Abstract

Middle East respiratory syndrome (MERS) is known to be transmitted through close contact. However, epidemiological surveys of MERS in Korea indicated that some secondary patients were infected without close contact. Therefore, the possibility of other transmission routes must be identified. In this study, the possibility of MERS spreading through airflow was investigated on the eighth floor of Pyeongtaek St Mary's Hospital. Computational fluid dynamics was used to analyse the indoor airflow and passive tracer diffusion during the index patient's stay. Six cases were simulated for different outdoor wind directions and indoor mechanical ventilation operations. When a passive tracer was released in ward 8104, where the index patient was hospitalized, the passive tracer spread through the indoor airflow, which was created by the outdoor airflow. Ward 8109, which had the largest number of infected cases and was far distant from ward 8104, showed passive tracer concentration in all cases. This result indicates that MERS may have spread through airflow. The study results do not imply that the infection pathway of MERS is airborne. However, the results show the possibility of MERS spreading through airflow in specific environments such as poor ventilation environments.

Highlights

  • Middle East respiratory syndrome (MERS) is known to be transmitted through close contact

  • When a passive tracer was released in ward 8104, where the index patient was hospitalized, the passive tracer spread through the indoor airflow, which was created by the outdoor airflow

  • The results showed that the pattern of the infection of the secondary patient was similar to the indoor airflow pattern [14]

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Summary

Introduction

Middle East respiratory syndrome (MERS) is known to be transmitted through close contact. Epidemiological surveys of MERS in Korea indicated that some secondary patients were infected without close contact. The possibility of MERS spreading through airflow was investigated on the eighth floor of Pyeongtaek St Mary’s Hospital. Ward 8109, which had the largest number of infected cases and was far distant from ward 8104, showed passive tracer concentration in all cases This result indicates that MERS may have spread through airflow. The results of previous studies indicate that the droplets from the index patient, who was a super-spreader, can partially evaporate and become small particles such as droplet nuclei and spread to the adjacent wards through airflow [14,22,23]

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