Infection control and prevention practices implemented to reduce transmission risk of Middle East respiratory syndrome-coronavirus in a tertiary care institution in Saudi Arabia

Am J Infect Control. 2016 May 1;44(5):605-11. doi: 10.1016/j.ajic.2016.01.004. Epub 2016 Feb 26.

Abstract

Background: Transmission of Middle East respiratory syndrome-coronavirus (MERS-CoV) among health care workers (HCWs) and patients has been documented with mortality rate approximating 36%. We propose advanced infection control measures (A-IC) used in conjunction with basic infection control measures (B-IC) help reduce pathogen transmission. B-IC include standard and transmission-based precautions. A-IC are initiatives implemented within our center to enhance effectiveness of B-IC.

Objective: Study effectiveness of combining B-IC and A-IC to prevent transmission of MERS-CoV to HCWs.

Methods: A retrospective observational study was undertaken. A-IC measures include administrative support with daily rounds; infection control risk assessment; timely screening, isolation, and specimen analysis; collaboration; epidemic planning; stockpiling; implementation of contingency plans; full personal protective equipment use for advanced airway management; use of a real-time electronic isolation flagging system; infection prevention and control team on-call protocols; pretransfer MERS-CoV testing; and education.

Results: A total of 874 real-time polymerase chain reaction MERS-CoV tests were performed during the period beginning July 1, 2013, and ending January 31, 2015. Six hundred ninety-four non-HCWs were tested, of these 16 tested positive for MERS-CoV and their infection was community acquired. Sixty-nine percent of the confirmed MERS-CoV-positive cases were men, with an average age of 56 years (range, 19-84 years). Of the total tested for MERS-CoV, 180 individuals were HCWs with zero positivity.

Conclusions: Adhering to a combination of B-IC and A-IC reduces the risk of MERS-CoV transmission to HCWs.

Keywords: Health care worker; Infection prevention; MERS-CoV; Occupational exposure.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control*
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Disease Transmission, Infectious / prevention & control*
  • Female
  • Humans
  • Infection Control / methods*
  • Infection Control / organization & administration*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Management
  • Saudi Arabia / epidemiology
  • Tertiary Care Centers
  • Young Adult