MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study
Identifieur interne : 001694 ( Ncbi/Checkpoint ); précédent : 001693; suivant : 001695MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study
Auteurs : Sun Young Cho [Corée du Sud] ; Ji-Man Kang [Corée du Sud] ; Young Eun Ha [Corée du Sud] ; Ga Eun Park [Corée du Sud] ; Ji Yeon Lee [Corée du Sud] ; Jae-Hoon Ko [Corée du Sud] ; Ji Yong Lee [Corée du Sud] ; Jong Min Kim [Corée du Sud] ; Cheol-In Kang [Corée du Sud] ; Ik Joon Jo [Corée du Sud] ; Jae Geum Ryu [Corée du Sud] ; Jong Rim Choi [Corée du Sud] ; Seonwoo Kim [Corée du Sud] ; Hee Jae Huh [Corée du Sud] ; Chang-Seok Ki [Corée du Sud] ; Eun-Suk Kang [Corée du Sud] ; Kyong Ran Peck [Corée du Sud] ; Hun-Jong Dhong [Corée du Sud] ; Jae-Hoon Song [Corée du Sud] ; Doo Ryeon Chung [Corée du Sud] ; Yae-Jean Kim [Corée du Sud]Source :
- Lancet (London, England) [ 0140-6736 ] ; 2016.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Coronavirus du syndrome respiratoire du Moyen-Orient (isolement et purification), Exposition professionnelle (), Facteurs de risque, Femelle, Flambées de maladies (), Humains, Impressions de foule, Incidence, Infection croisée (), Infection croisée (transmission), Infections à coronavirus (diagnostic), Infections à coronavirus (transmission), Infections à coronavirus (épidémiologie), Jeune adulte, Mâle, Personnel de santé (), République de Corée (épidémiologie), Service hospitalier d'urgences, Sujet âgé, Sujet âgé de 80 ans ou plus, Transmission de maladie infectieuse.
- MESH :
- diagnostic : Infections à coronavirus.
- isolement et purification : Coronavirus du syndrome respiratoire du Moyen-Orient.
- épidémiologie : Infection croisée, Infections à coronavirus, République de Corée.
- Adolescent, Adulte, Adulte d'âge moyen, Exposition professionnelle, Facteurs de risque, Femelle, Flambées de maladies, Humains, Impressions de foule, Incidence, Infection croisée, Jeune adulte, Mâle, Personnel de santé, Service hospitalier d'urgences, Sujet âgé, Sujet âgé de 80 ans ou plus, Transmission de maladie infectieuse.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (transmission), Cross Infection (prevention & control), Cross Infection (transmission), Crowding, Disease Outbreaks (statistics & numerical data), Disease Transmission, Infectious, Emergency Service, Hospital, Female, Health Personnel (statistics & numerical data), Humans, Incidence, Male, Middle Aged, Middle East Respiratory Syndrome Coronavirus (isolation & purification), Occupational Exposure (statistics & numerical data), Republic of Korea (epidemiology), Risk Factors, Young Adult.
- MESH :
- geographic , epidemiology : Republic of Korea.
- diagnosis : Coronavirus Infections.
- epidemiology : Coronavirus Infections.
- isolation & purification : Middle East Respiratory Syndrome Coronavirus.
- prevention & control : Cross Infection.
- statistics & numerical data : Disease Outbreaks, Health Personnel, Occupational Exposure.
- transmission : Coronavirus Infections, Cross Infection.
- Adolescent, Adult, Aged, Aged, 80 and over, Crowding, Disease Transmission, Infectious, Emergency Service, Hospital, Female, Humans, Incidence, Male, Middle Aged, Risk Factors, Young Adult.
Abstract
In 2015, a large outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection occurred following a single patient exposure in an emergency room at the Samsung Medical Center, a tertiary-care hospital in Seoul, South Korea. We aimed to investigate the epidemiology of MERS-CoV outbreak in our hospital.
We identified all patients and health-care workers who had been in the emergency room with the index case between May 27 and May 29, 2015. Patients were categorised on the basis of their exposure in the emergency room: in the same zone as the index case (group A), in different zones except for overlap at the registration area or the radiology suite (group B), and in different zones (group C). We documented cases of MERS-CoV infection, confirmed by real-time PCR testing of sputum samples. We analysed attack rates, incubation periods of the virus, and risk factors for transmission.
675 patients and 218 health-care workers were identified as contacts. MERS-CoV infection was confirmed in 82 individuals (33 patients, eight health-care workers, and 41 visitors). The attack rate was highest in group A (20% [23/117]
Our results showed increased transmission potential of MERS-CoV from a single patient in an overcrowded emergency room and provide compelling evidence that health-care facilities worldwide need to be prepared for emerging infectious diseases.
