A Case of Long-term Excretion and Subclinical Infection With Middle East Respiratory Syndrome Coronavirus in a Healthcare Worker

Algethamy, Manal; Corman, Victor M.; Hussain, Raheela; Al‐Tawfiq, Jaffar A.; Drosten, Christian; Memish, Ziad A.

doi:10.1093/cid/ciu1135

Cited by 59 publications

(59 citation statements)

References 5 publications

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“…31 In another report, an asymptomatic healthcare worker had detectable MERS-CoV for more than five weeks. 58 Although MERS-CoV transmission from an asymptomatic individual remains a strong probability, this has never been documented. 37,38 In the meantime, clinicians were becoming increasingly aware that MERS-CoV infections were being diagnosed in patients whose clinical presentations did not conform to those definitions, including the absence of fever, lack of respiratory involvement and the predominance of gastrointestinal or nonspecific generalized symptoms.…”

Section: Lesson Three: Guidelines Should Not Prevail Over Sound Clinimentioning

confidence: 99%

Middle East respiratory syndrome coronavirus (MERS-CoV): what lessons can we learn?

Omrani

Shalhoub

2015

Journal of Hospital Infection

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The Middle East Respiratory Coronavirus (MERS-CoV) was first isolated from a patient who died with severe pneumonia in June 2012. As of 19 June 2015, a total of 1,338 MERS-CoV infections have been notified to the World Health Organization (WHO). Clinical illness associated with MERS-CoV ranges from mild upper respiratory symptoms to rapidly progressive pneumonia and multi-organ failure. A significant proportion of patients present with non-respiratory symptoms such as headache, myalgia, vomiting and diarrhoea. A few potential therapeutic agents have been identified but none have been conclusively shown to be clinically effective. Human to human transmission is well documented, but the epidemic potential of MERS-CoV remains limited at present. Healthcare-associated clusters of MERS-CoV have been responsible for the majority of reported cases. The largest outbreaks have been driven by delayed diagnosis, overcrowding and poor infection control practices. However, chains of MERS-CoV transmission can be readily interrupted with implementation of appropriate control measures. As with any emerging infectious disease, guidelines for MERS-CoV case identification and surveillance evolved as new data became available. Sound clinical judgment is required to identify unusual presentations and trigger appropriate control precautions. Evidence from multiple sources implicates dromedary camels as natural hosts of MERS-CoV. Camel to human transmission has been demonstrated, but the exact mechanism of infection remains uncertain. The ubiquitously available social media have facilitated communication and networking amongst healthcare professionals and eventually proved to be important channels for presenting the public with factual material, timely updates and relevant advice.

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Section: Lesson Three: Guidelines Should Not Prevail Over Sound Clinimentioning

confidence: 99%

Middle East respiratory syndrome coronavirus (MERS-CoV): what lessons can we learn?

Omrani

Shalhoub

2015

Journal of Hospital Infection

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“…One study found that 30% of contacts and 76% of cases were still positive for MERS-CoV by PCR 12 days after initial positive samples [56]. A case report showed that a HCW shed MERS-COV for approximately 42 days after initial sampling for diagnosis [57]. Whether viral detection by molecular methods always equates to an infectious risk remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Healthcare-associated infections: the hallmark of Middle East respiratory syndrome coronavirus with review of the literature

Al‐Tawfiq

Auwaerter

2019

Journal of Hospital Infection

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Middle East respiratory syndrome coronavirus (MERS-CoV) is capable of causing acute respiratory illness. Laboratory-confirmed MERS-CoV cases may be asymptomatic, have mild disease, or have a life-threatening infection with a high case fatality rate. There are three patterns of transmission: sporadic community cases from presumed non-human exposure, family clusters arising from contact with an infected family index case, and healthcare-acquired infections among patients and from patients to healthcare workers. Healthcare-acquired MERS infection has become a well-known characteristic of the disease and a leading means of spread. The main factors contributing to healthcare-associated outbreaks include delayed recognition, inadequate infection control measures, inadequate triaging and isolation of suspected MERS or other respiratory illness patients, crowding, and patients remaining in the emergency department for many days. A review of the literature suggests that effective control of hospital outbreaks was accomplished in most instances by the application of proper infection control procedures. Prompt recognition, isolation and management of suspected cases are key factors for prevention of the spread of MERS. Repeated assessments of infection control and monitoring of corrective measures contribute to changing the course of an outbreak. Limiting the number of contacts and hospital visits are also important factors to decrease the spread of infection.

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“…Alt solunum yolu salgılarında virüsü atılımı, üst solunum yolu salgısı, serum veya dışkıda atılan miktardan en az iki kat daha fazladır ve hastalık şid-detinin atılan virüs miktarı ile korelasyon gösterdiği saptanmıştır (17) . Virüs atılımının hem asemptomatik bir sağlık çalışanında hem de bir diğer hastada 4-6 hafta kadar sürdüğü gösterilmiştir (18) .…”

Section: Patogenezunclassified

Middle East Respiratory Syndrome-Coronavirus (MERSCoV) Infection

İnal¹

2016

Okmeydani Medical Journal

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A Case of Long-term Excretion and Subclinical Infection With Middle East Respiratory Syndrome Coronavirus in a Healthcare Worker

Cited by 59 publications

References 5 publications

Middle East respiratory syndrome coronavirus (MERS-CoV): what lessons can we learn?

Middle East respiratory syndrome coronavirus (MERS-CoV): what lessons can we learn?

Healthcare-associated infections: the hallmark of Middle East respiratory syndrome coronavirus with review of the literature

Middle East Respiratory Syndrome-Coronavirus (MERSCoV) Infection

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