Middle East Respiratory Syndrome Coronavirus Superspreading Event Involving 81 Persons, Korea 2015
Identifieur interne : 000009 ( Pmc/Curation ); précédent : 000008; suivant : 000010Middle East Respiratory Syndrome Coronavirus Superspreading Event Involving 81 Persons, Korea 2015
Auteurs : Myoung-Don Oh [Corée du Sud] ; Pyoeng Gyun Choe [Corée du Sud] ; Hong Sang Oh [Corée du Sud] ; Wan Beom Park [Corée du Sud] ; Sang-Min Lee [Corée du Sud] ; Jinkyeong Park [Corée du Sud] ; Sang Kook Lee [Corée du Sud] ; Jeong-Sup Song [Corée du Sud] ; Nam Joong Kim [Corée du Sud]Source :
- Journal of Korean Medical Science [ 1011-8934 ] ; 2015.
Abstract
Since the first imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported on May 20, 2015 in Korea, there have been 186 laboratory-confirmed cases of MERS-CoV infection with 36 fatalities. Ninety-seven percent (181/186) of the cases had exposure to the health care facilities. We are reporting a superspreading event that transmitted MERS-CoV to 81 persons at a hospital emergency room (ER) during the Korean outbreak in 2015. The index case was a 35-yr-old man who had vigorous coughing while staying at the ER for 58 hr. As in severe acute respiratory syndrome outbreaks, superspreading events can cause a large outbreak of MERS in healthcare facilities with severe consequences. All healthcare facilities should establish and implement infection prevention and control measure as well as triage policies and procedures for early detection and isolation of suspected MERS-CoV cases.
Url:
DOI: 10.3346/jkms.2015.30.11.1701
PubMed: 26539018
PubMed Central: 4630490
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id="A2">Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Sang Kook" sort="Lee, Sang Kook" uniqKey="Lee S" first="Sang Kook" last="Lee">Sang Kook Lee</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Internal Medicine, Good Morning Hospital, Pyeongtaek, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Internal Medicine, Good Morning Hospital, Pyeongtaek</wicri:regionArea></affiliation></author><author><name sortKey="Song, Jeong Sup" sort="Song, Jeong Sup" uniqKey="Song J" first="Jeong-Sup" last="Song">Jeong-Sup Song</name><affiliation wicri:level="1"><nlm:aff id="A4">Department of Internal Medicine, Pyeongtaek St. Mary's Hospital, Pyeongtaek, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Internal Medicine, Pyeongtaek St. Mary's Hospital, Pyeongtaek</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Nam Joong" sort="Kim, Nam Joong" uniqKey="Kim N" first="Nam Joong" last="Kim">Nam Joong Kim</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Internal Medicine, Seoul National University College of Medicine, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Korean Medical Science</title><idno type="ISSN">1011-8934</idno><idno type="eISSN">1598-6357</idno><imprint><date 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Ninety-seven percent (181/186) of the cases had exposure to the health care facilities. We are reporting a superspreading event that transmitted MERS-CoV to 81 persons at a hospital emergency room (ER) during the Korean outbreak in 2015. The index case was a 35-yr-old man who had vigorous coughing while staying at the ER for 58 hr. As in severe acute respiratory syndrome outbreaks, superspreading events can cause a large outbreak of MERS in healthcare facilities with severe consequences. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Korean Med Sci</journal-id><journal-id journal-id-type="iso-abbrev">J. Korean Med. Sci</journal-id><journal-id journal-id-type="publisher-id">JKMS</journal-id><journal-title-group><journal-title>Journal of Korean Medical Science</journal-title></journal-title-group><issn pub-type="ppub">1011-8934</issn><issn pub-type="epub">1598-6357</issn><publisher><publisher-name>The Korean Academy of Medical Sciences</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26539018</article-id><article-id pub-id-type="pmc">4630490</article-id><article-id pub-id-type="doi">10.3346/jkms.2015.30.11.1701</article-id><article-categories><subj-group subj-group-type="heading"><subject>Brief Communication</subject><subj-group subj-group-type="subheading"><subject>Infectious Diseases, Microbiology & Parasitology</subject></subj-group></subj-group></article-categories><title-group><article-title>Middle East Respiratory Syndrome Coronavirus Superspreading Event Involving 81 Persons, Korea 2015</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Oh</surname><given-names>Myoung-don</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="author-notes" rid="FN1">*</xref></contrib><contrib