Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV): Revision of screening strategies urgently needed
Identifieur interne : 001351 ( Pmc/Curation ); précédent : 001350; suivant : 001352Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV): Revision of screening strategies urgently needed
Auteurs : Hala Amer [Arabie saoudite, Égypte] ; Abdulrahman S. Alqahtani [Arabie saoudite] ; Faisal Alaklobi [Arabie saoudite] ; Juhaina Altayeb [Arabie saoudite] ; Ziad A. Memish [Arabie saoudite, États-Unis]Source :
- International Journal of Infectious Diseases [ 1201-9712 ] ; 2018.
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause frequent hospital outbreaks in Saudi Arabia. Super-spreaders have always played a critical role in propagating healthcare facility outbreaks, and more recently asymptomatic healthcare workers (HCWs) have been identified to play a role. Differences do exist between the national and international guidance on handling HCWS exposed to MERS-CoV. Evidence to date supports liberal testing of all HCWs in close contact with MERS-CoV-positive cases, regardless of the significance of contact or presence or absence of symptoms, and the need for repeat testing. There is a need for urgent review of all guidelines regarding the return of asymptomatic MERS-CoV-positive HCWs under investigation to active duty.
Url:
DOI: 10.1016/j.ijid.2018.04.001
PubMed: 29649550
PubMed Central: 7110437
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Alqahtani</name><affiliation wicri:level="1"><nlm:aff id="aff0015">Medical Affairs, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Medical Affairs, King Saud Medical City, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Alaklobi, Faisal" sort="Alaklobi, Faisal" uniqKey="Alaklobi F" first="Faisal" last="Alaklobi">Faisal Alaklobi</name><affiliation wicri:level="1"><nlm:aff id="aff0020">Department of Pediatric Infectious Disease, King Saud Medical City, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Pediatric Infectious Disease, King Saud Medical City, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Altayeb, Juhaina" sort="Altayeb, Juhaina" uniqKey="Altayeb J" first="Juhaina" last="Altayeb">Juhaina Altayeb</name><affiliation wicri:level="1"><nlm:aff id="aff0005">Infection Control Department, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Infection Control Department, King Saud Medical City, Ministry of Health, Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><affiliation wicri:level="1"><nlm:aff id="aff0025">College of Medicine, Alfaisal University and Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>College of Medicine, Alfaisal University and Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Riyadh</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff0030">Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA</wicri:regionArea></affiliation></author></analytic><series><title level="j">International Journal of Infectious Diseases</title><idno type="ISSN">1201-9712</idno><idno type="eISSN">1878-3511</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label><p id="par0005">Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause frequent hospital outbreaks in Saudi Arabia.</p></list-item><list-item id="lsti0010"><label>•</label><p id="par0010">Super-spreaders have always played a critical role in propagating healthcare facility outbreaks, and more recently asymptomatic healthcare workers (HCWs) have been identified to play a role.</p></list-item><list-item id="lsti0015"><label>•</label><p id="par0015">Differences do exist between the national and international guidance on handling HCWS exposed to MERS-CoV.</p></list-item><list-item id="lsti0020"><label>•</label><p id="par0020">Evidence to date supports liberal testing of all HCWs in close contact with MERS-CoV-positive cases, regardless of the significance of contact or presence or absence of symptoms, and the need for repeat testing.</p></list-item><list-item id="lsti0025"><label>•</label><p id="par0025">There is a need for urgent review of all guidelines regarding the return of asymptomatic MERS-CoV-positive HCWs under investigation to active duty.