Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control
Identifieur interne : 001B96 ( Ncbi/Curation ); précédent : 001B95; suivant : 001B97Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control
Auteurs : Sarah H. Alfaraj [Arabie saoudite, Canada] ; Jaffar A. Al-Tawfiq [États-Unis, Arabie saoudite] ; Talal A. Altuwaijri [Arabie saoudite] ; Marzouqa Alanazi [Arabie saoudite] ; Nojoom Alzahrani [Arabie saoudite] ; Ziad A. Memish [Arabie saoudite, États-Unis]Source :
- American Journal of Infection Control [ 0196-6553 ] ; 2017.
Descripteurs français
- KwdFr :
- MESH :
- isolement et purification : Coronavirus du syndrome respiratoire du Moyen-Orient.
- virologie : Infections à coronavirus.
- Adulte, Arabie saoudite, Femelle, Humains, Infections à coronavirus, Lutte contre l'infection, Mâle, Personnel de santé, Philippines, Traçage des contacts.
- Wicri :
- geographic : Philippines, Arabie saoudite.
English descriptors
- KwdEn :
- MESH :
- geographic : Philippines, Saudi Arabia.
- isolation & purification : Middle East Respiratory Syndrome Coronavirus.
- methods : Infection Control.
- transmission : Coronavirus Infections.
- virology : Coronavirus Infections.
- Adult, Contact Tracing, Female, Health Personnel, Humans, Male.
Abstract
Many outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred in health care settings and involved health care workers (HCWs). We describe the occurrence of an outbreak among HCWs and attempt to characterize at-risk exposures to improve future infection control interventions.
This study included an index case and all HCW contacts. All contacts were screened for MERS-CoV using polymerase chain reaction.
During the study period in 2015, the index case was a 30-year-old Filipino nurse who had a history of unprotected exposure to a MERS-CoV–positive case on May 15, 2015, and had multiple negative tests for MERS-CoV. Weeks later, she was diagnosed with pulmonary tuberculosis and MERS-CoV infection. A total of 73 staff were quarantined for 14 days, and nasopharyngeal swabs were taken on days 2, 5, and 12 postexposure. Of those contacts, 3 (4%) were confirmed positive for MERS-CoV. An additional 18 staff were quarantined and had MERS-CoV swabs. A fourth case was confirmed positive on day 12. Subsequent contact investigations revealed a fourth-generation transmission. Only 7 (4.5%) of the total 153 contacts were positive for MERS-CoV.
The role of HCWs in MERS-CoV transmission is complex. Although most MERS-CoV–infected HCWs are asymptomatic or have mild disease, fatal infections can occur and HCWs can play a major role in propagating health care facility outbreaks. This investigation highlights the need to continuously review infection control guidance relating to the role of HCWs in MERS-CoV transmission in health care outbreaks, especially as it relates to the complex questions on definition of risky exposures, who to test, and the frequency of MERS-CoV testing; criteria for who to quarantine and for how long; and clearance and return to active duty criteria.
Url:
DOI: 10.1016/j.ajic.2017.08.010
PubMed: 28958446
PubMed Central: 7115310
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PMC:7115310Le document en format XML
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<term>Coronavirus Infections (virology)</term>
<term>Female</term>
<term>Health Personnel</term>
<term>Humans</term>
<term>Infection Control (methods)</term>
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<term>Infections à coronavirus (virologie)</term>
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<term>Personnel de santé</term>
<term>Philippines</term>
<term>Traçage des contacts</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Many outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred in health care settings and involved health care workers (HCWs). We describe the occurrence of an outbreak among HCWs and attempt to characterize at-risk exposures to improve future infection control interventions.</p>
</sec>
<sec><title>Methods</title>
<p>This study included an index case and all HCW contacts. All contacts were screened for MERS-CoV using polymerase chain reaction.</p>
</sec>
<sec><title>Results</title>
<p>During the study period in 2015, the index case was a 30-year-old Filipino nurse who had a history of unprotected exposure to a MERS-CoV–positive case on May 15, 2015, and had multiple negative tests for MERS-CoV. Weeks later, she was diagnosed with pulmonary tuberculosis and MERS-CoV infection. A total of 73 staff were quarantined for 14 days, and nasopharyngeal swabs were taken on days 2, 5, and 12 postexposure. Of those contacts, 3 (4%) were confirmed positive for MERS-CoV. An additional 18 staff were quarantined and had MERS-CoV swabs. A fourth case was confirmed positive on day 12. Subsequent contact investigations revealed a fourth-generation transmission. Only 7 (4.5%) of the total 153 contacts were positive for MERS-CoV.</p>
</sec>
<sec><title>Conclusions</title>
<p>The role of HCWs in MERS-CoV transmission is complex. Although most MERS-CoV–infected HCWs are asymptomatic or have mild disease, fatal infections can occur and HCWs can play a major role in propagating health care facility outbreaks. This investigation highlights the need to continuously review infection control guidance relating to the role of HCWs in MERS-CoV transmission in health care outbreaks, especially as it relates to the complex questions on definition of risky exposures, who to test, and the frequency of MERS-CoV testing; criteria for who to quarantine and for how long; and clearance and return to active duty criteria.</p>
</sec>
</div>
</front>
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<author><name sortKey="Assiri, A" uniqKey="Assiri A">A. Assiri</name>
</author>
<author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name>
</author>
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<biblStruct><analytic><author><name sortKey="Guery, B" uniqKey="Guery B">B. Guery</name>
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<author><name sortKey="Poissy, J" uniqKey="Poissy J">J. Poissy</name>
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<biblStruct><analytic><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name>
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</analytic>
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<biblStruct><analytic><author><name sortKey="Hastings, D L" uniqKey="Hastings D">D.L. Hastings</name>
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