contrib-type="author"><name><surname>Choe</surname><given-names>Pyoeng Gyun</given-names></name><xref ref-type="aff" rid="A1">1</xref><xref ref-type="author-notes" rid="FN1">*</xref></contrib><contrib contrib-type="author"><name><surname>Oh</surname><given-names>Hong Sang</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Park</surname><given-names>Wan Beom</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Sang-Min</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Park</surname><given-names>Jinkyeong</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Sang Kook</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Song</surname><given-names>Jeong-Sup</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Nam Joong</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.</aff><aff id="A2"><label>2</label>Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.</aff><aff id="A3"><label>3</label>Department of Internal Medicine, Good Morning Hospital, Pyeongtaek, Korea.</aff><aff id="A4"><label>4</label>Department of Internal Medicine, Pyeongtaek St. Mary's Hospital, Pyeongtaek, Korea.</aff><author-notes><corresp>Address for Correspondence: Myoung-don Oh, MD. Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82.2-2072-2945, Fax: +82.2-762-9662, <email>mdohmd@snu.ac.kr</email></corresp><fn id="FN1" fn-type="equal"><p><sup>*</sup>Myoung-don Oh and Pyoeng Gyun Choe contributed equally to this work.</p></fn></author-notes><pub-date pub-type="ppub"><month>11</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>16</day><month>10</month><year>2015</year></pub-date><volume>30</volume><issue>11</issue><fpage>1701</fpage><lpage>1705</lpage><history><date date-type="received"><day>03</day><month>10</month><year>2015</year></date><date date-type="accepted"><day>05</day><month>10</month><year>2015</year></date></history><permissions><copyright-statement>© 2015 The Korean Academy of Medical Sciences.</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Since the first imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported on May 20, 2015 in Korea, there have been 186 laboratory-confirmed cases of MERS-CoV infection with 36 fatalities. Ninety-seven percent (181/186) of the cases had exposure to the health care facilities. We are reporting a superspreading event that transmitted MERS-CoV to 81 persons at a hospital emergency room (ER) during the Korean outbreak in 2015. The index case was a 35-yr-old man who had vigorous coughing while staying at the ER for 58 hr. As in severe acute respiratory syndrome outbreaks, superspreading events can cause a large outbreak of MERS in healthcare facilities with severe consequences. All healthcare facilities should establish and implement infection prevention and control measure as well as triage policies and procedures for early detection and isolation of suspected MERS-CoV cases.</p></abstract><kwd-group><kwd>MERS</kwd><kwd>Coronavirus</kwd><kwd>Superspreading Event</kwd><kwd>Emergency Room</kwd><kwd>Prevention</kwd></kwd-group><funding-group><award-group><funding-source country="KR">Seoul National University Hospital</funding-source><award-id>2015-1980</award-id></award-group></funding-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label><caption><title>Abnormalities on chest imaging of the patient. Shown are computed tomography scans of the chest of the patient, obtained on May 21, 2015 (<bold>A</bold>, <bold>B</bold>, and <bold>C</bold>). Pre-existing pneumonic consolidation in the left lung (<bold>A</bold>) and newly appearing ground glass nodules were observed (<bold>A</bold>, <bold>B</bold>, and <bold>C</bold>, red lines). (<bold>D</bold>) is chest radiograph of the patient on May 25, 2015. Faint infiltrates were shown in both lung fields. (<bold>E</bold>) and (<bold>F</bold>) are chest radiographs of the patient on May 27 and May 29, 2015 respectively, when the patient stayed at the emergency room. Multiple patchy, opacities became more prominent on both lungs on May 27, 2015 and 2 days later, the opacities became more confluent.