RESUMEN
A total 130 cases of Middle East respiratory syndrome coronavirus were identified during a large hospital outbreak in Saudi Arabia; 87 patients and 43 healthcare workers. The majority (80%) of transmission was healthcare-acquired (HAI) infection, with 4 generations of HAI transmission. The emergency department was the main location of exposure.
Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infección Hospitalaria/transmisión , Brotes de Enfermedades/estadística & datos numéricos , Coronavirus del Síndrome Respiratorio de Oriente Medio , Adulto , Anciano , Anciano de 80 o más Años , Trazado de Contacto , Infecciones por Coronavirus/prevención & control , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Brotes de Enfermedades/prevención & control , Servicio de Urgencia en Hospital , Femenino , Personal de Salud , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Arabia Saudita/epidemiologíaRESUMEN
Since the first diagnosis of Middle East respiratory syndrome (MERS) caused by the MERS coronavirus (MERS-CoV) in the Kingdom of Saudi Arabia in 2012, sporadic cases and clusters have occurred throughout the country (1). During June-August, 2015, a large MERS outbreak occurred at King Abulaziz Medical City, a 1,200-bed tertiary-care hospital that includes a 150-bed emergency department that registers 250,000 visits per year.
Asunto(s)
Infecciones por Coronavirus/epidemiología , Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Centros de Atención Terciaria , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Arabia Saudita/epidemiologíaRESUMEN
BACKGROUND: The objective of this retrospective cohort study was to assess the impact of implementation of different levels of infection prevention and control (IPC) measures during an outbreak of Middle East respiratory syndrome (MERS) in a large tertiary hospital in Saudi Arabia. The setting was an emergency room (ER) in a large tertiary hospital and included primary and secondary MERS patients. METHODS: Rapid response teams conducted repeated assessments of IPC and monitored implementation of corrective measures using a detailed structured checklist. We ascertained the epidemiologic link between patients and calculated the secondary attack rate per 10,000 patients visiting the ER (SAR/10,000) in 3 phases of the outbreak. RESULTS: In phase I, 6 primary cases gave rise to 48 secondary cases over 4 generations, including a case that resulted in 9 cases in the first generation of secondary cases and 21 cases over a chain of 4 generations. During the second and third phases, the number of secondary cases sharply dropped to 18 cases and 1 case, respectively, from a comparable number of primary cases. The SAR/10,000 dropped from 75 (95% confidence interval [CI], 55-99) in phase I to 29 (95% CI, 17-46) and 3 (95% CI, 0-17) in phases II and III, respectively. CONCLUSIONS: The study demonstrated salient evidence that proper institution of IPC measures during management of an outbreak of MERS could remarkably change the course of the outbreak.