title: Assessment of the risk posed to Singapore by the 2015 Middle East respiratory syndrome outbreak in the Republic of Korea.
abstract: OBJECTIVE
  To assess the public health risk to Singapore posed by the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea in 2015.
  
  
  METHODS
  The likelihood of importation of MERS cases and the magnitude of the public health impact in Singapore were assessed to determine overall risk. Literature on the epidemiology and contextual factors associated with MERS coronavirus infection was collected and reviewed. Connectivity between the Republic of Korea and Singapore was analysed. Public health measures implemented by the two countries were reviewed.
  
  
  RESULTS
  The epidemiology of the 2015 MERS outbreak in the Republic of Korea remained similar to the MERS outbreaks in Saudi Arabia. In addition, strong infection control and response measures were effective in controlling the outbreak. In view of the air traffic between Singapore and MERS-affected areas, importation of MERS cases into Singapore is possible. Nonetheless, the risk of a serious public health impact to Singapore in the event of an imported case of MERS would be mitigated by its strong health-care system and established infection control practices.
  
  
  CONCLUSIONS
  The MERS outbreak was sparked by an exported case from the Middle East, which remains a concern as the reservoir of infection (thought to be camels) continues to exist in the Middle East, and sporadic cases in the community and outbreaks in health-care settings continue to occur there. This risk assessment highlights the need for Singapore to stay vigilant and to continue enhancing core public health capacities to detect and respond to MERS coronavirus.
authors: Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore .
authors: Emma Xuxiao
authors: EX
authors: Zhang
authors: Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore .
authors: Olivia Seen Huey
authors: OS
authors: Oh
authors: Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore .
authors: Wanhan
authors: W
authors: See
authors: Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore .
authors: Pream
authors: P
authors: Raj
authors: Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore .
authors: Lyn
authors: L
authors: James
authors: Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.; Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada.
authors: Kamran
authors: K
authors: Khan
authors: Epidemiology and Disease Control Division, Public Health Group, Ministry of Health, Singapore .
authors: Jeannie Su Hui
authors: JS
authors: Tey
mesh_terms: D000368:Aged; D064870:Air Travel / Q000706:statistics & numerical data; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D065207:Middle East Respiratory Syndrome Coronavirus; D011634:Public Health / Q000379:methods*; D011790:Quarantine / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012529:Saudi Arabia; D012846:Singapore / Q000453:epidemiology