Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study

Abstract

The Saudi Arabian Ministry of Health implemented a pro-active surveillance programme for Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV). We report MERS-CoV data from 5065 Kingdom of Saudi Arabia individuals who were screened for MERS-CoV over a 12-month period. From 1 October 2012 to 30 September 2013, demographic and clinical data were prospectively collected from all laboratory forms received at the Saudi Arabian Virology reference laboratory. Data were analysed by referral type, age, gender, and MERS-CoV real-time PCR test results. Five thousand and 65 individuals were screened for MER-CoV: hospitalized patients with suspected MERS-CoV infection (n = 2908, 57.4%), healthcare worker (HCW) contacts (n = 1695; 33.5%), and family contacts of laboratory-confirmed MERS cases (n = 462; 9.1%). Eleven per cent of persons tested were children (<17 years of age). There were 108 cases (99 adults and nine children) of MERS-CoV infection detected during the 12-month period (108/5065, 2% case detection rate). Of 108 cases, 45 were females (six children and 39 adults) and 63 were males (three children and 60 adults). Of the 99 adults with MERS-CoV infection, 70 were hospitalized patients, 19 were HCW contacts, and ten were family contacts. There were no significant increases in MERS-CoV detection rates over the 12-month period: 2.6% (19/731) in July 2013, 1.7% (19/1100) in August 2013, and 1.69% (21/1238) in September 2013. Male patients had a significantly higher MERS-CoV infection rate (63/2318, 2.7%) than females (45/2747, 1.6%) (p 0.013). MERS-CoV rates remain at low levels, with no significant increase over time. Pro-active surveillance for MERS-CoV in newly diagnosed patients and their contacts will continue.

An update on Middle East respiratory syndrome: 2 years later

“…Upper respiratory symptoms developed among 27% of case-contact compared to 33% of non-case-contacts [58]. Of the 48 case-contact, 87.5% had surgical mask and 33% had N-95 mask [58]. Contact investigation of healthcare workers (HCWs) of MERSCoV patients also revealed no transmission in two other studies [59,60].…”

“…Studies of the transmission of MERS-CoV in healthcare setting revealed a low transmission rate. The investigation of healthcare worker contacts of the first MERS case in KSA showed that none of the 48 case-contact and 48 non casecontacts was positive for MERS-CoV by HKU5.2N nucleocapsid enzyme immunoassay [58]. Upper respiratory symptoms developed among 27% of case-contact compared to 33% of non-case-contacts [58].…”

“…The investigation of healthcare worker contacts of the first MERS case in KSA showed that none of the 48 case-contact and 48 non casecontacts was positive for MERS-CoV by HKU5.2N nucleocapsid enzyme immunoassay [58]. Upper respiratory symptoms developed among 27% of case-contact compared to 33% of non-case-contacts [58]. Of the 48 case-contact, 87.5% had surgical mask and 33% had N-95 mask [58].…”

Knowledge and Perception of Health Practitioners towards MERS-CoV in Hail Region, Kingdom of Saudi Arabia

“…[3] The clinical sickness related to MERS-CoV ranges from mild upper respiratory manifestations to fulminant pneumonia and multi-system failure. [4,5,6] Human-tohuman transmission of MERS-CoV is all around recorded in the family, group settings and more frequently in social insurance settings [4,7,8]. As such, bigger hospital outbreaks have been driven by a combination of overdue recognition, over-crowding, and inadequate infection control precautionary measures [6,9,10].…”

Middle East Respiratory Syndrome

“…However, it is also clear that patients without underlying diseases can become infected, although most develop asymptomatic or mild clinical disease 52, 74,75 . MERS-CoV transmission requires close contact between infected patients and susceptible individuals, but even under these conditions, only a limited amount of transmission has been documented 52, [74][75][76][77] . In one study, Drosten et al showed that the rate of transmission from 26 MERS patients to 280 household contacts was approximately 4% 52 .…”