scholarly journals Scope and extent of healthcare-associated Middle East respiratory syndrome coronavirus transmission during two contemporaneous outbreaks in Riyadh, Saudi Arabia, 2017

2018 ◽  
Vol 40 (1) ◽  
pp. 79-88 ◽  
Author(s):  
Khalid H. Alanazi ◽  
Marie E. Killerby ◽  
Holly M. Biggs ◽  
Glen R. Abedi ◽  
Hani Jokhdar ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Outpatient Clinic ◽  
Index Case ◽  
Middle East Respiratory Syndrome ◽  
Contact Tracing ◽  
Care Hospital ◽  
Healthcare Facilities ◽  
Healthcare Associated ◽  
Unique Index

AbstractObjectiveTo investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.DesignOutbreak investigation.SettingCases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.MethodsContact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.ResultsIn total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.ConclusionsWe describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.

scholarly journals Notes from the Field: Nosocomial Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital — Riyadh, Saudi Arabia, 2015

2016 ◽  
Vol 65 (6) ◽  
pp. 163-164 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thamer H. Alenazi ◽  
Majid M. Alshamrani ◽  
Henry Baffoe-Bonnie ◽  
Hail M. Al-Abdely ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Middle East Respiratory Syndrome ◽  
Care Hospital ◽  
Nosocomial Outbreak ◽  
Large Tertiary Care

scholarly journals Laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Malaysia: preparedness and response, April 2014

2014 ◽  
Vol 19 (18) ◽  
Author(s):  
J Premila Devi ◽  
W Noraini ◽  
R Norhayati ◽  
C Chee Kheong ◽  
A S Badrul ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Respiratory Distress ◽  
Middle East Respiratory Syndrome ◽  
Contact Tracing ◽  
Local Hospital ◽  
Close Contacts

On 14 April 2014, the first laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection was reported in Malaysia in a man in his mid-fifties, who developed pneumonia with respiratory distress, after returning from a pilgrimage to Saudi Arabia. The case succumbed to his illness three days after admission at a local hospital. The follow-up of 199 close contacts identified through contact tracing and vigilant surveillance did not result in detecting any other confirmed cases of MERS-CoV infection.

scholarly journals Exploring the risk of Middle East Respiratory Syndrome- coronavirus among expatriate healthcare workers. A comparative epidemiological study of Saudi Arabian and South Korean healthcare workers

2019 ◽  
Author(s):  
Mohammed Owais Qureshi ◽  
Abrar Chughtai ◽  
Holly Seale
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Infectious Diseases ◽  
South Korea ◽  
Healthcare Workers ◽  
Saudi Arabian ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Healthcare Sector ◽  
Healthcare Associated

Abstract Background In comparison to South Korea, which was able to contain the outbreak of Middle East respiratory syndrome corona virus (MERS-CoV) in 2015, new cases are still emerging in the Kingdom of Saudi Arabia. The Saudi Arabian healthcare sector, which is dependent on the expatriate workforce to cater to its growing local healthcare demands, has been reporting multiple healthcare-associated MERS-CoV outbreaks since 2012. In this paper, we compare the epidemiology of MERS-CoV among healthcare workers (HCWs) in Saudi Arabia and South Korea and to ascertain the risks of MERS-CoV among expatriate HCWs. Methods Data were collected from publicly available resources such as World Health Organization and health department websites. A line list of all reported cases of MERS-CoV among HCWs in Saudi Arabia and South Korea was prepared and analysed. Results Among the total infected HCWs in Saudi Arabia, 84.6% (n=192/227) were expatriates. The mean age of infected HCWs in both settings was similar (Saudi Arabia 38 years, South Korea 39 years). Female HCWs were more likely to be infected, while male HCWs were more likely to die. In Saudi Arabia, 36.5% (n= 68/186) of HCWs with MERS-CoV were asymptomatic, compared to 7% (n=2/28) HCWs in South Korea. Most of the expatriate HCWs in Saudi Arabia were asymptomatic (78%, n=53/68) to MERS-CoV. Unlike South Korea, in Saudi Arabia, a diversity of HCWs other than doctors, and nurses were also infected with MERS-CoV. Conclusions A high proportion of expatriate HCWs were infected with MERS-CoV in Saudi Arabia which highlights the need for adequate training and education in this group about emerging infectious diseases and the appropriate strategies to prevent acquisition. Also, we did not find any policy statements restricting the contact of HCWs, vulnerable to MERS-CoV like pregnant HCW, HCWs over the age 60, HCWs with underlying comorbidity etc, from getting in proximity with a suspected or potential MERS-CoV infected patient. Policy development in this regard should be a priority, to contain healthcare-associated transmission of emerging and remerging infectious diseases like MERS-CoV. Further studies should be conducted to determine social, cultural and other factors contributing to high infection rate among expatriate HCWs.

scholarly journals Middle East Respiratory Syndrome Coronavirus Infection in Dromedary Camels in Saudi Arabia

mBio ◽  
2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Abdulaziz N. Alagaili ◽  
Thomas Briese ◽  
Nischay Mishra ◽  
Vishal Kapoor ◽  
Stephen C. Sameroff ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Index Case ◽  
Middle East Respiratory Syndrome ◽  
Domestic Sheep ◽  
Dromedary Camels ◽  
Kingdom Of Saudi Arabia ◽  
Current Prevalence ◽  
Coronavirus Infection ◽  
Viral Sequences

