Unusual presentation of Middle East respiratory syndrome coronavirus leading to a large outbreak in Riyadh during 2017

Amer, Hala; Alqahtani, Abdulrahman; Alzoman, Hind A; Aljerian, Nawfal; Memish, Ziad A.

doi:10.1016/j.ajic.2018.02.023

Cited by 33 publications

(28 citation statements)

References 25 publications

(25 reference statements)

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“…Countries face significant challenges in the early identification and diagnosis of MERS in humans due to the non-specificity of clinical symptoms ( The spectrum of illness ranges from no symptoms (or asymptomatic infection) to severe disease including pneumonia, acute respiratory disease syndrome, organ failure and death, with a case fatality ratio 35.5% among reported cases (World Health Organization, 2012). The delay in identification and recognition of signs and symptoms compatible with MERS and delay in early isolation of patients has reduced the ability to prevent transmission between people in health care settings, notably in emergency departments, cardiac care centers and renal dialysis units (Hijawi et al, 2013;Assiri et al, 2013;Drosten et al, 2015;Al Hosani et al, 2016;Ki, 2015;Park et al, 2015;Ahmed et al, 2018;Amer et al, 2018).…”

Section: Research Needs: Hospital Transmission and Infection Prevmentioning

confidence: 99%

MERS: Progress on the global response, remaining challenges and the way forward

et al. 2018

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This article summarizes progress in research on Middle East Respiratory Syndrome (MERS) since a FAO-OIE-WHO Global Technical Meeting held at WHO Headquarters in Geneva on 25-27 September 2017. The meeting reviewed the latest scientific findings and identified and prioritized the global activities necessary to prevent, manage and control the disease. Critical needs for research and technical guidance identified during the meeting have been used to update the WHO R&D MERS-CoV Roadmap for diagnostics, therapeutics and vaccines and a broader public health research agenda. Since the 2017 meeting, progress has been made on several key actions in animal populations, at the animal/human interface and in human populations. This report also summarizes the latest scientific studies on MERS since 2017, including data from more than 50 research studies examining the presence of MERS-CoV infection in dromedary camels.

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Section: Research Needs: Hospital Transmission and Infection Prevmentioning

confidence: 99%

MERS: Progress on the global response, remaining challenges and the way forward

et al. 2018

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“…A recent MERS-CoV outbreak occurred at King Saud Medical City (KSMC), concurrent with outbreaks at two other hospitals in the Riyadh region in June 2017 (Amer et al, 2018). This study was performed to better understand the best strategies to handle exposed HCWs.…”

Section: Introductionmentioning

confidence: 99%

Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV): Revision of screening strategies urgently needed

Amer¹,

Alqahtani²,

Alaklobi³

et al. 2018

International Journal of Infectious Diseases

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“…Our results demonstrate the need for a minimum of 2 samples to confirm MERS-CoV, and that a third sample will increase the yield by only 1% (from 96.5% to 97.6%). Concerns about the infectivity of RT-PCR−positive patients 16,17 have been confirmed by a recent report of a positive MERS-CoV culture from the upper respiratory tract of an asymptomatic positive case from KSA obtained at 15 days after illness onset. 18 There is an urgent need to verify how many negative results are needed to confirm negativity.…”

Section: Discussionmentioning

confidence: 91%

Middle East respiratory syndrome coronavirus intermittent positive cases: Implications for infection control

Alfaraj

Al‐Tawfiq

Memish

2019

American Journal of Infection Control

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Background: Middle East respiratory syndrome coronavirus (MERS-CoV) continues to be reported from the Kingdom of Saudi Arabia. Data on the phenomenon of intermittent positive results for MERS-CoV on reverse-transcription polymerase chain reaction (RT-PCR) with negative results in between are lacking. Here we describe cases with intermittent positive MERS-CoV test results and highlight the required number of tests to rule out or rule in MERS-CoV infection based on a large retrospective cohort of patients with confirmed MERS-CoV. Methods: This analysis included cases admitted between January 2014 and December 2017. The included patients had a minimum of 3 nasopharyngeal MERS-CoV RT-PCR tests for confirmation and needed 2 negative samples for MERS-CoV evaluated 48 hours apart with clinical improvement or stabilization apart to ensure clearance. Results: A total of 408 patients with positive MERS-CoV test results were treated at the referring hospital. We excluded 72 patients who had only 1 swab result available in the system and were treated in the initial years of the disease. Of the remaining 336 patients, 300 (89%) had a positive result after 1 swab, 324 (96.5%) had a positive result after 2 consecutive swabs, and 328 (97.6%) had a positive result after 3 consecutive swabs. Of the total cases, 46 (13.7%) had a positive MERS-CoV test then a negative test, followed by positive test results. Conclusions: Our data indicate that 2 to 3 nasopharyngeal samples are needed to produce the highest yield of positive results for MERS-CoV. In addition, 2 negative results 48 hours apart with clinical improvement or stabilization are needed to clear patients from MERS-CoV. Evaluation of the yield of sputum samples is needed to assess the effectiveness against nasopharyngeal swabs.

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Unusual presentation of Middle East respiratory syndrome coronavirus leading to a large outbreak in Riyadh during 2017

Cited by 33 publications

References 25 publications

MERS: Progress on the global response, remaining challenges and the way forward

MERS: Progress on the global response, remaining challenges and the way forward

Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV): Revision of screening strategies urgently needed

Middle East respiratory syndrome coronavirus intermittent positive cases: Implications for infection control

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