</title></caption><graphic xlink:href="jkms-30-1701-g001"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label><caption><title>Clinical course of the patient and the epidemic curve for the cases of Middle East respiratory syndrome coronavirus infections directly exposed to the patient. The patient had productive cough due to pneumonia in his left lung prior to the onset of MERS-CoV infection. New infiltrates on chest radiograph and dyspnea developed on May 25, 2015, and 5 days later respiratory failure developed (<bold>A</bold>). Of the cluster of 91 cases related to Hospital C, 81 had exposure to the patient at the emergency room. Among 81 cases, the date of symptoms onset was not available in four cases. The incubation period ranged from 2 to 16 days, with a median of 6 days (<bold>B</bold>). <sup>*</sup>The case had another exposure to a family member with MERS-CoV infection between 8 to 10 days prior to onset of symptom. GGO, ground glass opacity; CT, computed tomography; MERS-CoV, Middle East respiratory syndrome coronavirus; INF-α2a, interferon-alpha2a.</title></caption><graphic xlink:href="jkms-30-1701-g002"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><title>Laboratory data for the patient</title></caption><alternatives><graphic xlink:href="jkms-30-1701-i001"></graphic><table frame="hsides" rules="rows"><thead><tr><th valign="middle" align="left" rowspan="1" colspan="1">Day</th><th valign="middle" align="center" rowspan="1" colspan="1">White blood cells (cell/µL)</th><th valign="middle" align="center" rowspan="1" colspan="1">Lymphocytes (cell/µL)</th><th valign="middle" align="center" rowspan="1" colspan="1">Hemoglobin (g/dL)</th><th valign="middle" align="center" rowspan="1" colspan="1">Platelets (cell/µL)</th><th valign="middle" align="center" rowspan="1" colspan="1">Creatinine (mg/dL)</th><th valign="middle" align="center" rowspan="1" colspan="1">Albumin (g/dL)</th><th valign="middle" align="center" rowspan="1" colspan="1">AST (U/L)</th><th valign="middle" align="center" rowspan="1" colspan="1">ALT (U/L)</th><th valign="middle" align="center" rowspan="1" colspan="1">PT (INR)</th><th valign="middle" align="center" rowspan="1" colspan="1">Urine albumin in dipstick test</th></tr></thead><tbody><tr><td valign="top" align="left" rowspan="1" colspan="1">May 21</td><td valign="top" align="right" rowspan="1" colspan="1">8,280</td><td valign="top" align="right" rowspan="1" colspan="1">3,146</td><td valign="top" align="center" rowspan="1" colspan="1">18.5</td><td valign="top" align="center" rowspan="1" colspan="1">339,000</td><td valign="top" align="left" rowspan="1" colspan="1">1.03</td><td valign="top" align="center" rowspan="1" colspan="1">4.7</td><td valign="top" align="right" rowspan="1" colspan="1">42</td><td valign="top" align="right" rowspan="1" colspan="1">74</td><td valign="top" align="center" rowspan="1" colspan="1">ND</td><td valign="top" align="center" rowspan="1" colspan="1">ND</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">May 25</td><td valign="top" align="right" rowspan="1" colspan="1">5,200</td><td valign="top" align="right" rowspan="1" colspan="1">634</td><td valign="top" align="center" rowspan="1" colspan="1">16.6</td><td valign="top" align="center" rowspan="1" colspan="1">164,000</td><td valign="top" align="left" rowspan="1" colspan="1">1.0</td><td valign="top" align="center" rowspan="1" colspan="1">4.1</td><td valign="top" align="right" rowspan="1" colspan="1">50</td><td valign="top" align="right" rowspan="1" colspan="1">57</td><td valign="top" align="center" rowspan="1" colspan="1">1.26</td><td valign="top" align="center" rowspan="1" colspan="1">-</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">May 27</td><td valign="top" align="right" rowspan="1" colspan="1">4,000</td><td valign="top" align="right" rowspan="1" colspan="1">688</td><td valign="top" align="center" rowspan="1" colspan="1">15.9</td><td valign="top" align="center" rowspan="1" colspan="1">122,000</td><td valign="top" align="left" rowspan="1" colspan="1">1.0</td><td valign="top" align="center" rowspan="1" colspan="1">3.6</td><td valign="top" align="right" rowspan="1" colspan="1">55</td><td valign="top" align="right" rowspan="1" colspan="1">46</td><td valign="top" align="center" rowspan="1" colspan="1">ND</td><td valign="top" align="center" rowspan="1" colspan="1">ND</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">May 30</td><td valign="top" align="right" rowspan="1" colspan="1">5,260</td><td valign="top" align="right" rowspan="1" colspan="1">652</td><td valign="top" align="center" rowspan="1" colspan="1">15.9</td><td valign="top" align="center" rowspan="1" colspan="1">138,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.66</td><td valign="top" align="center" rowspan="1" colspan="1">3.3</td><td valign="top" align="right" rowspan="1" colspan="1">134</td><td valign="top" align="right" rowspan="1" colspan="1">70</td><td valign="top" align="center" rowspan="1" colspan="1">1.01</td><td