Hospital outbreak of Middle East respiratory syndrome coronavirus.

BACKGROUND: In September 2012, the World Health Organization reported the first cases of pneumonia caused by the novel Middle East respiratory syndrome coronavirus (MERS-CoV). We describe a cluster of health care-acquired MERS-CoV infections. METHODS: Medical records were reviewed for clinical and demographic information and determination of potential contacts and exposures. Case patients and contacts were interviewed. The incubation period and serial interval (the time between the successive onset of symptoms in a chain of transmission) were estimated. Viral RNA was sequenced. RESULTS: Between April 1 and May 23, 2013, a total of 23 cases of MERS-CoV infection were reported in the eastern province of Saudi Arabia. Symptoms included fever in 20 patients (87%), cough in 20 (87%), shortness of breath in 11 (48%), and gastrointestinal symptoms in 8 (35%); 20 patients (87%) presented with abnormal chest radiographs. As of June 12, a total of 15 patients (65%) had died, 6 (26%) had recovered, and 2 (9%) remained hospitalized. The median incubation period was 5.2 days (95% confidence interval [CI], 1.9 to 14.7), and the serial interval was 7.6 days (95% CI, 2.5 to 23.1). A total of 21 of the 23 cases were acquired by person-to-person transmission in hemodialysis units, intensive care units, or in-patient units in three different health care facilities. Sequencing data from four isolates revealed a single monophyletic clade. Among 217 household contacts and more than 200 health care worker contacts whom we identified, MERS-CoV infection developed in 5 family members (3 with laboratory-confirmed cases) and in 2 health care workers (both with laboratory-confirmed cases). CONCLUSIONS: Person-to-person transmission of MERS-CoV can occur in health care settings and may be associated with considerable morbidity. Surveillance and infection-control measures are critical to a global public health response.

Energy efficient optimal deployment of industrial wireless mesh networks using transient trigonometric Harris Hawks optimizer.

Wireless mesh networks (WMNs) play a vital role in modern communication systems, and optimizing the placement of wireless mesh routers is crucial for achieving efficient network performance in terms of coverage and connectivity. However, network congestion caused by overlapping routers poses challenges in WMN optimization. To address these issues, researchers have explored metaheuristic algorithms to strike a balance between coverage and connectivity in WMNs. This study introduces a novel hybrid optimization algorithm, namely Transient Trigonometric Harris Hawks Optimizer (TTHHO), specifically designed to tackle the optimization problems in WMNs. The primary objective of TTHHO is to find an optimal placement of routers that maximizes network coverage and ensures full connectivity among mesh routers. Notably, TTHHO's unique advantage lies in its efficient utilization of residual energy, strategically placing the sink node in areas with higher energy levels. The effectiveness of TTHHO is demonstrated through a comprehensive comparison with seven well-known algorithms, including Harris Hawks optimization (HHO), Sine Cosine Algorithm (SCA), Gray Wolf Optimization (GWO), Particle Swarm Optimization (PSO), Moth Flame Optimization (MFO), Equilibrium Optimizer (EO), and Transient Search Optimizer (TSO). The proposed algorithm is rigorously validated using 33 benchmark functions, and statistical analyses and simulation results confirm its superiority over other algorithms in terms of network connectivity, coverage, congestion reduction, and convergence. The simulation outcomes demonstrate the effectiveness and efficacy of the proposed TTHHO algorithm in optimizing WMNs, making it a promising approach for enhancing the performance of wireless communication systems.