None.
Url:
DOI: 10.1016/S0140-6736(16)30623-7
PubMed: 27402381
PubMed Central: 7159268
Affiliations:
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<author><name sortKey="Ki, Chang Seok" sort="Ki, Chang Seok" uniqKey="Ki C" first="Chang-Seok" last="Ki">Chang-Seok Ki</name>
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<author><name sortKey="Peck, Kyong Ran" sort="Peck, Kyong Ran" uniqKey="Peck K" first="Kyong Ran" last="Peck">Kyong Ran Peck</name>
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<author><name sortKey="Dhong, Hun Jong" sort="Dhong, Hun Jong" uniqKey="Dhong H" first="Hun-Jong" last="Dhong">Hun-Jong Dhong</name>
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<author><name sortKey="Song, Jae Hoon" sort="Song, Jae Hoon" uniqKey="Song J" first="Jae-Hoon" last="Song">Jae-Hoon Song</name>
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<author><name sortKey="Chung, Doo Ryeon" sort="Chung, Doo Ryeon" uniqKey="Chung D" first="Doo Ryeon" last="Chung">Doo Ryeon Chung</name>
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<author><name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study</title>
<author><name sortKey="Cho, Sun Young" sort="Cho, Sun Young" uniqKey="Cho S" first="Sun Young" last="Cho">Sun Young Cho</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
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<author><name sortKey="Kang, Ji Man" sort="Kang, Ji Man" uniqKey="Kang J" first="Ji-Man" last="Kang">Ji-Man Kang</name>
<affiliation wicri:level="3"><nlm:aff id="aff2">Division of Infectious Diseases, Department of Paediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
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<wicri:regionArea>Division of Infectious Diseases, Department of Paediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
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<author><name sortKey="Ha, Young Eun" sort="Ha, Young Eun" uniqKey="Ha Y" first="Young Eun" last="Ha">Young Eun Ha</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
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<author><name sortKey="Park, Ga Eun" sort="Park, Ga Eun" uniqKey="Park G" first="Ga Eun" last="Park">Ga Eun Park</name>
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<author><name sortKey="Lee, Ji Yeon" sort="Lee, Ji Yeon" uniqKey="Lee J" first="Ji Yeon" last="Lee">Ji Yeon Lee</name>
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<author><name sortKey="Ko, Jae Hoon" sort="Ko, Jae Hoon" uniqKey="Ko J" first="Jae-Hoon" last="Ko">Jae-Hoon Ko</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lee, Ji Yong" sort="Lee, Ji Yong" uniqKey="Lee J" first="Ji Yong" last="Lee">Ji Yong Lee</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Jong Min" sort="Kim, Jong Min" uniqKey="Kim J" first="Jong Min" last="Kim">Jong Min Kim</name>
<affiliation wicri:level="3"><nlm:aff id="aff2">Division of Infectious Diseases, Department of Paediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Paediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kang, Cheol In" sort="Kang, Cheol In" uniqKey="Kang C" first="Cheol-In" last="Kang">Cheol-In Kang</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Jo, Ik Joon" sort="Jo, Ik Joon" uniqKey="Jo I" first="Ik Joon" last="Jo">Ik Joon Jo</name>
<affiliation wicri:level="3"><nlm:aff id="aff3">Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ryu, Jae Geum" sort="Ryu, Jae Geum" uniqKey="Ryu J" first="Jae Geum" last="Ryu">Jae Geum Ryu</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Infection Control Office, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Infection Control Office, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Choi, Jong Rim" sort="Choi, Jong Rim" uniqKey="Choi J" first="Jong Rim" last="Choi">Jong Rim Choi</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Infection Control Office, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Infection Control Office, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Seonwoo" sort="Kim, Seonwoo" uniqKey="Kim S" first="Seonwoo" last="Kim">Seonwoo Kim</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Biostatistics team, Samsung Biomedical Research Institute, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Biostatistics team, Samsung Biomedical Research Institute, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Huh, Hee Jae" sort="Huh, Hee Jae" uniqKey="Huh H" first="Hee Jae" last="Huh">Hee Jae Huh</name>
<affiliation wicri:level="3"><nlm:aff id="aff5">Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ki, Chang Seok" sort="Ki, Chang Seok" uniqKey="Ki C" first="Chang-Seok" last="Ki">Chang-Seok Ki</name>
