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Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards.
Clin Infect Dis. 2016 08 01; 63(3):363-9.CI

Abstract

BACKGROUND

The largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) outside the Middle East occurred in South Korea in 2015 and resulted in 186 laboratory-confirmed infections, including 36 (19%) deaths. Some hospitals were considered epicenters of infection and voluntarily shut down most of their operations after nearly half of all transmissions occurred in hospital settings. However, the ways that MERS-CoV is transmitted in healthcare settings are not well defined.

METHODS

We explored the possible contribution of contaminated hospital air and surfaces to MERS transmission by collecting air and swabbing environmental surfaces in 2 hospitals treating MERS-CoV patients. The samples were tested by viral culture with reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence assay (IFA) using MERS-CoV Spike antibody, and electron microscopy (EM).

RESULTS

The presence of MERS-CoV was confirmed by RT-PCR of viral cultures of 4 of 7 air samples from 2 patients' rooms, 1 patient's restroom, and 1 common corridor. In addition, MERS-CoV was detected in 15 of 68 surface swabs by viral cultures. IFA on the cultures of the air and swab samples revealed the presence of MERS-CoV. EM images also revealed intact particles of MERS-CoV in viral cultures of the air and swab samples.

CONCLUSIONS

These data provide experimental evidence for extensive viable MERS-CoV contamination of the air and surrounding materials in MERS outbreak units. Thus, our findings call for epidemiologic investigation of the possible scenarios for contact and airborne transmission, and raise concern regarding the adequacy of current infection control procedures.

Authors+Show Affiliations

Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul.Respiratory Viruses Research Laboratory, Institut Pasteur Korea, Seongnam-si, Gyeonggi Province.Department of Architectural Engineering, Sejong University, Seoul.Respiratory Viruses Research Laboratory, Institut Pasteur Korea, Seongnam-si, Gyeonggi Province.Division of Infectious Diseases, Department of Internal Medicine.Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi Province.Division of Infectious Diseases, Department of Internal Medicine, Seoul Medical Center.Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.Respiratory Viruses Research Laboratory, Institut Pasteur Korea, Seongnam-si, Gyeonggi Province.

Pub Type(s)

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

Language

eng

PubMed ID

27090992

Citation

Kim, Sung-Han, et al. "Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 63, no. 3, 2016, pp. 363-9.
Kim SH, Chang SY, Sung M, et al. Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards. Clin Infect Dis. 2016;63(3):363-9.
Kim, S. H., Chang, S. Y., Sung, M., Park, J. H., Bin Kim, H., Lee, H., Choi, J. P., Choi, W. S., & Min, J. Y. (2016). Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 63(3), 363-9. https://doi.org/10.1093/cid/ciw239
Kim SH, et al. Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards. Clin Infect Dis. 2016 08 1;63(3):363-9. PubMed PMID: 27090992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards. AU - Kim,Sung-Han, AU - Chang,So Young, AU - Sung,Minki, AU - Park,Ji Hoon, AU - Bin Kim,Hong, AU - Lee,Heeyoung, AU - Choi,Jae-Phil, AU - Choi,Won Suk, AU - Min,Ji-Young, Y1 - 2016/04/18/ PY - 2016/01/04/received PY - 2016/04/07/accepted PY - 2016/4/20/entrez PY - 2016/4/20/pubmed PY - 2018/3/15/medline KW - MERS KW - contamination KW - transmission SP - 363 EP - 9 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 63 IS - 3 N2 - BACKGROUND: The largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) outside the Middle East occurred in South Korea in 2015 and resulted in 186 laboratory-confirmed infections, including 36 (19%) deaths. Some hospitals were considered epicenters of infection and voluntarily shut down most of their operations after nearly half of all transmissions occurred in hospital settings. However, the ways that MERS-CoV is transmitted in healthcare settings are not well defined. METHODS: We explored the possible contribution of contaminated hospital air and surfaces to MERS transmission by collecting air and swabbing environmental surfaces in 2 hospitals treating MERS-CoV patients. The samples were tested by viral culture with reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescence assay (IFA) using MERS-CoV Spike antibody, and electron microscopy (EM). RESULTS: The presence of MERS-CoV was confirmed by RT-PCR of viral cultures of 4 of 7 air samples from 2 patients' rooms, 1 patient's restroom, and 1 common corridor. In addition, MERS-CoV was detected in 15 of 68 surface swabs by viral cultures. IFA on the cultures of the air and swab samples revealed the presence of MERS-CoV. EM images also revealed intact particles of MERS-CoV in viral cultures of the air and swab samples. CONCLUSIONS: These data provide experimental evidence for extensive viable MERS-CoV contamination of the air and surrounding materials in MERS outbreak units. Thus, our findings call for epidemiologic investigation of the possible scenarios for contact and airborne transmission, and raise concern regarding the adequacy of current infection control procedures. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27090992/Extensive_Viable_Middle_East_Respiratory_Syndrome__MERS__Coronavirus_Contamination_in_Air_and_Surrounding_Environment_in_MERS_Isolation_Wards_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciw239 DB - PRIME DP - Unbound Medicine ER -