ArticleInfection control and hospital epidemiology2019
Scope and extent of healthcare-associated Middle East respiratory syndrome coronavirus transmission during two contemporaneous outbreaks in Riyadh, Saudi Arabia, 2017.
Article in Infection control and hospital epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Coronavirus-associated kidney outcomes in COVID-19, SARS, and MERS: a meta-analysis and systematic review.Renal failure · 2020Pooled it
- Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19: A Living Systematic Review of Multiple Streams of Evidence.Annals of internal medicine · 2020Pooled it
- Coronaviridae-Old friends, new enemy!Oral diseases · 2022Review
- Article
- Surveillance and Testing for Middle East Respiratory Syndrome Coronavirus, Saudi Arabia, March 2016-March 2019.Emerging infectious diseases · 2020Article
- Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians.Australasian emergency care · 2020Article
- The coronavirus (COVID-19) epidemic and patient safety.Journal of the American Academy of Dermatology · 2020Article
- Middle East respiratory syndrome.Lancet (London, England) · 2020Review
- The Middle East Respiratory Syndrome (MERS).Infectious disease clinics of North America · 2019Review
- Middle East Respiratory Syndrome Coronavirus, Saudi Arabia, 2017-2018.Emerging infectious diseases · 2019Article
- Comparison of Serologic Assays for Middle East Respiratory Syndrome Coronavirus.Emerging infectious diseases · 2019Article
- Middle East respiratory syndrome coronavirus in the last two years: Health care workers still at risk.American journal of infection control · 2019Article
- Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice.Infection, disease & health · 2019Article
- Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017.Scientific reports · 2019Article
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Authors and funding
31 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo 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.
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