Risk assessment and laboratory investigation of respiratory illness in travellers returning to Singapore 2012-2015: experience from the MERS-CoV Surveillance Programme

Epidemiol Infect. 2017 Jan;145(2):285-288. doi: 10.1017/S0950268816002326. Epub 2016 Oct 26.

Abstract

Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV), Singapore has enhanced its national surveillance system to detect the potential importation of this novel pathogen. Using the guidelines from the Singapore Ministry of Health, a suspect case was defined as a person with clinical signs and symptoms suggestive of pneumonia or severe respiratory infection with breathlessness, and with an epidemiological link to countries where MERS-CoV cases had been reported within the preceding 14 days. This report describes a retrospective review of 851 suspected MERS-CoV cases assessed at the adult tertiary-care hospital in Singapore between September 2012 and December 2015. In total, 262 patients (31%) were hospitalized. All had MERS-CoV infection ruled out by RT-PCR or clinical assessment. Two hundred and thirty (88%) of the hospitalized patients were also investigated for influenza virus by RT-PCR. Of these, 62 (27%) tested positive for seasonal influenza. None of the patients with positive influenza results had been vaccinated in the year prior to hospital admission. Ninety-three (36%) out of the 262 hospitalized patients had clinical and/or radiological evidence of pneumonia. This study demonstrates the potential benefits of pre-travel vaccination against influenza and pneumococcal disease.

Keywords: Influenza (seasonal); surveillance.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Coronavirus Infections / epidemiology*
  • Epidemiological Monitoring*
  • Female
  • Humans
  • Infant
  • Influenza, Human / epidemiology*
  • Male
  • Middle Aged
  • Middle East Respiratory Syndrome Coronavirus / genetics
  • Middle East Respiratory Syndrome Coronavirus / isolation & purification
  • Orthomyxoviridae / genetics
  • Orthomyxoviridae / isolation & purification
  • Pneumonia / epidemiology*
  • Retrospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • Risk Assessment
  • Singapore / epidemiology
  • Travel*
  • Young Adult