Contact investigation for imported case of Middle East respiratory syndrome, Germany

Abstract

On March 19, 2013, a patient from United Arab Emirates who had severe respiratory infection was transferred to a hospital in Germany, 11 days after symptom onset. Infection with Middle East respiratory syndrome coronavirus (MERS-CoV) was suspected on March 21 and confirmed on March 23; the patient, who had contact with an ill camel shortly before symptom onset, died on March 26. A contact investigation was initiated to identify possible person-to-person transmission and assess infection control measures. Of 83 identified contacts, 81 were available for follow-up. Ten contacts experienced mild symptoms, but test results for respiratory and serum samples were negative for MERS-CoV. Serologic testing was done for 53 (75%) of 71 nonsymptomatic contacts; all results were negative. Among contacts, the use of FFP2/FFP3 face masks during aerosol exposure was more frequent after MERS-CoV infection was suspected than before. Infection control measures may have prevented nosocomial transmission of the virus.

Keywords: CoV; Germany; MERS; MERS-CoV; Middle East respiratory syndrome; United Arab Emirates; coronavirus; coronavirus infections; nCoV; respiratory infections; viruses.

Figure 1

Timeline for patient history and contact investigation in imported case of Middle East respiratory syndrome (MERS), Germany, 2013.

Figure 2

Daily number of health care workers who had contact with a patient infected with Middle East respiratory syndrome (MERS) coronavirus who was hospitalized in Germany, March 19–26, 2013.