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Alfaraj, S H" uniqKey="Alfaraj S">S.H. Alfaraj</name></author><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author><author><name sortKey="Altuwaijri, T A" uniqKey="Altuwaijri T">T.A. Altuwaijri</name></author><author><name sortKey="Alanazi, M" uniqKey="Alanazi M">M. Alanazi</name></author><author><name sortKey="Alzahrani, N" uniqKey="Alzahrani N">N. Alzahrani</name></author><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alfaraj, S H" uniqKey="Alfaraj S">S.H. Alfaraj</name></author><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author><author><name sortKey="Altuwaijri, T A" uniqKey="Altuwaijri T">T.A. Altuwaijri</name></author><author><name sortKey="Alanazi, M" uniqKey="Alanazi M">M. Alanazi</name></author><author><name sortKey="Alzahrani, N" uniqKey="Alzahrani N">N. Alzahrani</name></author><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Amer, H" uniqKey="Amer H">H. Amer</name></author><author><name sortKey="Alqahtani, A S" uniqKey="Alqahtani A">A.S. Alqahtani</name></author><author><name sortKey="Alzoman, H" uniqKey="Alzoman H">H. Alzoman</name></author><author><name sortKey="Aljerian, N" uniqKey="Aljerian N">N. Aljerian</name></author><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anon" uniqKey="Anon">Anon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A. Assiri</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A. McGeer</name></author><author><name sortKey="Perl, T M" uniqKey="Perl T">T.M. Perl</name></author><author><name sortKey="Price, C S" uniqKey="Price C">C.S. Price</name></author><author><name sortKey="Al Rabeeah, A A" uniqKey="Al Rabeeah A">A.A. Al Rabeeah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Balkhy, H H" uniqKey="Balkhy H">H.H. Balkhy</name></author><author><name sortKey="Alenazi, T H" uniqKey="Alenazi T">T.H. Alenazi</name></author><author><name sortKey="Alshamrani, M M" uniqKey="Alshamrani M">M.M. Alshamrani</name></author><author><name sortKey="Baffoe Bonnie, H" uniqKey="Baffoe Bonnie H">H. Baffoe-Bonnie</name></author><author><name sortKey="Arabi, Y" uniqKey="Arabi Y">Y. Arabi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cdc" uniqKey="Cdc">CDC</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Command And Control Center Ministry Of Health Kingdom Of Saudi Arabia Scientific Advisory Board" uniqKey="Command And Control Center Ministry Of Health Kingdom Of Saudi Arabia Scientific Advisory Board">Command and Control Center Ministry of Health Kingdom of Saudi Arabia Scientific Advisory Board</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ghazal, H S" uniqKey="Ghazal H">H.S. Ghazal</name></author><author><name sortKey="Ghazal, S" uniqKey="Ghazal S">S. Ghazal</name></author><author><name sortKey="Alharbi, T M" uniqKey="Alharbi T">T.M. Alharbi</name></author><author><name sortKey="Al Nujaidi, M" uniqKey="Al Nujaidi M">M. Al Nujaidi</name></author><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Memish, Z A" uniqKey="Memish Z">Z.A. Memish</name></author><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Who" uniqKey="Who">WHO</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Who" uniqKey="Who">WHO</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Who" uniqKey="Who">WHO</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Infect. Dis</journal-id><journal-title-group><journal-title>International Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1201-9712</issn><issn pub-type="epub">1878-3511</issn><publisher><publisher-name>The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">29649550</article-id><article-id pub-id-type="pmc">7110437</article-id><article-id pub-id-type="publisher-id">S1201-9712(18)30083-3</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2018.04.001</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV): Revision of screening strategies urgently needed</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Amer</surname><given-names>Hala</given-names></name><email>haamr@ksmc.med.sa</email><xref rid="aff0005" ref-type="aff">a</xref><xref rid="aff0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Alqahtani</surname><given-names>Abdulrahman S.</given-names></name><email>asalqahtani@ksmc.med.sa</email><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Alaklobi</surname><given-names>Faisal</given-names></name><email>Falaklobi@ksmc.med.sa</email><xref rid="aff0020" ref-type="aff">d</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Altayeb</surname><given-names>Juhaina</given-names></name><email>jaltiyeb@ksmc.med.sa</email><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Memish</surname><given-names>Ziad A.