A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) in a Hospital Setting Through Bioaerosols.
Identifieur interne : 000747 ( Main/Exploration ); précédent : 000746; suivant : 000748A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) in a Hospital Setting Through Bioaerosols.
Auteurs : Umesh Adhikari [États-Unis] ; Alexandre Chabrelie [États-Unis] ; Mark Weir [États-Unis] ; Kevin Boehnke [États-Unis] ; Erica Mckenzie [États-Unis] ; Luisa Ikner [États-Unis] ; Meng Wang [États-Unis] ; Qing Wang [États-Unis] ; Kyana Young [États-Unis] ; Charles N. Haas [États-Unis] ; Joan Rose [États-Unis] ; Jade Mitchell [États-Unis]Source :
- Risk analysis : an official publication of the Society for Risk Analysis [ 1539-6924 ] ; 2019.
Abstract
Middle Eastern respiratory syndrome, an emerging viral infection with a global case fatality rate of 35.5%, caused major outbreaks first in 2012 and 2015, though new cases are continuously reported around the world. Transmission is believed to mainly occur in healthcare settings through aerosolized particles. This study uses Quantitative Microbial Risk Assessment to develop a generalizable model that can assist with interpreting reported outbreak data or predict risk of infection with or without the recommended strategies. The exposure scenario includes a single index patient emitting virus-containing aerosols into the air by coughing, leading to short- and long-range airborne exposures for other patients in the same room, nurses, healthcare workers, and family visitors. Aerosol transport modeling was coupled with Monte Carlo simulation to evaluate the risk of MERS illness for the exposed population. Results from a typical scenario show the daily mean risk of infection to be the highest for the nurses and healthcare workers (8.49 × 10-4 and 7.91 × 10-4 , respectively), and the lowest for family visitors and patients staying in the same room (3.12 × 10-4 and 1.29 × 10-4 , respectively). Sensitivity analysis indicates that more than 90% of the uncertainty in the risk characterization is due to the viral concentration in saliva. Assessment of risk interventions showed that respiratory masks were found to have a greater effect in reducing the risks for all the groups evaluated (>90% risk reduction), while increasing the air exchange was effective for the other patients in the same room only (up to 58% risk reduction).
DOI: 10.1111/risa.13389
PubMed: 31524301
Affiliations:
- États-Unis
- Arizona, Delaware, Floride, Michigan, Ohio, Pennsylvanie
- East Lansing, Tampa
- Université d'État du Michigan, Université de Floride du Sud
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sortKey="Adhikari, Umesh" sort="Adhikari, Umesh" uniqKey="Adhikari U" first="Umesh" last="Adhikari">Umesh Adhikari</name><affiliation wicri:level="4"><nlm:affiliation>Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Chabrelie, Alexandre" sort="Chabrelie, Alexandre" uniqKey="Chabrelie A" first="Alexandre" last="Chabrelie">Alexandre Chabrelie</name><affiliation wicri:level="4"><nlm:affiliation>Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Weir, Mark" sort="Weir, Mark" uniqKey="Weir M" first="Mark" last="Weir">Mark Weir</name><affiliation wicri:level="2"><nlm:affiliation>Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Boehnke, Kevin" sort="Boehnke, Kevin" uniqKey="Boehnke K" first="Kevin" last="Boehnke">Kevin Boehnke</name><affiliation wicri:level="2"><nlm:affiliation>Department of Anesthesiology & the Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology & the Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Mckenzie, Erica" sort="Mckenzie, Erica" uniqKey="Mckenzie E" first="Erica" last="Mckenzie">Erica Mckenzie</name><affiliation wicri:level="2"><nlm:affiliation>Department of Civil and Environmental Engineering, Temple University, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Civil and Environmental Engineering, Temple University, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Ikner, Luisa" sort="Ikner, Luisa" uniqKey="Ikner L" first="Luisa" last="Ikner">Luisa Ikner</name><affiliation wicri:level="2"><nlm:affiliation>Department of Soil, Water and Environmental Science, University of Arizona, Tucson, AZ, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Soil, Water and Environmental Science, University of Arizona, Tucson, AZ</wicri:regionArea><placeName><region type="state">Arizona</region></placeName></affiliation></author><author><name sortKey="Wang, Meng" sort="Wang, Meng" uniqKey="Wang M" first="Meng" last="Wang">Meng Wang</name><affiliation wicri:level="4"><nlm:affiliation>Department of Civil & Environmental Engineering, University of South Florida, Tampa, FL, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Civil & Environmental Engineering, University of South Florida, Tampa, FL</wicri:regionArea><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Wang, Qing" sort="Wang, Qing" uniqKey="Wang Q" first="Qing" last="Wang">Qing