ABSTRACT The Middle East respiratory syndrome (MERS) is proposed to be a zoonotic disease; however, the reservoir and mechanism for transmission of the causative agent, the MERS coronavirus, are unknown. Dromedary camels have been implicated through reports that some victims have been exposed to camels, camels in areas where the disease has emerged have antibodies to the virus, and viral sequences have been recovered from camels in association with outbreaks of the disease among humans. Nonetheless, whether camels mediate transmission to humans is unresolved. Here we provide evidence from a geographic and temporal survey of camels in the Kingdom of Saudi Arabia that MERS coronaviruses have been circulating in camels since at least 1992, are distributed countrywide, and can be phylogenetically classified into clades that correlate with outbreaks of the disease among humans. We found no evidence of infection in domestic sheep or domestic goats. IMPORTANCE This study was undertaken to determine the historical and current prevalence of Middle East respiratory syndrome (MERS) coronavirus infection in dromedary camels and other livestock in the Kingdom of Saudi Arabia, where the index case and the majority of cases of MERS have been reported.

scholarly journals Outbreak of Middle East Respiratory Syndrome at Tertiary Care Hospital, Jeddah, Saudi Arabia, 2014

2016 ◽  
Vol 22 (5) ◽  
pp. 794-801 ◽  
Author(s):  
Deborah L. Hastings ◽  
Jerome I. Tokars ◽  
Inas Zakaria A.M. Abdel Aziz ◽  
Khulud Z. Alkhaldi ◽  
Areej T. Bensadek ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Middle East Respiratory Syndrome ◽  
Care Hospital

scholarly journals A case of imported Middle East Respiratory Syndrome coronavirus infection and public health response, Greece, April 2014

2014 ◽  
Vol 19 (16) ◽  
Author(s):  
S Tsiodras ◽  
A Baka ◽  
A Mentis ◽  
D Iliopoulos ◽  
X Dedoukou ◽  
...  
Keyword(s):  
Public Health ◽  
Saudi Arabia ◽  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
Initial Presentation ◽  
Contact Tracing ◽  
Public Health Response ◽  
Healthcare Environment ◽  
Health Response ◽  
Coronavirus Infection

On 18 April 2014, a case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection was laboratory confirmed in Athens, Greece in a patient returning from Jeddah, Saudi Arabia. Main symptoms upon initial presentation were protracted fever and diarrhoea, during hospitalisation he developed bilateral pneumonia and his condition worsened. During 14 days prior to onset of illness, he had extensive contact with the healthcare environment in Jeddah. Contact tracing revealed 73 contacts, no secondary cases had occurred by 22 April.

scholarly journals Middle East Respiratory Syndrome Coronavirus, Saudi Arabia, 2017 Outbreak: Super-Spreading Event and Control Measures

2020 ◽  
Vol 41 (S1) ◽  
pp. s317-s317
Author(s):  
Hala Amer
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Middle East ◽  
Early Detection ◽  
Infection Control ◽  
Middle East Respiratory Syndrome ◽  
Control Measures ◽  
Contact Tracing ◽  
Healthcare Facilities ◽  
Medical City

Background: The hallmark of Middle East respiratory syndrome coronavirus (MERS-CoV) disease is the ability to cause major healthcare-associated outbreaks with superspreading events leading to massive transmission and excessive morbidity and mortality. This abstract provides overview of MERS-CoV multi-healthcare facilities outbreak in Riyadh in June 2017, with focus on cluster reported and the control measures taken at King Saud Medical City. The outbreak began with a patient who presented with acute renal failure requiring hemodialysis and became a MERS-CoV superspreader, igniting the cluster of cases in several hospitals in King Saud Medical City. Methods: For epidemiologic investigation, a case was defined as any patient with laboratory-confirmed MERS-CoV infection with connection to the affected healthcare facilities. Contact tracing and testing were performed according to the Ministry of Health (MOH) guidelines. MERS-CoV testing was recommended for HCWs who had unprotected close contact with a confirmed case. Considering the superspreading phenomena, contact tracing was included all persons attended the same area with the positive case either as a patient, an HCW, or a patient’s visitor or companion. Laboratory confirmation was conducted using real-time RT-PCR. Genome sequencing and phylogenetic analysis were performed for available MERS-CoV rRT-PCR–positive samples by the CDC. The infection control measures applied included decreasing patient load through downsizing emergency department acceptance, maintaining low elective services, limiting inpatient admissions, and encouraging discharge. Early detection and quarantining of any suspected cases took place through extensive contact tracing, properly triaging all patients upon admission, consistent monitoring of inpatients and HCWs for any emerging acute respiratory illness, allocation of more single rooms inside the facility and staff dormitory, and extending the services of virology laboratory to get timely results. Further measures consisted of extensive education on infection control practices, monitoring healthcare worker adherence, reassuring the public by maintaining transparency of published reports, and launching a hotline to respond to HCW concerns. Moreover, travel restrictions applied to any person with a history of exposure to a confirmed MERS-CoV case during the 2-week monitoring period. Results: Overall, 44 cases of MERS-CoV infection were reported from 3 simultaneous clusters during the 2017 Riyadh outbreak, including 11 fatal cases. Among all of the cases, 29 cases were reported at King Saud Medical City. The outbreak at KSMC required 30 days to be controlled. Conclusions: High vigilance for early detection is a key control measure. To be more sensitive, point-of-care MERS-CoV testing is required because clinical suspicion is challenging in patients presenting with acute renal failure.Funding: NoneDisclosures: None

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