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Observational Study
. 2016 May 1;44(5):605-11.
doi: 10.1016/j.ajic.2016.01.004. Epub 2016 Feb 26.

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

Taimur S Butt  1 , Irene Koutlakis-Barron  2 , Suliman AlJumaah  2 , Sahar AlThawadi  3 , Saleh AlMofada  4
Affiliations
Observational Study

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

Taimur S Butt et al. Am J Infect Control. .

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.

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Figures

Fig 1
Fig 1
Prescreening for flu-like illness in the emergency department. AIIR, airborne infection isolation room; DEM, Department of Emergency Medicine; MERS-CoV, Middle East respiratory syndrome-coronavirus; NPA, nasopharyngeal aspirate; PCR, polymerase chain reaction; PPE, personal protective equipment; SARI, severe acute respiratory illness. *Including hand hygiene, facial protection, gloves with or without gown, and N-95 mask (if fit tested).
Fig 2
Fig 2
Education posters/rollups.
Fig 3
Fig 3
Test results of the study period beginning July 1, 2013, and ending January 31, 2015.
See this image and copyright information in PMC

References

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