Transmission of Middle East Respiratory Syndrome Coronavirus Infections in Healthcare Settings, Abu Dhabi.

Jennifer C Hunter,Ahmed Khudair,Kimberly Pringle,Farida Ismail Al Hosani,Laila Abdel Wareth,Bashir Aden,Asma Al Ameri,Alexander J Kallen,Hala Imambaccus,Wesal Abu Amer,Wafa Al Dhaheri,Negar N Alami,Feda El Saleh,Lia M Haynes,Andrew Turner,Huong Pham,Farrukh Amin Sheikh,Aron J Hall,Stefan Weber,Kheir Abu Elkheir,Suxiang Tong,Nawal Al Kaabi,Susan I Gerber,Mariam Al Mulla,Sudhir Bunga,Zyad Al Bandar,Duc T Nguyen ,David T Kuhar ,Jürgen Sasse ,Brett Whitaker

doi:10.3201/eid2204.151615

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) infections sharply increased in the Arabian Peninsula during spring 2014. In Abu Dhabi, United Arab Emirates, these infections occurred primarily among healthcare workers and patients. To identify and describe epidemiologic and clinical characteristics of persons with healthcare-associated infection, we reviewed laboratory-confirmed MERS-CoV cases reported to the Health Authority of Abu Dhabi during January 1, 2013-May 9, 2014. Of 65 case-patients identified with MERS-CoV infection, 27 (42%) had healthcare-associated cases. Epidemiologic and genetic sequencing findings suggest that 3 healthcare clusters of MERS-CoV infection occurred, including 1 that resulted in 20 infected persons in 1 hospital. MERS-CoV in healthcare settings spread predominantly before MERS-CoV infection was diagnosed, underscoring the importance of increasing awareness and infection control measures at first points of entry to healthcare facilities.

Highlights

By early September 2015, a total of 74 patients with laboratory-confirmed MERS-CoV infection were reported in the United Arab Emirates (UAE); most were reported from Abu Dhabi during March–April 2014, when the Arabian Peninsula had a sharp increase in infections, primarily involving healthcare workers (HCWs) and patients with recent healthcare exposure [8,9,11]
The extensive case investigation and contact tracing by HCWs and the Health Authority of Abu Dhabi in response to this increase provide resources to inform our understanding of MERS-CoV infections acquired and spread in healthcare settings
Case and Contact Investigation Of 65 MERS-CoV case-patients identified during our investigation period (July 1, 2013–May 9, 2014) in AbuDhabi, 27 (42%) were healthcare associated; 19 (70%) of the 27 were HCWs; 6 (22%) were hospitalized patients, Transmission of MERS-CoV in Healthcare Settings

Summary

Introduction

To identify and describe epidemiologic and clinical characteristics of persons with healthcare-associated infection, we reviewed laboratory-confirmed MERS-CoV cases reported to the Health Authority of Abu Dhabi during January 1, 2013–May 9, 2014. By early September 2015, a total of 74 patients with laboratory-confirmed MERS-CoV infection were reported in the United Arab Emirates (UAE); most were reported from Abu Dhabi during March–April 2014, when the Arabian Peninsula had a sharp increase in infections, primarily involving healthcare workers (HCWs) and patients with recent healthcare exposure [8,9,11]. The extensive case investigation and contact tracing by HCWs and the Health Authority of Abu Dhabi in response to this increase provide resources to inform our understanding of MERS-CoV infections acquired and spread in healthcare settings. We describe the epidemiologic and clinical characteristics of healthcare-associated MERS-CoV infections in Abu Dhabi and characterize the size and suspected transmission patterns in healthcare settings

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Conclusion