J Korean Med Assoc.  2015 Jul;58(7):611-616. 10.5124/jkma.2015.58.7.611.

Emergency medical services in response to the middle east respiratory syndrome outbreak in Korea

• Lee KH

• KMID: 2064917
• DOI: http://doi.org/10.5124/jkma.2015.58.7.611

Abstract

After the 15 days from the first confirmed case of Middle East respiratory syndrome (MERS) in South Korea on May 20, 2015, the MERS infected case from emergency room (ER) was recognized. I provide the review of characteristics and prevention plan of re-outbreak of a MERS coronavirus at the ER in South Korea. Emergency medical services-related infections with MERS coronavirus have been reported 91 cases (49%) of total 186 cases in South Korea. The first patient was diagnosed with the ER and spent at least 3 days in a busy ER until he was admitted to an isolated room. The causes of MERS's spreading in ER are mainly due to emergency department (ED) overcrowding, long ED stay time, improper infection control system in ED, and a failure of emergency medical service coordination system in South Korea. Early and rapid detection of suspected infected patients with communicable diseases along with appropriate infection control system in ED, reducing the ED overcrowding and ER stay time would help to prevent the disease transmission in ED.

Keyword

Middle East respiratory syndrome coronavirus; Emergency medical services; Infection; Emergency room

MeSH Terms

Communicable Diseases
Coronavirus
Emergencies
Emergency Medical Services*
Emergency Service, Hospital
Humans
Infection Control
Korea
Middle East*

Figure

• 

  Figure 1 Number of total confirmed patients, and emergency room (ER) infected patient with Middle East respiratory syndrome coronavirus in South Korea (20 May to 04 July, 2015).

Reference

1. Korea Centers for Disease Control and Prevention. Middle East respiratory syndrome information [Internet]. Cheongju: Korea Centers for Disease Control and Prevention;2015. cited 2015 Jun 12. Available from: http://www.mers.go.kr/mers/html/jsp/main.jsp.

2. Choi JW, Kim KH, Cho YM, Kim SH. Current epidemiological situation of Middle East respiratory syndrome coronavirus clusters and implications for public health response in South Korea. J Korean Med Assoc. 2015; 58:487–497.

3. Lloyd-Smith JO, Schreiber SJ, Kopp PE, Getz WM. Superspreading and the effect of individual variation on disease emergence. Nature. 2005; 438:355–359.

4. Bassetti S, Bischoff WE, Walter M, Bassetti-Wyss BA, Mason L, Reboussin BA, D'Agostino RB Jr, Gw altney, Pfaller MA, Sherertz RJ. Dispersal of Staphylococcus aureus into the air associated with a rhinovirus infection. Infect Control Hosp Epidemiol. 2005; 26:196–203.

5. Krochmal P, Riley TA. Increased health care costs associated with ED overcrowding. Am J Emerg Med. 1994; 12:265–266.

6. Davis B, Sullivan S, Levine A, Dallara J. Factors affecting ED length-of-stay in surgical critical care patients. Am J Emerg Med. 1995; 13:495–500.

7. Selby JV, Fireman BH, Swain BE. Effect of a copayment on use of the emergency department in a health maintenance organization. N Engl J Med. 1996; 334:635–641.

8. Asplin BR, Magid DJ, Rhodes KV, Solberg LI, Lurie N, Camargo CA Jr. A conceptual model of emergency department crowding. Ann Emerg Med. 2003; 42:173–180.

9. Korea Centers for Disease Control and Prevention. Guideline for management of MERS. 2nd ed. Cheongju: Korea Centers for Disease Control and Prevention;2014.

10. American Academy of Emergency Medicine. Position statement on emergency physician-to-patient ED staffing ratios [Internet]. Milwaukee: American Academy of Emergency Medicine;2001. cited 2015 Jul 14. Available from: http://www.aaem.org/em-resources/position-statements/workforce/physician-to-patient.