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Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea.
Clin Infect Dis. 2016 Mar 15; 62(6):755-60.CI

Abstract

BACKGROUND

Although Middle East Respiratory Syndrome coronavirus (MERS-CoV) is characterized by a risk of nosocomial transmission, the detailed mode of transmission and period of virus shedding from infected patients are poorly understood. The aims of this study were to investigate the potential role of environmental contamination by MERS-CoV in healthcare settings and to define the period of viable virus shedding from MERS patients.

METHODS

We investigated environmental contamination from 4 patients in MERS-CoV units of 2 hospitals. MERS-CoV was detected by reverse transcription polymerase chain reaction (PCR) and viable virus was isolated by cultures.

RESULTS

Many environmental surfaces of MERS patient rooms, including points frequently touched by patients or healthcare workers, were contaminated by MERS-CoV. Viral RNA was detected up to five days from environmental surfaces following the last positive PCR from patients' respiratory specimens. MERS-CoV RNA was detected in samples from anterooms, medical devices, and air-ventilating equipment. In addition, MERS-CoV was isolated from environmental objects such as bed sheets, bedrails, IV fluid hangers, and X-ray devices. During the late clinical phase of MERS, viable virus could be isolated in 3 of the 4 enrolled patients on day 18 to day 25 after symptom onset.

CONCLUSIONS

Most of touchable surfaces in MERS units were contaminated by patients and health care workers and the viable virus could shed through respiratory secretion from clinically fully recovered patients. These results emphasize the need for strict environmental surface hygiene practices, and sufficient isolation period based on laboratory results rather than solely on clinical symptoms.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon.Departments of Internal Medicine, and.Microbiology, College of Medicine and Medical Research Institute, and.Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon.Microbiology, College of Medicine and Medical Research Institute, and.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.Microbiology, College of Medicine and Medical Research Institute, and.Microbiology, College of Medicine and Medical Research Institute, and.Departments of Internal Medicine, and.Departments of Internal Medicine, and.Microbiology, College of Medicine and Medical Research Institute, and Zoonotic Infectious Diseases Research Center, Chungbuk National University, Seowon-Gu, Cheongju, Republic of Korea.

Pub Type(s)

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

Language

eng

PubMed ID

26679623

Citation

Bin, Seo Yu, et al. "Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62, no. 6, 2016, pp. 755-60.
Bin SY, Heo JY, Song MS, et al. Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea. Clin Infect Dis. 2016;62(6):755-60.
Bin, S. Y., Heo, J. Y., Song, M. S., Lee, J., Kim, E. H., Park, S. J., Kwon, H. I., Kim, S. M., Kim, Y. I., Si, Y. J., Lee, I. W., Baek, Y. H., Choi, W. S., Min, J., Jeong, H. W., & Choi, Y. K. (2016). Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62(6), 755-60. https://doi.org/10.1093/cid/civ1020
Bin SY, et al. Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea. Clin Infect Dis. 2016 Mar 15;62(6):755-60. PubMed PMID: 26679623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Environmental Contamination and Viral Shedding in MERS Patients During MERS-CoV Outbreak in South Korea. AU - Bin,Seo Yu, AU - Heo,Jung Yeon, AU - Song,Min-Suk, AU - Lee,Jacob, AU - Kim,Eun-Ha, AU - Park,Su-Jin, AU - Kwon,Hyeok-Il, AU - Kim,Se Mi, AU - Kim,Young-Il, AU - Si,Young-Jae, AU - Lee,In-Won, AU - Baek,Yun Hee, AU - Choi,Won-Suk, AU - Min,Jinsoo, AU - Jeong,Hye Won, AU - Choi,Young Ki, Y1 - 2015/12/17/ PY - 2015/09/22/received PY - 2015/12/04/accepted PY - 2015/12/19/entrez PY - 2015/12/19/pubmed PY - 2016/12/15/medline KW - MERS-CoV KW - South Korea KW - environmental contamination KW - prolonged viral shedding KW - transmission mode SP - 755 EP - 60 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 IS - 6 N2 - BACKGROUND: Although Middle East Respiratory Syndrome coronavirus (MERS-CoV) is characterized by a risk of nosocomial transmission, the detailed mode of transmission and period of virus shedding from infected patients are poorly understood. The aims of this study were to investigate the potential role of environmental contamination by MERS-CoV in healthcare settings and to define the period of viable virus shedding from MERS patients. METHODS: We investigated environmental contamination from 4 patients in MERS-CoV units of 2 hospitals. MERS-CoV was detected by reverse transcription polymerase chain reaction (PCR) and viable virus was isolated by cultures. RESULTS: Many environmental surfaces of MERS patient rooms, including points frequently touched by patients or healthcare workers, were contaminated by MERS-CoV. Viral RNA was detected up to five days from environmental surfaces following the last positive PCR from patients' respiratory specimens. MERS-CoV RNA was detected in samples from anterooms, medical devices, and air-ventilating equipment. In addition, MERS-CoV was isolated from environmental objects such as bed sheets, bedrails, IV fluid hangers, and X-ray devices. During the late clinical phase of MERS, viable virus could be isolated in 3 of the 4 enrolled patients on day 18 to day 25 after symptom onset. CONCLUSIONS: Most of touchable surfaces in MERS units were contaminated by patients and health care workers and the viable virus could shed through respiratory secretion from clinically fully recovered patients. These results emphasize the need for strict environmental surface hygiene practices, and sufficient isolation period based on laboratory results rather than solely on clinical symptoms. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/26679623/Environmental_Contamination_and_Viral_Shedding_in_MERS_Patients_During_MERS_CoV_Outbreak_in_South_Korea_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ1020 DB - PRIME DP - Unbound Medicine ER -