Wang</name><affiliation wicri:level="2"><nlm:affiliation>Department of Animal and Food Sciences, University of Delaware, Newark, DE, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Animal and Food Sciences, University of Delaware, Newark, DE</wicri:regionArea><placeName><region type="state">Delaware</region></placeName></affiliation></author><author><name sortKey="Young, Kyana" sort="Young, Kyana" uniqKey="Young K" first="Kyana" last="Young">Kyana Young</name><affiliation wicri:level="4"><nlm:affiliation>Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Haas, Charles N" sort="Haas, Charles N" uniqKey="Haas C" first="Charles N" last="Haas">Charles N. Haas</name><affiliation wicri:level="2"><nlm:affiliation>Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Rose, Joan" sort="Rose, Joan" uniqKey="Rose J" first="Joan" last="Rose">Joan Rose</name><affiliation wicri:level="4"><nlm:affiliation>Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Mitchell, Jade" sort="Mitchell, Jade" uniqKey="Mitchell J" first="Jade" last="Mitchell">Jade Mitchell</name><affiliation wicri:level="4"><nlm:affiliation>Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author></analytic><series><title level="j">Risk analysis : an official publication of the Society for Risk Analysis</title><idno type="eISSN">1539-6924</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Middle Eastern respiratory syndrome, an emerging viral infection with a global case fatality rate of 35.5%, caused major outbreaks first in 2012 and 2015, though new cases are continuously reported around the world. Transmission is believed to mainly occur in healthcare settings through aerosolized particles. This study uses Quantitative Microbial Risk Assessment to develop a generalizable model that can assist with interpreting reported outbreak data or predict risk of infection with or without the recommended strategies. The exposure scenario includes a single index patient emitting virus-containing aerosols into the air by coughing, leading to short- and long-range airborne exposures for other patients in the same room, nurses, healthcare workers, and family visitors. Aerosol transport modeling was coupled with Monte Carlo simulation to evaluate the risk of MERS illness for the exposed population. Results from a typical scenario show the daily mean risk of infection to be the highest for the nurses and healthcare workers (8.49 × 10<sup>-4</sup> and 7.91 × 10<sup>-4</sup> , respectively), and the lowest for family visitors and patients staying in the same room (3.12 × 10<sup>-4</sup> and 1.29 × 10<sup>-4</sup> , respectively). Sensitivity analysis indicates that more than 90% of the uncertainty in the risk characterization is due to the viral concentration in saliva. Assessment of risk interventions showed that respiratory masks were found to have a greater effect in reducing the risks for all the groups evaluated (>90% risk reduction), while increasing the air exchange was effective for the other patients in the same room only (up to 58% risk reduction).</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arizona</li><li>Delaware</li><li>Floride</li><li>Michigan</li><li>Ohio</li><li>Pennsylvanie</li></region><settlement><li>East Lansing</li><li>Tampa</li></settlement><orgName><li>Université d'État du Michigan</li><li>Université de Floride du Sud</li></orgName></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Adhikari, Umesh" sort="Adhikari, Umesh" uniqKey="Adhikari U" first="Umesh" last="Adhikari">Umesh Adhikari</name></region><name sortKey="Boehnke, Kevin" sort="Boehnke, Kevin" uniqKey="Boehnke K" first="Kevin" last="Boehnke">Kevin Boehnke</name><name sortKey="Chabrelie, Alexandre" sort="Chabrelie, Alexandre" uniqKey="Chabrelie A" first="Alexandre" last="Chabrelie">Alexandre Chabrelie</name><name sortKey="Haas, Charles N" sort="Haas, Charles N" uniqKey="Haas C" first="Charles N" last="Haas">Charles N. Haas</name><name sortKey="Ikner, Luisa" sort="Ikner, Luisa" uniqKey="Ikner L" first="Luisa" last="Ikner">Luisa Ikner</name><name sortKey="Mckenzie, Erica" sort="Mckenzie, Erica" uniqKey="Mckenzie E" first="Erica" last="Mckenzie">Erica Mckenzie</name><name sortKey="Mitchell, Jade" sort="Mitchell, Jade" uniqKey="Mitchell J" first="Jade" last="Mitchell">Jade Mitchell</name><name sortKey="Rose, Joan" sort="Rose, Joan" uniqKey="Rose J" first="Joan" last="Rose">Joan Rose</name><name sortKey="Wang, Meng" sort="Wang, Meng" uniqKey="Wang M" first="Meng" last="Wang">Meng Wang</name><name sortKey="Wang, Qing" sort="Wang, Qing" uniqKey="Wang Q" first="Qing" last="Wang">Qing Wang</name><name sortKey="Weir, Mark" sort="Weir, Mark" uniqKey="Weir M" first="Mark" last="Weir">Mark Weir</name><name sortKey="Young, Kyana" sort="Young, Kyana" uniqKey="Young K" first="Kyana" last="Young">Kyana Young</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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