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Assessing the risk of MERS importation from South Korea into cities of China: a retrospective study

Assessing the risk of MERS importation from South Korea into cities of China: a retrospective study
Assessing the risk of MERS importation from South Korea into cities of China: a retrospective study
On May 20th, 2015, the Republic of Korea reported its first laboratory-confirmed case of Middle East respiratory syndrome coronavirus(MERS-CoV) infection, followed by the largest outbreak of MERS-CoV outside of the Middle East, which included a case imported from South Korea into China. To understand the risk of MERS importation into China, we analyzed the epidemic situation of MERS globally, especially in South Korea, using the data of MERS cases notified to the World Health Organization. Then the volumes and travel destinations of passengers from South Korea to China were explored based on the historic flight itinerary data in June 2014. The relative probability of MERS importation from South Korea to cities in China was retrospectively assessed with the assumptions:(i) the same probability of MERS-CoV infection in the population of South Korea;(ii) an equal chance of traveling from South Korea to the cities in China between the infected and uninfected population;(iii) the same mobility pattern of air travelers in 2014 and 2015;(iv) the epidemic of MERS was stable during the study period in 2015;(v) the volume of air traveler from South Koreas has a potential correlation with the importation risk of MERS-CoV from the Republic of Korea to China. As of September 2nd, 2015, 26 countries have reported 1542 laboratory-confirmed MERS cases, including 185 cases in the Republic of Korea. In June 2014, a total of 1978647 passengers departed from the Republic of Korea by airplane, of which 697922(35.3%) travelers arrived in the mainland of China, Hong Kong and Macao Special Administrative Region of China. The primary airports of entry into China were located in Shanghai, Hong Kong, Beijing, and Qingdao. With the assumptions of this study, if a passenger with MERS-CoV infection traveled from South Korea to China, there was a highest probability(23.2%) of entry into the cities in Pearl River Delta(Hong Kong, Guangzhou, Shenzhen and Macao) with a secondary probability to cities in Yangtze River Delta(21.6%), Beijing and Tianjin(15.5%), and cities in Shangdong province(12.2%). Among the four primary destinations(Hong Kong, Shanghai, Beijing and Qingdao) of the travelers from South Korea, the entry airport will be most likely located in Hong Kong(34.9%) for the case departing from Seoul, and Shanghai(30.4%) and Beijing(29.5%) for the infected passenger departing from Busan, and Shanghai(67.0%) if the case leaved from Jeju Island of South Korea. In reality, we found that Hong Kong was the entry point of the imported MERS case from Seoul of South Korea, then travelling to the mainland of China via ground transportations. This study shows that there was a variable risk of MERS importation from South Korea into Chinese cities via commercial air travel, which can provide relative basis for assessing the high risk areas of the importation of MERS and the development of the pre-warming system and the control methods. China could heighten surveillance at the primary points of entry and leading destination cities of China, as a means to detect individuals with MERS-Co V infection at the earliest possible stage.
0023-074X
1016-1024
Geng, MengJie
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Khan, Kamran
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Ren, Xiang
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German, Marrhew
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Creatore, Maria
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Wang, Liping
ef5828b8-d874-42db-bb25-713890281af2
Li, Zhongjie
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Gao, Fu
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Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Yu, Hongjie
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Geng, MengJie
e6f1eb5b-86e9-4ac4-89ae-a9ec3b6df56f
Khan, Kamran
f55abc91-5af0-4175-a845-90e88ab2e45a
Ren, Xiang
79e57eaa-a085-47b3-a8b3-274840938696
German, Marrhew
7f8a1a2d-8761-401b-9a7a-caef663e98c4
Creatore, Maria
4dffbe36-2d44-47f6-a61b-57cfd0c9f37b
Wang, Liping
ef5828b8-d874-42db-bb25-713890281af2
Li, Zhongjie
f89a98f7-f6d3-4312-995a-bc658ae9a93f
Gao, Fu
7c4b3ee7-56dd-4f02-a329-847c4293e6cc
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c

Geng, MengJie, Khan, Kamran, Ren, Xiang, German, Marrhew, Creatore, Maria, Wang, Liping, Li, Zhongjie, Gao, Fu, Lai, Shengjie and Yu, Hongjie (2016) Assessing the risk of MERS importation from South Korea into cities of China: a retrospective study. Chinese Science Bulletin [Ke xue tong bao], 61 (9), 1016-1024. (doi:10.1360/N972015-01174).

