Tags

Type your tag names separated by a space and hit enter

Clinical and laboratory findings of the first imported case of Middle East respiratory syndrome coronavirus to the United States.
Clin Infect Dis. 2014 Dec 01; 59(11):1511-8.CI

Abstract

BACKGROUND

The Middle East respiratory syndrome coronavirus (MERS-CoV) was discovered September 2012 in the Kingdom of Saudi Arabia (KSA). The first US case of MERS-CoV was confirmed on 2 May 2014.

METHODS

We summarize the clinical symptoms and signs, laboratory and radiologic findings, and MERS-CoV-specific tests.

RESULTS

The patient is a 65-year-old physician who worked in a hospital in KSA where MERS-CoV patients were treated. His illness onset included malaise, myalgias, and low-grade fever. He flew to the United States on day of illness (DOI) 7. His first respiratory symptom, a dry cough, developed on DOI 10. On DOI 11, he presented to an Indiana hospital as dyspneic, hypoxic, and with a right lower lobe infiltrate on chest radiography. On DOI 12, his serum tested positive by real-time reverse transcription polymerase chain reaction (rRT-PCR) for MERS-CoV and showed high MERS-CoV antibody titers, whereas his nasopharyngeal swab was rRT-PCR negative. Expectorated sputum was rRT-PCR positive the following day, with a high viral load (5.31 × 10(6) copies/mL). He was treated with antibiotics, intravenous immunoglobulin, and oxygen by nasal cannula. He was discharged on DOI 22. The genome sequence was similar (>99%) to other known MERS-CoV sequences, clustering with those from KSA from June to July 2013.

CONCLUSIONS

This patient had a prolonged nonspecific prodromal illness before developing respiratory symptoms. Both sera and sputum were rRT-PCR positive when nasopharyngeal specimens were negative. US clinicians must be vigilant for MERS-CoV in patients with febrile and/or respiratory illness with recent travel to the Arabian Peninsula, especially among healthcare workers.

Authors+Show Affiliations

Division of Infectious Diseases.Epidemic Intelligence Service, Division of Scientific Education and Professional Development.Department of Emergency Medicine, Community Hospital, Munster.Indiana State Department of Health, Indianapolis, Indiana.Indiana State Department of Health, Indianapolis, Indiana.Indiana State Department of Health, Indianapolis, Indiana.Indiana State Department of Health, Indianapolis, Indiana.Indiana State Department of Health, Indianapolis, Indiana.Indiana State Department of Health, Indianapolis, Indiana.Indiana State Department of Health, Indianapolis, Indiana.Epidemic Intelligence Service, Division of Scientific Education and Professional Development.Epidemic Intelligence Service, Division of Scientific Education and Professional Development.Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases.Division of Viral Diseases.Division of Viral Diseases.Division of Viral Diseases.Division of Viral Diseases.Division of Viral Diseases.Division of Viral Diseases.Division of Viral Diseases.National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Viral Diseases.

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25100864

Citation

Kapoor, Minal, et al. "Clinical and Laboratory Findings of the First Imported Case of Middle East Respiratory Syndrome Coronavirus to the United States." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 59, no. 11, 2014, pp. 1511-8.
Kapoor M, Pringle K, Kumar A, et al. Clinical and laboratory findings of the first imported case of Middle East respiratory syndrome coronavirus to the United States. Clin Infect Dis. 2014;59(11):1511-8.
Kapoor, M., Pringle, K., Kumar, A., Dearth, S., Liu, L., Lovchik, J., Perez, O., Pontones, P., Richards, S., Yeadon-Fagbohun, J., Breakwell, L., Chea, N., Cohen, N. J., Schneider, E., Erdman, D., Haynes, L., Pallansch, M., Tao, Y., Tong, S., ... Feikin, D. R. (2014). Clinical and laboratory findings of the first imported case of Middle East respiratory syndrome coronavirus to the United States. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 59(11), 1511-8. https://doi.org/10.1093/cid/ciu635
Kapoor M, et al. Clinical and Laboratory Findings of the First Imported Case of Middle East Respiratory Syndrome Coronavirus to the United States. Clin Infect Dis. 2014 Dec 1;59(11):1511-8. PubMed PMID: 25100864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and laboratory findings of the first imported case of Middle East respiratory syndrome coronavirus to the United States. AU - Kapoor,Minal, AU - Pringle,Kimberly, AU - Kumar,Alan, AU - Dearth,Stephanie, AU - Liu,Lixia, AU - Lovchik,Judith, AU - Perez,Omar, AU - Pontones,Pam, AU - Richards,Shawn, AU - Yeadon-Fagbohun,Jaime, AU - Breakwell,Lucy, AU - Chea,Nora, AU - Cohen,Nicole J, AU - Schneider,Eileen, AU - Erdman,Dean, AU - Haynes,Lia, AU - Pallansch,Mark, AU - Tao,Ying, AU - Tong,Suxiang, AU - Gerber,Susan, AU - Swerdlow,David, AU - Feikin,Daniel R, Y1 - 2014/08/06/ PY - 2014/8/8/entrez PY - 2014/8/8/pubmed PY - 2015/7/3/medline KW - Middle East respiratory syndrome coronavirus KW - viral pneumonia SP - 1511 EP - 8 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 59 IS - 11 N2 - BACKGROUND: The Middle East respiratory syndrome coronavirus (MERS-CoV) was discovered September 2012 in the Kingdom of Saudi Arabia (KSA). The first US case of MERS-CoV was confirmed on 2 May 2014. METHODS: We summarize the clinical symptoms and signs, laboratory and radiologic findings, and MERS-CoV-specific tests. RESULTS: The patient is a 65-year-old physician who worked in a hospital in KSA where MERS-CoV patients were treated. His illness onset included malaise, myalgias, and low-grade fever. He flew to the United States on day of illness (DOI) 7. His first respiratory symptom, a dry cough, developed on DOI 10. On DOI 11, he presented to an Indiana hospital as dyspneic, hypoxic, and with a right lower lobe infiltrate on chest radiography. On DOI 12, his serum tested positive by real-time reverse transcription polymerase chain reaction (rRT-PCR) for MERS-CoV and showed high MERS-CoV antibody titers, whereas his nasopharyngeal swab was rRT-PCR negative. Expectorated sputum was rRT-PCR positive the following day, with a high viral load (5.31 × 10(6) copies/mL). He was treated with antibiotics, intravenous immunoglobulin, and oxygen by nasal cannula. He was discharged on DOI 22. The genome sequence was similar (>99%) to other known MERS-CoV sequences, clustering with those from KSA from June to July 2013. CONCLUSIONS: This patient had a prolonged nonspecific prodromal illness before developing respiratory symptoms. Both sera and sputum were rRT-PCR positive when nasopharyngeal specimens were negative. US clinicians must be vigilant for MERS-CoV in patients with febrile and/or respiratory illness with recent travel to the Arabian Peninsula, especially among healthcare workers. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/25100864/Clinical_and_laboratory_findings_of_the_first_imported_case_of_Middle_East_respiratory_syndrome_coronavirus_to_the_United_States_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciu635 DB - PRIME DP - Unbound Medicine ER -