Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia
Identifieur interne : 000C02 ( Pmc/Checkpoint ); précédent : 000C01; suivant : 000C03Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia
Auteurs : Hanan H. Balkhy [Arabie saoudite] ; Thamer H. Alenazi [Arabie saoudite] ; Majid M. Alshamrani [Arabie saoudite] ; Henry Baffoe-Bonnie [Arabie saoudite] ; Yaseen Arabi [Arabie saoudite] ; Raed Hijazi [Arabie saoudite] ; Hail M. Al-Abdely [Arabie saoudite] ; Aiman El-Saed [Arabie saoudite] ; Sameera Al Johani [Arabie saoudite] ; Abdullah M. Assiri [Arabie saoudite] ; Abdulaziz Bin Saeed [Arabie saoudite]Source :
- Infection Control and Hospital Epidemiology [ 0899-823X ] ; 2016.
Abstract
Since the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported.
To describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia.
We conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV.
Of the 130 suspected cases, 81 (62%) were confirmed and 49 (38%) were probable. These included 87 patients (67%) and 43 healthcare workers (33%). Older age (mean [SD], 64.4 [18.3] vs 40.1 [11.3] years,
MERS-CoV remains a major healthcare threat. Early recognition of cases and rapid implementation of infection control measures are necessary.
Url:
DOI: 10.1017/ice.2016.132
PubMed: 27426423
PubMed Central: 7113028
Affiliations:
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PMC:7113028Le document en format XML
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<author><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H." last="Balkhy">Hanan H. Balkhy</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
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<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
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<affiliation><nlm:aff id="aff2"><addr-line>King Abdullah International Medical Research Center</addr-line>
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<affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Alenazi, Thamer H" sort="Alenazi, Thamer H" uniqKey="Alenazi T" first="Thamer H." last="Alenazi">Thamer H. Alenazi</name>
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,<country>Riyadh Saudi Arabia</country>
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,<country>Saudi Arabia</country>
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<author><name sortKey="Alshamrani, Majid M" sort="Alshamrani, Majid M" uniqKey="Alshamrani M" first="Majid M." last="Alshamrani">Majid M. Alshamrani</name>
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,<country>Saudi Arabia</country>
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<author><name sortKey="Baffoe Bonnie, Henry" sort="Baffoe Bonnie, Henry" uniqKey="Baffoe Bonnie H" first="Henry" last="Baffoe-Bonnie">Henry Baffoe-Bonnie</name>
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</nlm:aff>
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<country xml:lang="fr">Arabie saoudite</country>
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<author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name>
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<affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Intensive Care Department</addr-line>
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<author><name sortKey="Hijazi, Raed" sort="Hijazi, Raed" uniqKey="Hijazi R" first="Raed" last="Hijazi">Raed Hijazi</name>
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<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
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,<country>Saudi Arabia</country>
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<author><name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M." last="Al-Abdely">Hail M. Al-Abdely</name>
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<author><name sortKey="El Saed, Aiman" sort="El Saed, Aiman" uniqKey="El Saed A" first="Aiman" last="El-Saed">Aiman El-Saed</name>
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,<country>Saudi Arabia</country>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Al Johani, Sameera" sort="Al Johani, Sameera" uniqKey="Al Johani S" first="Sameera" last="Al Johani">Sameera Al Johani</name>
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,<country>Saudi Arabia</country>
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<author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>King Fahad Medical City</addr-line>
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,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
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<country xml:lang="fr">Arabie saoudite</country>
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<author><name sortKey="Bin Saeed, Abdulaziz" sort="Bin Saeed, Abdulaziz" uniqKey="Bin Saeed A" first="Abdulaziz" last="Bin Saeed">Abdulaziz Bin Saeed</name>
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,<addr-line>Riyadh</addr-line>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia</title>
