Abstract
Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts. Observed low rates of virus transmission and the psychological effect of contact monitoring indicate that thoughtful assessment of close contacts is prudent and must be guided by clinical and epidemiologic risk factors.
Highlights
Notification of 2 imported cases of infection with Middle East respiratory syndrome coronavirus in the Netherlands triggered comprehensive monitoring of contacts
In 2014, Saudi Arabia experienced an outbreak due to increased zoonotic transmission and amplification by health care–related human-to-human transmission [3]; the risk for secondary transmission from patients to household contacts was estimated at ≈5% [5]
On May 13 and 14, 2014, MERS-CoV infection was confirmed in 2 residents of the Netherlands who had taken pilgrimages to Medina and Mecca, Saudi Arabia [7]
Summary
MERS-CoV reverse transcription PCR (RT-PCR) was performed on paired throat swabs from 106 (81%) and serologic analysis on paired serum samples from 99 (76%) of the 131 contacts (Table 1). All specimens obtained from the symptomatic contacts tested negative by RT-PCR and analysis of paired serum samples for MERS-CoV. The mean score on 3 subscale domains indicates the level of distress experienced [9]. Mean scores of unprotected contacts were compared with those of protected contacts by a Wilcoxon rank-sum test or t-test. Protected contacts were younger (median of 31 vs 48 years) and had a higher education (88% vs 31%) than unprotected contacts. Unprotected contacts had a significantly higher mean IES-R score (10.4 95% CI 7.2–13.6 versus 2.9, 95% CI 0.6–5.3); this result was seen on the different subscale domains (Table 2)
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