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No transmission detected among contacts of 2014 MERS patient
Despite making multiple contacts at home and in the hospital before receiving suitable infection control treatment, the first imported patient with Middle East respiratory syndrome coronavirus in the United States did not transmit the infection, according to recent data published in Emerging Infectious Diseases.
CDC investigators responded to an April 29, 2014 report from the Indiana State Department of Health informing them of a patient with suspected MERS coronavirus (MERS-CoV) infection. After confirming the diagnosis on May 2, 2014 via clinical specimen, this case was identified as the first imported MERS-CoV case in the United States.
The patient was a physician and Saudi Arabian resident who traveled by air to Chicago via London, then by bus to Indiana. From there, he stayed with his family for 4 days and interacted twice with a business associate before presenting for medical care at an Indiana hospital. Several health care personnel (HCP) came into contact with the patient during this time.
The researchers conducted a thorough contact investigation into the case to assess exposures in the household, community and hospital settings. Contacts were defined as all individuals who were possibly exposed to the case-patient before the introduction of airborne and contact precautions. HCP contacts were defined as all individuals who had a face-to-face interaction with the case-patient without suitable personal protective equipment.
The researchers defined household contacts as all individuals who stayed overnight in the same household as the case-patient between his arrival in the U.S. and his hospital admission. Community contacts were all individuals, other than household or HCP contacts, who had face-to-face contact with the patient. Respiratory and blood samples were collected from all contacts, and tested for MERS-CoV. The researchers also interviewed 56 of the case-patient’s 61 contacts.
Of the 45 HCP contacts, the most frequently exposed personnel were in the hospital’s ED (69%). Nurses had the most frequent hospital contact with the case-patient (47%).
Among household and community contacts, the exposure to the case-patient consisted of brief physical contact (such as hugging). All laboratory test results were negative for MERS-CoV, and no secondary cases were identified.
“We conducted a thorough contact investigation into this MERS case,” the researchers wrote. “We documented the absence of transmission of MERS-CoV from the first identified imported case-patient in the United States despite his having multiple contacts at home and in the hospital before the implementation of appropriate infection-control procedures.” – by Jen Byrne
Disclosure : The researchers report no relevant financial disclosures.