Transmission of Middle East Respiratory Syndrome Coronavirus Infections in Healthcare Settings, Abu Dhabi

Abstract

Early detection and adherence to infection prevention recommendations are necessary to avoid transmission.

MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study

“…4 Both Patient 1 and Patient 14 had sought medical attention at diff erent health-care facilities before being treated at the Samsung Medical Center on May 17-20 (Patient 1) and May 27-29 (Patient 14), around day 7 of their illness when they were highly infectious. The median incubation period of patients who stayed in the same zone as Patient 14 was shorter than that in patients who stayed in diff erent zones (5 days [IQR 4-8] vs 11 days [6][7][8][9][10][11][12]; p<0·0001). 3 Patient 1 had initially presented to the emergency room on May 17, 2015, when the hospital was full; he was admitted and isolated immediately on May 18, 2015, after his travel history to the Middle East was ascertained by a medical offi cer, without causing any nosocomial outbreak.…”

“…5,9,10 Common risk factors include exposure to contaminated and overcrowded health-care facilities, poor compliance with appropriate personal protection equipment when assessing patients with febrile respiratory illness, application of potential aerosolgenerating procedures (eg, resuscitation, continuous positive airway pressure, nebulised drugs), and lack of proper isolation room facilities. 5,[7][8][9][10] The customs of patients seeking care at diff erent health-care facilities (so-called doctor shopping), as in the cases of Patients 1 and 14, and having friends and family members to stay with patients as caregivers at already overcrowded health-care facilities are unique factors in South Korea. 11 Although no aerosol-generating procedures were performed (with the exception of Patient 14 receiving supplemental oxygen at 2-5 L per min during his stay at the emergency room), 5 the role of such procedures, environmental contamination, and asymptomatic carriers in disease transmission would require further investigation in future major nosocomial outbreaks of MERS-CoV infection.…”

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

“…Of the 277 healthcare contacts, four (1.4%) had healthcareassociated infections. These four patients were exposed to the index case before the diagnosis of MERS-CoV and institution of any respiratory protection measures [28].…”

“…In this cluster, the index case arose from camel exposure. Only two (2.2%) of 90 hospital contacts were positive for MERS-CoV [28]. Another cluster was traced to a community member who visited an emergency room three times, and was subsequently admitted to a regular unit.…”

“…Another cluster was traced to a community member who visited an emergency room three times, and was subsequently admitted to a regular unit. Evaluation of 224 contacts identified 15 (6.7%) positive cases [28].…”