</given-names></name><email>memishz@pmah.med.sa</email><xref rid="aff0025" ref-type="aff">e</xref><xref rid="aff0030" ref-type="aff">f</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Infection Control Department, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff0010"><label>b</label>Department of Community Medicine, National Research Center, Egypt</aff><aff id="aff0015"><label>c</label>Medical Affairs, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff0020"><label>d</label>Department of Pediatric Infectious Disease, King Saud Medical City, Riyadh, Saudi Arabia</aff><aff id="aff0025"><label>e</label>College of Medicine, Alfaisal University and Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia</aff><aff id="aff0030"><label>f</label>Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author at: College of Medicine, Alfaisal University and Prince Mohammed Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia. <email>memishz@pmah.med.sa</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>9</day><month>4</month><year>2018</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>6</month><year>2018</year></pub-date><pub-date pub-type="epub"><day>9</day><month>4</month><year>2018</year></pub-date><volume>71</volume><fpage>113</fpage><lpage>116</lpage><history><date date-type="received"><day>15</day><month>3</month><year>2018</year></date><date date-type="rev-recd"><day>3</day><month>4</month><year>2018</year></date><date date-type="accepted"><day>3</day><month>4</month><year>2018</year></date></history><permissions><copyright-statement>© 2018 The Author(s)</copyright-statement><copyright-year>2018</copyright-year><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract abstract-type="author-highlights" id="abs0005"><title>Highlights</title><p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label><p id="par0005">Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause frequent hospital outbreaks in Saudi Arabia.</p></list-item><list-item id="lsti0010"><label>•</label><p id="par0010">Super-spreaders have always played a critical role in propagating healthcare facility outbreaks, and more recently asymptomatic healthcare workers (HCWs) have been identified to play a role.</p></list-item><list-item id="lsti0015"><label>•</label><p id="par0015">Differences do exist between the national and international guidance on handling HCWS exposed to MERS-CoV.</p></list-item><list-item id="lsti0020"><label>•</label><p id="par0020">Evidence to date supports liberal testing of all HCWs in close contact with MERS-CoV-positive cases, regardless of the significance of contact or presence or absence of symptoms, and the need for repeat testing.</p></list-item><list-item id="lsti0025"><label>•</label><p id="par0025">There is a need for urgent review of all guidelines regarding the return of asymptomatic MERS-CoV-positive HCWs under investigation to active duty.</p></list-item></list></p></abstract><abstract id="abs0010"><sec><title>Objectives</title><p>Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause frequent hospital outbreaks in Saudi Arabia, with emergency departments as the initial site of the spread of this virus.</p></sec><sec><title>Methods</title><p>The risk of transmission of MERS-CoV infection to healthcare workers (HCWs) was assessed in an outbreak in Riyadh. All HCWs with unprotected exposure to confirmed cases were tested after 24 h of exposure. Two negative results for MERS-CoV obtained 3 days apart and being free of any suggestive signs and symptoms were used to end the isolation of the HCWs and allow their return to duty.</p></sec><sec><title>Results</title><p>Overall 17 out of 879 HCWS with different levels of exposure tested positive for MERS-CoV. Of the 15 positive HCWS with adequate follow-up, 40% (6/15 HCWs) tested positive on the first sampling and 53% (8/15) tested positive on the second sampling. The time to negative results among the 15 positive HCWs ranged between 4 and 47 days (average 14.5 days) and the infected HCWs needed on average two samples for clearance. All positive HCWs were either asymptomatic or had mild disease.</p></sec><sec><title>Conclusions</title><p>The data obtained in this study support the widespread testing of all close contacts of MERS-CoV cases, regardless of the significance of the contact or presence or absence of symptoms. In addition, urgent careful review of guidance regarding the return of asymptomatic MERS-CoV-positive HCWs under investigation to active duty is needed.</p></sec></abstract><kwd-group id="kwd0005"><title>Keywords</title><kwd>Screening</kwd><kwd>HCWs</kwd><kwd>Quarantine</kwd><kwd>Isolation</kwd><kwd>Saudi Arabia</kwd><kwd>MERS-CoV</kwd></kwd-group></article-meta><notes><p id="misc0005"><bold>Corresponding Editor:</bold> Eskild Petersen, Aarhus, Denmark</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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