Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV): Revision of screening strategies urgently needed

• Type of Material: Article
• Authors: Hala Amer, Ministry of Health Saudi Arabia; Abdulrahman S. Alqahtani, Ministry of Health Saudi Arabia; Faisal Alaklobi, Ministry of Health Saudi Arabia; Juhaina Altayeb, Ministry of Health Saudi Arabia; Ziad Memish, Emory University
• Language: English
• Date: 2018-06-01
• Publisher: Emory University Libraries
• Publication Version: Final Published Version
• Copyright Statement: © 2018 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ijid.2018.04.001
• Title of Journal or Parent Work: International Journal of Infectious Diseases
• Volume: 71
• Start Page: 113
• End Page: 116
• Grant/Funding Information: No funding was obtained for this study.
• Keywords: Health Personnel; Coronavirus Infections; Quarantine; MERS-CoV; Disease Outbreaks; Isolation; Middle East Respiratory Syndrome Coronavirus; Adult; HCWs; Occupational Exposure; Saudi Arabia; Male; Female; Screening; Humans
• Research Categories: Health Sciences, Public Health; Health Sciences, Occupational Health and Safety; Health Sciences, Health Care Management

Abstract

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.