Middle East respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014

Dirkzwager, Marleen Kraaij –; Timen, Aura; Dirksen, Kees; Gelinck, L. B. S.; Leyten, Eliane M. S.; Groeneveld, P. H. P.; Jansen, C. L.; Jonges, Marcel; Raj, Sibi; Thurkow, Ingrid; Gageldonk-Lafeber, Rianne van; Eijk, Annemiek van der; Koopmans, Marion

doi:10.2807/1560-7917.es2014.19.21.20817

Cited by 72 publications

(72 citation statements)

References 18 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: 56%

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: 56%

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 a macaque monkey model, MERS-CoV RNA was shed from both the URT and LRT (deWit et al, 2013). In a human case, throat swabs were positive for six days, and again after a gap (Kraaij-Dirkzwager et al, 2014). In another case, a 40-year old female HCW shed MERS-CoV RNA from the URT (Ziad A. Memish, personal communication) for at least 42-days between April and June 2014 (Al-Gethamy et al, 2014).…”

Section: Specimen Types and Length Of Viral Sheddingmentioning

confidence: 99%

“…Gastrointestinal symptoms were not seen at all in one family cluster (Omrani et al, 2013) nor among symptomatic children in another . On occasion, fever and gastrointestinal upset may form a prodrome, after which symptoms decline to be are later followed by more severe systemic and respiratory signs and symptoms (Kraaij-Dirkzwager et al, 2014;Mailles et al, 2013). Rarely, MERS-CoV has been detected in a person with fever but no respiratory or gastrointestinal symptoms .…”

Section: Middle East Respiratory Syndrome (Mers)mentioning

confidence: 99%

“…However at writing, no human data exist to define whether the virus replicates solely in the LRT, the URT, has a preference for one over the other, or replicates in other human tissues in vivo. Sampling of the URT has been frequently noted from the largest human MERS-CoV investigative studies (Gautret et al, 2013; Health Protection Agency (HPA) UK Novel Coronavirus Investigation Team, 2013; Memish et al, 2014b,d) and, if noted, for other smaller investigative MERS-CoV testing (Kraaij-Dirkzwager et al, 2014;Memish et al, 2013b). In a macaque monkey model, MERS-CoV RNA was shed from both the URT and LRT (deWit et al, 2013).…”

Section: Specimen Types and Length Of Viral Sheddingmentioning

confidence: 99%

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Middle East respiratory syndrome: An emerging coronavirus infection tracked by the crowd

Mackay

Arden

2015

Virus Research

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In 2012 in Jordan, infection by a novel coronavirus (CoV) caused the first known cases of Middle East respiratory syndrome (MERS). MERS-CoV sequences have since been found in a bat and the virus appears to be enzootic among dromedary camels across the Arabian Peninsula and in parts of Africa. The majority of human cases have occurred in the Kingdom of Saudi Arabia (KSA). In humans, the etiologic agent, MERS-CoV, has been detected in severe, mild and influenza-like illness and in those without any obvious signs or symptoms of disease. MERS is often a lower respiratory tract disease associated with fever, cough, breathing difficulties, pneumonia that can progress to acute respiratory distress syndrome, multiorgan failure and death among more than a third of those infected. Severe disease is usually found in older males and comorbidities are frequently present in cases of MERS. Compared to SARS, MERS progresses more rapidly to respiratory failure and acute kidney injury, is more often observed as severe disease in patients with underlying illnesses and is more often fatal. MERS-CoV has a broader tropism than SARS-CoV, rapidly triggers cellular damage, employs a different receptor and induces a delayed proinflammatory response in cells. Most human cases have been linked to lapses in infection prevention and control in healthcare settings, with a fifth of virus detections reported among healthcare workers. This review sets out what is currently known about MERS and the MERS-CoV, summarises the new phenomenon of crowd-sourced epidemiology and lists some of the many questions that remain unanswered, nearly three years after the first reported case.

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“…A recent example is the Middle East respiratory syndrome coronavirus (MERS-CoV), which emerged in 2012 in the Arabian Peninsula [3]. The consecutive importation of MERS-CoV cases to the United Kingdom (UK) [4,5], Germany [6], France [7], Italy [8], Greece [9], the Netherlands [10], United States (US) [11] and Malaysia [12] required considerable public health resources with wide public health follow-up of contacts, extensive virological testing and international risk assessments.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the surveillance system for undiagnosed serious infectious illness (USII) in intensive care units, England, 2011 to 2013

2014

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Emerging infections are a potential risk during mass gathering events due to the congregation of large numbers of international travellers. To mitigate this risk for the London 2012 Olympic and Paralympic Games, a sentinel surveillance system was developed to identify clusters of emerging infections presenting as undiagnosed serious infectious illness (USII) in intensive care units (ICUs). Following a six month pilot period, which had begun in January 2011, the surveillance was operational for a further 18 months spanning the Games. The surveillance system and reported USII cases were reviewed and evaluated after this 18 month operational period including assessment of positive predictive value (PPV), timeliness, acceptability and sensitivity of the system. Surveillance records were used to review reported cases and calculate the PPV and median reporting times of USII surveillance. Sensitivity was assessed through comparison with the pilot period. Participating clinicians completed a five-point Likert scale questionnaire about the acceptability of surveillance. Between 11 July 2011 and 10 January 2013, 34 cases were reported. Of these, 22 remained classified as USII at the time of the evaluation, none of which were still hospitalised. No clusters were identified. The 22 USII cases had no association with the Games, suggesting that they represented the background level of USII in the area covered by the surveillance. This corresponded to an annualised rate of 0.39 cases/100,000 population and a PPV of 65%. Clinicians involved in the surveillance reported high acceptability levels. The USII surveillance model could be a useful public health tool in other countries and during mass gathering events for identifying potential clusters of emerging infections.

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Middle East respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014

Cited by 72 publications

References 18 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: An emerging coronavirus infection tracked by the crowd

Evaluation of the surveillance system for undiagnosed serious infectious illness (USII) in intensive care units, England, 2011 to 2013

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