<author><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H." last="Balkhy">Hanan H. Balkhy</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
</nlm:aff>
<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
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<affiliation><nlm:aff id="aff2"><addr-line>King Abdullah International Medical Research Center</addr-line>
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</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Alenazi, Thamer H" sort="Alenazi, Thamer H" uniqKey="Alenazi T" first="Thamer H." last="Alenazi">Thamer H. Alenazi</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
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<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
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<affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Infection Prevention and Control Department</addr-line>
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,<country>Saudi Arabia</country>
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<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Alshamrani, Majid M" sort="Alshamrani, Majid M" uniqKey="Alshamrani M" first="Majid M." last="Alshamrani">Majid M. Alshamrani</name>
<affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Jeddah</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Baffoe Bonnie, Henry" sort="Baffoe Bonnie, Henry" uniqKey="Baffoe Bonnie H" first="Henry" last="Baffoe-Bonnie">Henry Baffoe-Bonnie</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
</nlm:aff>
<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
</nlm:aff>
<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Intensive Care Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Hijazi, Raed" sort="Hijazi, Raed" uniqKey="Hijazi R" first="Raed" last="Hijazi">Raed Hijazi</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
</nlm:aff>
<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>Emergency Care Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M." last="Al-Abdely">Hail M. Al-Abdely</name>
<affiliation wicri:level="1"><nlm:aff id="aff7"><addr-line>Ministry of Health</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<author><name sortKey="El Saed, Aiman" sort="El Saed, Aiman" uniqKey="El Saed A" first="Aiman" last="El-Saed">Aiman El-Saed</name>
<affiliation><nlm:aff id="aff1"><institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
</nlm:aff>
<wicri:noCountry code="nlm country">Riyadh Saudi Arabia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Al Johani, Sameera" sort="Al Johani, Sameera" uniqKey="Al Johani S" first="Sameera" last="Al Johani">Sameera Al Johani</name>
<affiliation wicri:level="1"><nlm:aff id="aff8"><addr-line>Pathology and Laboratory Medicine Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name>
<affiliation wicri:level="1"><nlm:aff id="aff7"><addr-line>Ministry of Health</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff9"><addr-line>King Fahad Medical City</addr-line>
,<addr-line>Ministry of Health</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bin Saeed, Abdulaziz" sort="Bin Saeed, Abdulaziz" uniqKey="Bin Saeed A" first="Abdulaziz" last="Bin Saeed">Abdulaziz Bin Saeed</name>
<affiliation wicri:level="1"><nlm:aff id="aff7"><addr-line>Ministry of Health</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="aff10"><institution>King Saud University</institution>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Infection Control and Hospital Epidemiology</title>
<idno type="ISSN">0899-823X</idno>
<idno type="eISSN">1559-6834</idno>
<imprint><date when="2016">2016</date>
</imprint>
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<front><div type="abstract" xml:lang="en"><sec id="abs1" sec-type="general"><title>BACKGROUND</title>
<p>Since the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported.</p>
</sec>
<sec id="abs2" sec-type="general"><title>OBJECTIVE</title>
<p>To describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia.</p>
</sec>
<sec id="abs3" sec-type="methods"><title>METHODS</title>
<p>We conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV.</p>
</sec>
<sec id="abs4" sec-type="results"><title>RESULTS</title>
<p>Of the 130 suspected cases, 81 (62%) were confirmed and 49 (38%) were probable. These included 87 patients (67%) and 43 healthcare workers (33%). Older age (mean [SD], 64.4 [18.3] vs 40.1 [11.3] years, <italic>P<</italic>
.001), symptoms (97% vs 58%, <italic>P<</italic>
.001), and comorbidity (99% vs 42%, <italic>P<</italic>
.001) were more common in patients than healthcare workers. Almost all patients (97%) were hospitalized whereas most healthcare workers (72%) were home isolated. Among 96 hospitalized cases, 63 (66%) required intensive care unit management and 60 (63%) required mechanical ventilation. Among all 130 cases, 51 (39%) died; all were patients (51 [59%]) with no deaths among healthcare workers. More than half (54%) of infections were believed to be caught at the emergency department. Strict infection control measures, including isolation and closure of the emergency department, were implemented to interrupt the chain of transmission and end the outbreak.</p>