<affiliation wicri:level="3"><nlm:aff id="aff5">Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kang, Eun Suk" sort="Kang, Eun Suk" uniqKey="Kang E" first="Eun-Suk" last="Kang">Eun-Suk Kang</name>
<affiliation wicri:level="3"><nlm:aff id="aff5">Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Peck, Kyong Ran" sort="Peck, Kyong Ran" uniqKey="Peck K" first="Kyong Ran" last="Peck">Kyong Ran Peck</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dhong, Hun Jong" sort="Dhong, Hun Jong" uniqKey="Dhong H" first="Hun-Jong" last="Dhong">Hun-Jong Dhong</name>
<affiliation wicri:level="3"><nlm:aff id="aff6">Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Song, Jae Hoon" sort="Song, Jae Hoon" uniqKey="Song J" first="Jae-Hoon" last="Song">Jae-Hoon Song</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Chung, Doo Ryeon" sort="Chung, Doo Ryeon" uniqKey="Chung D" first="Doo Ryeon" last="Chung">Doo Ryeon Chung</name>
<affiliation wicri:level="3"><nlm:aff id="aff1">Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name>
<affiliation wicri:level="3"><nlm:aff id="aff2">Division of Infectious Diseases, Department of Paediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Paediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Lancet (London, England)</title>
<idno type="ISSN">0140-6736</idno>
<idno type="eISSN">1474-547X</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Coronavirus Infections (transmission)</term>
<term>Cross Infection (prevention & control)</term>
<term>Cross Infection (transmission)</term>
<term>Crowding</term>
<term>Disease Outbreaks (statistics & numerical data)</term>
<term>Disease Transmission, Infectious</term>
<term>Emergency Service, Hospital</term>
<term>Female</term>
<term>Health Personnel (statistics & numerical data)</term>
<term>Humans</term>
<term>Incidence</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Middle East Respiratory Syndrome Coronavirus (isolation & purification)</term>
<term>Occupational Exposure (statistics & numerical data)</term>
<term>Republic of Korea (epidemiology)</term>
<term>Risk Factors</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Coronavirus du syndrome respiratoire du Moyen-Orient (isolement et purification)</term>
<term>Exposition professionnelle ()</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Flambées de maladies ()</term>
<term>Humains</term>
<term>Impressions de foule</term>
<term>Incidence</term>
<term>Infection croisée ()</term>
<term>Infection croisée (transmission)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (transmission)</term>
<term>Infections à coronavirus (épidémiologie)</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Personnel de santé ()</term>
<term>République de Corée (épidémiologie)</term>
<term>Service hospitalier d'urgences</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Transmission de maladie infectieuse</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Republic of Korea</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Middle East Respiratory Syndrome Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Coronavirus du syndrome respiratoire du Moyen-Orient</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Disease Outbreaks</term>
<term>Health Personnel</term>
<term>Occupational Exposure</term>
</keywords>
<keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
<term>République de Corée</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Crowding</term>
<term>Disease Transmission, Infectious</term>
<term>Emergency Service, Hospital</term>
<term>Female</term>
<term>Humans</term>
<term>Incidence</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Risk Factors</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Exposition professionnelle</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Flambées de maladies</term>
<term>Humains</term>
<term>Impressions de foule</term>
<term>Incidence</term>
<term>Infection croisée</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Personnel de santé</term>
<term>Service hospitalier d'urgences</term>
<term>Sujet âgé</term>
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<front><div type="abstract" xml:lang="en"><title>Summary</title>
<sec><title>Background</title>
<p>In 2015, a large outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection occurred following a single patient exposure in an emergency room at the Samsung Medical Center, a tertiary-care hospital in Seoul, South Korea. We aimed to investigate the epidemiology of MERS-CoV outbreak in our hospital.</p>
</sec>
<sec><title>Methods</title>
