Control of Middle East respiratory syndrome.

To the Editor:

The recent report, “Outcome of strict implementation of infection prevention control measures during an outbreak of Middle East respiratory syndrome,” by El Bushra et al is very interesting. El Bushra et al noted that “proper institution of infection prevention and control (IPC) measures during management of an outbreak of MERS [Middle East respiratory syndrome] could remarkably change the course of the outbreak.” We would like to share ideas and experience from Thailand where the disease already existed. There are at least 3 imported cases of Middle East respiratory syndrome in Thailand, and the disease control is successful. All patients were from the Middle East and received early diagnoses for Middle East respiratory syndrome. All patients were treated in the same tertiary hospital with a standard isolation unit. The key factors for success in disease control are early diagnosis, prompt treatment, and sufficient facilities for management of contagious disease. Focusing on prevention of further nosocomial infection to medical personnel, strict infection prevention and control is proven for effectiveness. According to a recent survey on the hospital that was used for management of imported Middle East respiratory syndrome cases, “all contacts reported 100% compliance with hand hygiene, using N95 respirator, performing respirator fit test, wearing gown, gloves, eye protection, and cap during their entire working period.” Nevertheless, a big concern is availability of standard ventilation-filtration units for respiratory isolation. Sufficient respiratory isolation units are required.