</sec>
<sec id="abs5" sec-type="conclusion"><title>CONCLUSION</title>
<p>MERS-CoV remains a major healthcare threat. Early recognition of cases and rapid implementation of infection control measures are necessary.</p>
<p><italic>Infect Control Hosp Epidemiol</italic>
2016;1–9</p>
</sec>
</div>
</front>
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<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Alameer, K" uniqKey="Alameer K">K Alameer</name>
</author>
<author><name sortKey="Abukhzam, B" uniqKey="Abukhzam B">B Abukhzam</name>
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</author>
<author><name sortKey="Balkhy, H" uniqKey="Balkhy H">H Balkhy</name>
</author>
</analytic>
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<biblStruct></biblStruct>
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</author>
<author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name>
</author>
<author><name sortKey="Makhdoom, Hq" uniqKey="Makhdoom H">HQ Makhdoom</name>
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<author><name sortKey="Tomczyk, Sm" uniqKey="Tomczyk S">SM Tomczyk</name>
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<author><name sortKey="Al Asmari, Am" uniqKey="Al Asmari A">AM Al-Asmari</name>
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</biblStruct>
<biblStruct><analytic><author><name sortKey="Das, Km" uniqKey="Das K">KM Das</name>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Infect Control Hosp Epidemiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Infect Control Hosp Epidemiol</journal-id>
<journal-id journal-id-type="publisher-id">ICE</journal-id>
<journal-title-group><journal-title>Infection Control and Hospital Epidemiology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0899-823X</issn>
<issn pub-type="epub">1559-6834</issn>
<publisher><publisher-name>Cambridge University Press</publisher-name>
<publisher-loc>New York, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27426423</article-id>
<article-id pub-id-type="pmc">7113028</article-id>
<article-id pub-id-type="doi">10.1017/ice.2016.132</article-id>
<article-id pub-id-type="publisher-id">S0899823X1600132X</article-id>
<article-id pub-id-type="publisher-id">00132</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia</article-title>
<alt-title alt-title-type="left-running">INFECTION CONTROL & HOSPITAL EPIDEMIOLOGY</alt-title>
<alt-title alt-title-type="right-running">MERS Outbreak in Riyadh in 2015</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Balkhy</surname>
<given-names>Hanan H.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff2">2</xref>
<xref ref-type="aff" rid="aff3">3</xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Alenazi</surname>
<given-names>Thamer H.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Alshamrani</surname>
<given-names>Majid M.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Baffoe-Bonnie</surname>
<given-names>Henry</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Arabi</surname>
<given-names>Yaseen</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hijazi</surname>
<given-names>Raed</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Al-Abdely</surname>
<given-names>Hail M.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff7">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>El-Saed</surname>
<given-names>Aiman</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Al Johani</surname>
<given-names>Sameera</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff8">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Assiri</surname>
<given-names>Abdullah M.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff7">7</xref>
<xref ref-type="aff" rid="aff9">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>bin Saeed</surname>
<given-names>Abdulaziz</given-names>
</name>
<degrees>MD, PhD</degrees>
<xref ref-type="aff" rid="aff7">7</xref>
<xref ref-type="aff" rid="aff10">10</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<institution>King Saud bin Abdulaziz University for Health Sciences</institution>
,<country>Riyadh Saudi Arabia</country>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>King Abdullah International Medical Research Center</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Infection Prevention and Control Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Jeddah</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Intensive Care Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff6"><label>6</label>
<addr-line>Emergency Care Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff7"><label>7</label>
<addr-line>Ministry of Health</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff8"><label>8</label>
<addr-line>Pathology and Laboratory Medicine Department</addr-line>
,<addr-line>King Abdulaziz Medical City</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff9"><label>9</label>
<addr-line>King Fahad Medical City</addr-line>
,<addr-line>Ministry of Health</addr-line>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<aff id="aff10"><label>10</label>
