A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case

Omrani, Ali S.; Matin, Mohammad A.; Haddad, Qais; Al-Nakhli, Daifullah; Memish, Ziad A.; Albarrak, Ali

doi:10.1016/j.ijid.2013.07.001

Cited by 160 publications

(189 citation statements)

References 15 publications

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“…Similarly, the absence of transmission to the community contact may have been due to the case-patient's lack of respiratory symptoms during the 2 meetings. The absence of transmission to household and community contacts in this investigation is similar to that seen in contact investigations of several other patients with MERS (11-13); however, in other settings, transmission to household members who provided care to persons with MERS-CoV infection have been reported, and household clusters have been documented (3)(4)(5)(6)(7)16).…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Lack of Transmission among Close Contacts of Patient with Imported Case of Middle East Respiratory Syndrome into the United States, 2014

Breakwell¹,

Pringle²,

Chea³

et al. 2015

Emerg. Infect. Dis.

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In May 2014, a traveler from the Kingdom of Saudi Arabia was the first person identified with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the United States. To evaluate transmission risk, we determined the type, duration, and frequency of patient contact among health care personnel (HCP), household, and community contacts by using standard questionnaires and, for HCP, global positioning system (GPS) tracer tag logs. Respiratory and serum samples from all contacts were tested for MERS-CoV. Of 61 identified contacts, 56 were interviewed. HCP exposures occurred most frequently in the emergency department (69%) and among nurses (47%); some HCP had contact with respiratory secretions. Household and community contacts had brief contact (e.g., hugging). All laboratory test results were negative for MERS-CoV. This contact investigation found no secondary cases, despite case-patient contact by 61 persons, and provides useful information about MERS-CoV transmission risk. Compared with GPS tracer tag recordings, self-reported contact may not be as accurate.

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Section: Discussionsupporting

confidence: 82%

“…Clusters of MERS-CoV infection have occurred within extended families, households, and healthcare settings (3)(4)(5)(6). Contact investigations around imported cases in the United Kingdom, France, and Tunisia identified cases among household and healthcare contacts, suggesting person-to-person transmission (7)(8)(9).…”

mentioning

confidence: 99%

Lack of Transmission among Close Contacts of Patient with Imported Case of Middle East Respiratory Syndrome into the United States, 2014

Breakwell¹,

Pringle²,

Chea³

et al. 2015

Emerg. Infect. Dis.

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show abstract

“…While the source or reservoir of MERS-CoV is unknown, the disease is transmitted from person to person, for example by close contacts or in healthcare facilities [17][18][19][20][21][22][23][24]. Based on information related to the first 77 cases, the basic reproduction number of the infection (R0) was estimated to be 0.69 (95% CI 0.50-0.92) at the time [25], indicating a low pandemic potential [26].…”

Section: Human-to-human Transmissionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels, Qatar, April 2014

et al. 2014

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Antibodies to Middle East respiratory syndrome coronavirus (MERS-CoV) were detected in serum and milk collected according to local customs from 33 camels in Qatar, April 2014. At one location, evidence for active virus shedding in nasal secretions and/or faeces was observed for 7/12 camels; viral RNA was detected in milk of five of these seven camels. The presence of MERS-CoV RNA in milk of camels actively shedding the virus warrants measures to prevent putative food-borne transmission of MERS-CoV.

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“…7 Moreover, it was reported that unrecognized, asymptomatic patients transferred MERS-CoV to their family or close contacts. 9 All these factors were alarming and potentially distressing for the hospital staff who worked during the outbreak.…”

mentioning

confidence: 99%

Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak

Khalid

Qabajah

et al. 2016

Clinical Medicine & Research

634

721

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Objective: Healthcare workers (HCWs) are at high risk of contracting Middle East respiratory syndrome coronavirus (MERS-CoV) during an epidemic. We explored the emotions, perceived stressors, and coping strategies of healthcare workers who worked during a MERS-CoV outbreak in our hospital. Design:A cross-sectional descriptive survey design. Setting:A tertiary care hospital.Participants: HCWs (150) who worked in high risk areas during the April-May 2014 MERS-CoV outbreak that occurred in Jeddah, Saudi Arabia. Methods:We developed and administered a "MERS-CoV staff questionnaire" to study participants. The questionnaire consisted of 5 sections with 72 questions. The sections evaluated hospital staffs emotions, perceived stressors, factors that reduced their stress, coping strategies, and motivators to work during future outbreaks. Responses were scored on a scale from 0-3. The varying levels of stress or effectiveness of measures were reported as mean and standard deviation, as appropriate. Results:Completed questionnaires were returned by 117 (78%) of the participants. The results had many unique elements. HCWs ethical obligation to their profession pushed them to continue with their jobs. The main sentiments centered upon fear of personal safety and well-being of colleagues and family. Positive attitudes in the workplace, clinical improvement of infected colleagues, and stoppage of disease transmission among HCWs after adopting strict protective measures alleviated their fear and drove them through the epidemic. They appreciated recognition of their efforts by hospital management and expected similar acknowledgment, infection control guidance, and equipment would entice them to work during future epidemics. Conclusion:The MERS-CoV outbreak was a distressing time for our staff. Hospitals can enhance HCWs experiences during any future MERS-CoV outbreak by focusing on the above mentioned aspects.

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A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case

Abstract: MERS-CoV acquisition from unrecognized mild or asymptomatic cases may be a more important contributor to ongoing transmission than previously appreciated.

Cited by 160 publications

References 15 publications

Lack of Transmission among Close Contacts of Patient with Imported Case of Middle East Respiratory Syndrome into the United States, 2014

Lack of Transmission among Close Contacts of Patient with Imported Case of Middle East Respiratory Syndrome into the United States, 2014

Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels, Qatar, April 2014

Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak

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