Record type: Article

Abstract

On May 20th, 2015, the Republic of Korea reported its first laboratory-confirmed case of Middle East respiratory syndrome coronavirus(MERS-CoV) infection, followed by the largest outbreak of MERS-CoV outside of the Middle East, which included a case imported from South Korea into China. To understand the risk of MERS importation into China, we analyzed the epidemic situation of MERS globally, especially in South Korea, using the data of MERS cases notified to the World Health Organization. Then the volumes and travel destinations of passengers from South Korea to China were explored based on the historic flight itinerary data in June 2014. The relative probability of MERS importation from South Korea to cities in China was retrospectively assessed with the assumptions:(i) the same probability of MERS-CoV infection in the population of South Korea;(ii) an equal chance of traveling from South Korea to the cities in China between the infected and uninfected population;(iii) the same mobility pattern of air travelers in 2014 and 2015;(iv) the epidemic of MERS was stable during the study period in 2015;(v) the volume of air traveler from South Koreas has a potential correlation with the importation risk of MERS-CoV from the Republic of Korea to China. As of September 2nd, 2015, 26 countries have reported 1542 laboratory-confirmed MERS cases, including 185 cases in the Republic of Korea. In June 2014, a total of 1978647 passengers departed from the Republic of Korea by airplane, of which 697922(35.3%) travelers arrived in the mainland of China, Hong Kong and Macao Special Administrative Region of China. The primary airports of entry into China were located in Shanghai, Hong Kong, Beijing, and Qingdao. With the assumptions of this study, if a passenger with MERS-CoV infection traveled from South Korea to China, there was a highest probability(23.2%) of entry into the cities in Pearl River Delta(Hong Kong, Guangzhou, Shenzhen and Macao) with a secondary probability to cities in Yangtze River Delta(21.6%), Beijing and Tianjin(15.5%), and cities in Shangdong province(12.2%). Among the four primary destinations(Hong Kong, Shanghai, Beijing and Qingdao) of the travelers from South Korea, the entry airport will be most likely located in Hong Kong(34.9%) for the case departing from Seoul, and Shanghai(30.4%) and Beijing(29.5%) for the infected passenger departing from Busan, and Shanghai(67.0%) if the case leaved from Jeju Island of South Korea. In reality, we found that Hong Kong was the entry point of the imported MERS case from Seoul of South Korea, then travelling to the mainland of China via ground transportations. This study shows that there was a variable risk of MERS importation from South Korea into Chinese cities via commercial air travel, which can provide relative basis for assessing the high risk areas of the importation of MERS and the development of the pre-warming system and the control methods. China could heighten surveillance at the primary points of entry and leading destination cities of China, as a means to detect individuals with MERS-Co V infection at the earliest possible stage.

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Accepted/In Press date: 10 January 2016
Published date: 8 March 2016
Organisations: WorldPop, Population, Health & Wellbeing (PHeW)

Identifiers

Local EPrints ID: 396777
URI: https://eprints.soton.ac.uk/id/eprint/396777
ISSN: 0023-074X
PURE UUID: bbf72247-d81e-4077-aa94-725987f3486d
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 14 Jun 2016 09:40
Last modified: 08 Mar 2019 01:21

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Contributors

Author: MengJie Geng
Author: Kamran Khan
Author: Xiang Ren
Author: Marrhew German
Author: Maria Creatore
Author: Liping Wang
Author: Zhongjie Li
Author: Fu Gao
Author: Shengjie Lai ORCID iD
Author: Hongjie Yu

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