<institution>King Saud University</institution>
,<addr-line>Riyadh</addr-line>
,<country>Saudi Arabia</country>
</aff>
<author-notes><corresp id="cor1">Address correspondence to Hanan Balkhy, MD, Infection Prevention and Control Department, King Abdulaziz Medical City, Riyadh, PO Box 22490, Riyadh 11426 Kingdom of Saudi Arabia (<email>balkhyh@ngha.med.sa</email>
).</corresp>
</author-notes>
<pub-date pub-type="epub"><day>18</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2016</year>
</pub-date>
<volume>37</volume>
<issue>10</issue>
<fpage>1147</fpage>
<lpage>1155</lpage>
<history><date date-type="received"><day>11</day>
<month>2</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>18</day>
<month>4</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© © 2016 by The Society for Healthcare Epidemiology of America 2016</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>© 2016 by The Society for Healthcare Epidemiology of America</copyright-holder>
<license license-type="other" xlink:href="simple"><license-p>This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means subject to acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.</license-p>
</license>
</permissions>
<self-uri xlink:title="pdf" xlink:href="S0899823X1600132Xa.pdf"></self-uri>
<abstract abstract-type="normal"><sec id="abs1" sec-type="general"><title>BACKGROUND</title>
<p>Since the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported.</p>
</sec>
<sec id="abs2" sec-type="general"><title>OBJECTIVE</title>
<p>To describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia.</p>
</sec>
<sec id="abs3" sec-type="methods"><title>METHODS</title>
<p>We conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV.</p>
</sec>
<sec id="abs4" sec-type="results"><title>RESULTS</title>
<p>Of the 130 suspected cases, 81 (62%) were confirmed and 49 (38%) were probable. These included 87 patients (67%) and 43 healthcare workers (33%). Older age (mean [SD], 64.4 [18.3] vs 40.1 [11.3] years, <italic>P<</italic>
.001), symptoms (97% vs 58%, <italic>P<</italic>
.001), and comorbidity (99% vs 42%, <italic>P<</italic>
.001) were more common in patients than healthcare workers. Almost all patients (97%) were hospitalized whereas most healthcare workers (72%) were home isolated. Among 96 hospitalized cases, 63 (66%) required intensive care unit management and 60 (63%) required mechanical ventilation. Among all 130 cases, 51 (39%) died; all were patients (51 [59%]) with no deaths among healthcare workers. More than half (54%) of infections were believed to be caught at the emergency department. Strict infection control measures, including isolation and closure of the emergency department, were implemented to interrupt the chain of transmission and end the outbreak.</p>
</sec>
<sec id="abs5" sec-type="conclusion"><title>CONCLUSION</title>
<p>MERS-CoV remains a major healthcare threat. Early recognition of cases and rapid implementation of infection control measures are necessary.</p>
<p><italic>Infect Control Hosp Epidemiol</italic>
2016;1–9</p>
</sec>
</abstract>
<counts><fig-count count="2"></fig-count>
<table-count count="4"></table-count>
<page-count count="9"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Arabie saoudite</li>
</country>
</list>
<tree><country name="Arabie saoudite"><noRegion><name sortKey="Balkhy, Hanan H" sort="Balkhy, Hanan H" uniqKey="Balkhy H" first="Hanan H." last="Balkhy">Hanan H. Balkhy</name>
</noRegion>
<name sortKey="Al Abdely, Hail M" sort="Al Abdely, Hail M" uniqKey="Al Abdely H" first="Hail M." last="Al-Abdely">Hail M. Al-Abdely</name>
<name sortKey="Al Johani, Sameera" sort="Al Johani, Sameera" uniqKey="Al Johani S" first="Sameera" last="Al Johani">Sameera Al Johani</name>
<name sortKey="Alenazi, Thamer H" sort="Alenazi, Thamer H" uniqKey="Alenazi T" first="Thamer H." last="Alenazi">Thamer H. Alenazi</name>
<name sortKey="Alshamrani, Majid M" sort="Alshamrani, Majid M" uniqKey="Alshamrani M" first="Majid M." last="Alshamrani">Majid M. Alshamrani</name>
<name sortKey="Arabi, Yaseen" sort="Arabi, Yaseen" uniqKey="Arabi Y" first="Yaseen" last="Arabi">Yaseen Arabi</name>
<name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name>
<name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name>
<name sortKey="Baffoe Bonnie, Henry" sort="Baffoe Bonnie, Henry" uniqKey="Baffoe Bonnie H" first="Henry" last="Baffoe-Bonnie">Henry Baffoe-Bonnie</name>
<name sortKey="Bin Saeed, Abdulaziz" sort="Bin Saeed, Abdulaziz" uniqKey="Bin Saeed A" first="Abdulaziz" last="Bin Saeed">Abdulaziz Bin Saeed</name>
<name sortKey="Bin Saeed, Abdulaziz" sort="Bin Saeed, Abdulaziz" uniqKey="Bin Saeed A" first="Abdulaziz" last="Bin Saeed">Abdulaziz Bin Saeed</name>
<name sortKey="El Saed, Aiman" sort="El Saed, Aiman" uniqKey="El Saed A" first="Aiman" last="El-Saed">Aiman El-Saed</name>
<name sortKey="Hijazi, Raed" sort="Hijazi, Raed" uniqKey="Hijazi R" first="Raed" last="Hijazi">Raed Hijazi</name>
</country>
</tree>
</affiliations>
</record>
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