<p>We identified all patients and health-care workers who had been in the emergency room with the index case between May 27 and May 29, 2015. Patients were categorised on the basis of their exposure in the emergency room: in the same zone as the index case (group A), in different zones except for overlap at the registration area or the radiology suite (group B), and in different zones (group C). We documented cases of MERS-CoV infection, confirmed by real-time PCR testing of sputum samples. We analysed attack rates, incubation periods of the virus, and risk factors for transmission.</p>
</sec>
<sec><title>Findings</title>
<p>675 patients and 218 health-care workers were identified as contacts. MERS-CoV infection was confirmed in 82 individuals (33 patients, eight health-care workers, and 41 visitors). The attack rate was highest in group A (20% [23/117] <italic>vs</italic>
5% [3/58] in group B <italic>vs</italic>
1% [4/500] in group C; p<0·0001), and was 2% (5/218) in health-care workers. After excluding nine cases (because of inability to determine the date of symptom onset in six cases and lack of data from three visitors), the median incubation period was 7 days (range 2–17, IQR 5–10). The median incubation period was significantly shorter in group A than in group C (5 days [IQR 4–8] <italic>vs</italic>
11 days [6–12]; p<0·0001). There were no confirmed cases in patients and visitors who visited the emergency room on May 29 and who were exposed only to potentially contaminated environment without direct contact with the index case. The main risk factor for transmission of MERS-CoV was the location of exposure.</p>
</sec>
<sec><title>Interpretation</title>
<p>Our results showed increased transmission potential of MERS-CoV from a single patient in an overcrowded emergency room and provide compelling evidence that health-care facilities worldwide need to be prepared for emerging infectious diseases.</p>
</sec>
<sec><title>Funding</title>
<p>None.</p>
</sec>
</div>
</front>
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<affiliations><list><country><li>Corée du Sud</li>
</country>
<region><li>Région capitale de Séoul</li>
</region>
<settlement><li>Séoul</li>
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<tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Cho, Sun Young" sort="Cho, Sun Young" uniqKey="Cho S" first="Sun Young" last="Cho">Sun Young Cho</name>
</region>
<name sortKey="Choi, Jong Rim" sort="Choi, Jong Rim" uniqKey="Choi J" first="Jong Rim" last="Choi">Jong Rim Choi</name>
<name sortKey="Chung, Doo Ryeon" sort="Chung, Doo Ryeon" uniqKey="Chung D" first="Doo Ryeon" last="Chung">Doo Ryeon Chung</name>
<name sortKey="Dhong, Hun Jong" sort="Dhong, Hun Jong" uniqKey="Dhong H" first="Hun-Jong" last="Dhong">Hun-Jong Dhong</name>
<name sortKey="Ha, Young Eun" sort="Ha, Young Eun" uniqKey="Ha Y" first="Young Eun" last="Ha">Young Eun Ha</name>
<name sortKey="Huh, Hee Jae" sort="Huh, Hee Jae" uniqKey="Huh H" first="Hee Jae" last="Huh">Hee Jae Huh</name>
<name sortKey="Jo, Ik Joon" sort="Jo, Ik Joon" uniqKey="Jo I" first="Ik Joon" last="Jo">Ik Joon Jo</name>
<name sortKey="Kang, Cheol In" sort="Kang, Cheol In" uniqKey="Kang C" first="Cheol-In" last="Kang">Cheol-In Kang</name>
<name sortKey="Kang, Eun Suk" sort="Kang, Eun Suk" uniqKey="Kang E" first="Eun-Suk" last="Kang">Eun-Suk Kang</name>
<name sortKey="Kang, Ji Man" sort="Kang, Ji Man" uniqKey="Kang J" first="Ji-Man" last="Kang">Ji-Man Kang</name>
<name sortKey="Ki, Chang Seok" sort="Ki, Chang Seok" uniqKey="Ki C" first="Chang-Seok" last="Ki">Chang-Seok Ki</name>
<name sortKey="Kim, Jong Min" sort="Kim, Jong Min" uniqKey="Kim J" first="Jong Min" last="Kim">Jong Min Kim</name>
<name sortKey="Kim, Seonwoo" sort="Kim, Seonwoo" uniqKey="Kim S" first="Seonwoo" last="Kim">Seonwoo Kim</name>
<name sortKey="Kim, Yae Jean" sort="Kim, Yae Jean" uniqKey="Kim Y" first="Yae-Jean" last="Kim">Yae-Jean Kim</name>
<name sortKey="Ko, Jae Hoon" sort="Ko, Jae Hoon" uniqKey="Ko J" first="Jae-Hoon" last="Ko">Jae-Hoon Ko</name>
<name sortKey="Lee, Ji Yeon" sort="Lee, Ji Yeon" uniqKey="Lee J" first="Ji Yeon" last="Lee">Ji Yeon Lee</name>
<name sortKey="Lee, Ji Yong" sort="Lee, Ji Yong" uniqKey="Lee J" first="Ji Yong" last="Lee">Ji Yong Lee</name>
<name sortKey="Park, Ga Eun" sort="Park, Ga Eun" uniqKey="Park G" first="Ga Eun" last="Park">Ga Eun Park</name>
<name sortKey="Peck, Kyong Ran" sort="Peck, Kyong Ran" uniqKey="Peck K" first="Kyong Ran" last="Peck">Kyong Ran Peck</name>
<name sortKey="Ryu, Jae Geum" sort="Ryu, Jae Geum" uniqKey="Ryu J" first="Jae Geum" last="Ryu">Jae Geum Ryu</name>
<name sortKey="Song, Jae Hoon" sort="Song, Jae Hoon" uniqKey="Song J" first="Jae-Hoon" last="Song">Jae-Hoon Song</name>
</country>
</tree>
</affiliations>
</record>
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