could not catch the diagnosis of MERS. The new suggestions are:

1. The active epidemiological system setting is required for any country when there is a new emerging disease in any part of the world and
2. Strict control during outbreak is the key for success.

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.179127