valign="top" align="center" rowspan="1" colspan="1">2+</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">June 2</td><td valign="top" align="right" rowspan="1" colspan="1">6,780</td><td valign="top" align="right" rowspan="1" colspan="1">623</td><td valign="top" align="center" rowspan="1" colspan="1">13.7</td><td valign="top" align="center" rowspan="1" colspan="1">230,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.89</td><td valign="top" align="center" rowspan="1" colspan="1">2.6</td><td valign="top" align="right" rowspan="1" colspan="1">141</td><td valign="top" align="right" rowspan="1" colspan="1">61</td><td valign="top" align="center" rowspan="1" colspan="1">1.09</td><td valign="top" align="center" rowspan="1" colspan="1">2+</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">June 6</td><td valign="top" align="right" rowspan="1" colspan="1">8,300</td><td valign="top" align="right" rowspan="1" colspan="1">1,307</td><td valign="top" align="center" rowspan="1" colspan="1">13.9</td><td valign="top" align="center" rowspan="1" colspan="1">392,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.69</td><td valign="top" align="center" rowspan="1" colspan="1">3.1</td><td valign="top" align="right" rowspan="1" colspan="1">64</td><td valign="top" align="right" rowspan="1" colspan="1">131</td><td valign="top" align="center" rowspan="1" colspan="1">1.15</td><td valign="top" align="center" rowspan="1" colspan="1">1+</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">June 10</td><td valign="top" align="right" rowspan="1" colspan="1">11,220</td><td valign="top" align="right" rowspan="1" colspan="1">2,221</td><td valign="top" align="center" rowspan="1" colspan="1">15.5</td><td valign="top" align="center" rowspan="1" colspan="1">453,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.67</td><td valign="top" align="center" rowspan="1" colspan="1">3.7</td><td valign="top" align="right" rowspan="1" colspan="1">91</td><td valign="top" align="right" rowspan="1" colspan="1">212</td><td valign="top" align="center" rowspan="1" colspan="1">1.08</td><td valign="top" align="center" rowspan="1" colspan="1">+/-</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">June 14</td><td valign="top" align="right" rowspan="1" colspan="1">8,890</td><td valign="top" align="right" rowspan="1" colspan="1">3,138</td><td valign="top" align="center" rowspan="1" colspan="1">15.2</td><td valign="top" align="center" rowspan="1" colspan="1">334,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.81</td><td valign="top" align="center" rowspan="1" colspan="1">4.0</td><td valign="top" align="right" rowspan="1" colspan="1">67</td><td valign="top" align="right" rowspan="1" colspan="1">167</td><td valign="top" align="center" rowspan="1" colspan="1">1.02</td><td valign="top" align="center" rowspan="1" colspan="1">+/-</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">June 18</td><td valign="top" align="right" rowspan="1" colspan="1">6,280</td><td valign="top" align="right" rowspan="1" colspan="1">1,720</td><td valign="top" align="center" rowspan="1" colspan="1">13.1</td><td valign="top" align="center" rowspan="1" colspan="1">184,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.73</td><td valign="top" align="center" rowspan="1" colspan="1">3.6</td><td valign="top" align="right" rowspan="1" colspan="1">29</td><td valign="top" align="right" rowspan="1" colspan="1">66</td><td valign="top" align="center" rowspan="1" colspan="1">1.06</td><td valign="top" align="center" rowspan="1" colspan="1">+/-</td></tr><tr><td valign="top" align="left" rowspan="1" colspan="1">June 22</td><td valign="top" align="right" rowspan="1" colspan="1">7,640</td><td valign="top" align="right" rowspan="1" colspan="1">2,009</td><td valign="top" align="center" rowspan="1" colspan="1">13.2</td><td valign="top" align="center" rowspan="1" colspan="1">259,000</td><td valign="top" align="left" rowspan="1" colspan="1">0.82</td><td valign="top" align="center" rowspan="1" colspan="1">3.8</td><td valign="top" align="right" rowspan="1" colspan="1">36</td><td valign="top" align="right" rowspan="1" colspan="1">56</td><td valign="top" align="center" rowspan="1" colspan="1">1.13</td><td valign="top" align="center" rowspan="1" colspan="1">-</td></tr></tbody></table></alternatives><table-wrap-foot><fn><p>AST, aspartate aminotransferase; ALT, alanine transaminase; PT, prothrombin time; INR, international normalized ratio; ND, not determined.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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