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

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 Middle East Respiratory Syndrome Infection Control and Prevention Guideline for Healthcare Facilities

2015 ◽  
Vol 47 (4) ◽  
pp. 278 ◽  
Author(s):  
Jin Yong Kim ◽  
Joon Young Song ◽  
Young Kyung Yoon ◽  
Seong-Ho Choi ◽  
Young Goo Song ◽  
...  
Keyword(s):  
Middle East ◽  
Infection Control ◽  
Middle East Respiratory Syndrome ◽  
Healthcare Facilities ◽  
Prevention Guideline ◽  
Control And Prevention ◽  
Infection Control And Prevention

scholarly journals Can Copper Products and Surfaces Reduce the Spread of Infectious Microorganisms and Hospital-Acquired Infections?

Materials ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3444
Author(s):  
Joji Abraham ◽  
Kim Dowling ◽  
Singarayer Florentine
Keyword(s):  
Infection Control ◽  
Hospital Admissions ◽  
Copper Alloys ◽  
Well Being ◽  
Mortality Rates ◽  
Pathogen Transmission ◽  
Control Measures ◽  
Traditional Use ◽  
Healthcare Facilities ◽  
Infection Control Measures

Pathogen transfer and infection in the built environment are globally significant events, leading to the spread of disease and an increase in subsequent morbidity and mortality rates. There are numerous strategies followed in healthcare facilities to minimize pathogen transfer, but complete infection control has not, as yet, been achieved. However, based on traditional use in many cultures, the introduction of copper products and surfaces to significantly and positively retard pathogen transmission invites further investigation. For example, many microbes are rendered unviable upon contact exposure to copper or copper alloys, either immediately or within a short time. In addition, many disease-causing bacteria such as E. coli O157:H7, hospital superbugs, and several viruses (including SARS-CoV-2) are also susceptible to exposure to copper surfaces. It is thus suggested that replacing common touch surfaces in healthcare facilities, food industries, and public places (including public transport) with copper or alloys of copper may substantially contribute to limiting transmission. Subsequent hospital admissions and mortality rates will consequently be lowered, with a concomitant saving of lives and considerable levels of resources. This consideration is very significant in times of the COVID-19 pandemic and the upcoming epidemics, as it is becoming clear that all forms of possible infection control measures should be practiced in order to protect community well-being and promote healthy outcomes.

scholarly journals Contact Tracing for Imported Case of Middle East Respiratory Syndrome, China, 2015

2016 ◽  
Vol 22 (9) ◽  
pp. 1644-1646 ◽  
Author(s):  
Min Kang ◽  
Tie Song ◽  
Haojie Zhong ◽  
Jie Hou ◽  
Jun Wang ◽  
...  
Keyword(s):  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
Contact Tracing ◽  
Imported Case

scholarly journals COVID-19: Need of the hour to revisit asymptomatic prevalence of coronavirus pandemic

2020 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Richard Avoi ◽  
Syed Sharizman Syed Abdul Rahim ◽  
Mohammad Saffree Jeffree ◽  
Visweswara Rao Pasupuleti
Keyword(s):  
Middle East ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Tract ◽  
Middle East Respiratory Syndrome ◽  
Control Measures ◽  
Case Detection ◽  
Viral Loads ◽  
Early Stages ◽  
Exponential Increase ◽  
Asymptomatic Patients

  Since the Coronavirus disease 2019 (COVID-19) pandemic unfolded in China (Huang et al., 2020) back in December 2019, thus far, more than five million people were infected with the virus and 333,401 death were recorded worldwide (WHO, 2020b). The exponential increase in number shows that COVID-19 spreads faster compared to Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS). A study (Zou et al., 2020) has shown that high viral loads of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are detected in symptomatic patients soon after the onset of symptoms, wherein the load content is higher in their nose than in their throat. Furthermore, the same study has revealed similar viral loads between symptomatic and asymptomatic patients. Therefore, these findings may suggest the possibility of COVID-19 transmission earlier before the onset of symptoms itself. In the early stages of the pandemic, the control measures carried out have focused on screening of symptomatic person; at the time, the whole world thought that the spread of SARS-Cov-2 would only occur through symptomatic person-to-person transmission. In comparison, transmission in SARS would happen after the onset of illness, whereby the viral loads in the respiratory tract peaked around ten days after the development of symptoms by patients (Peiris et al., 2003). However, case detection for SARS (i.e. screening of symptomatic persons) will be grossly inadequate for the current COVID-19 pandemic, thus requiring different strategies to detect those infected with SARS-CoV-2 before they develop the symptoms.

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