Abstract
To investigate a cluster of Middle East respiratory syndrome (MERS) cases in a women-only dormitory in Riyadh, Saudi Arabia, in October 2015, we collected epidemiologic information, nasopharyngeal/oropharyngeal swab samples, and blood samples from 828 residents during November 2015 and December 2015–January 2016. We found confirmed infection for 19 (8 by reverse transcription PCR and 11 by serologic testing). Infection attack rates varied (2.7%–32.3%) by dormitory building. No deaths occurred. Independent risk factors for infection were direct contact with a confirmed case-patient and sharing a room with a confirmed case-patient; a protective factor was having an air conditioner in the bedroom. For 9 women from whom a second serum sample was collected, antibodies remained detectable at titers >1:20 by pseudoparticle neutralization tests (n = 8) and 90% plaque-reduction neutralization tests (n = 2). In closed high-contact settings, MERS coronavirus was highly infectious and pathogenicity was relatively low.
Highlights
To investigate a cluster of Middle East respiratory syndrome (MERS) cases in a women-only dormitory in Riyadh, Saudi Arabia, in October 2015, we collected epidemiologic information, nasopharyngeal/oropharyngeal swab samples, and blood samples from 828 residents during November 2015 and December 2015–January 2016
At the time the outbreak investigation was initiated, Kingdom of Saudi Arabia (KSA) Ministry of Health officials had identified 8 MERS case-patients by reverse transcription PCR (RT-PCR) [17]; all patients were epidemiologically linked through their place of residence, a dormitory that housed expatriate women
The first patient in this cluster who had laboratory-confirmed MERS was a 27-year-old woman who worked as a janitor in a women-only university in Riyadh
Summary
To investigate a cluster of Middle East respiratory syndrome (MERS) cases in a women-only dormitory in Riyadh, Saudi Arabia, in October 2015, we collected epidemiologic information, nasopharyngeal/oropharyngeal swab samples, and blood samples from 828 residents during November 2015 and December 2015–January 2016. Few outbreaks of MERS-CoV outside of healthcare settings have been documented, and Author affiliations: Institut Pasteur, Paris, France (M.D. Van Kerkhove); Ministry of Health, Riyadh, Saudi Arabia In early October 2015, a cluster of MERS-CoV infections was identified among expatriate women working for a women-only university in Riyadh, Saudi Arabia. At the time the outbreak investigation was initiated, Kingdom of Saudi Arabia (KSA) Ministry of Health officials had identified 8 MERS case-patients by reverse transcription PCR (RT-PCR) [17]; all patients were epidemiologically linked through their place of residence, a dormitory that housed expatriate women. Two additional laboratory-confirmed cases were identified among healthcare workers who had been exposed to the first case-patient, who had sought treatment at a medical clinic near the residence [17]
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