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Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity.
Clin Microbiol Infect. 2016 Oct; 22(10):880-886.CM

Abstract

Given the mode of transmission of Middle East respiratory syndrome (MERS), healthcare workers (HCWs) in contact with MERS patients are expected to be at risk of MERS infections. We evaluated the prevalence of MERS coronavirus (CoV) immunoglobulin (Ig) G in HCWs exposed to MERS patients and calculated the incidence of MERS-affected cases in HCWs. We enrolled HCWs from hospitals where confirmed MERS patients had visited. Serum was collected 4 to 6 weeks after the last contact with a confirmed MERS patient. We performed an enzyme-linked immunosorbent assay (ELISA) to screen for the presence of MERS-CoV IgG and an indirect immunofluorescence test (IIFT) to confirm MERS-CoV IgG. We used a questionnaire to collect information regarding the exposure. We calculated the incidence of MERS-affected cases by dividing the sum of PCR-confirmed and serology-confirmed cases by the number of exposed HCWs in participating hospitals. In total, 1169 HCWs in 31 hospitals had contact with 114 MERS patients, and among the HCWs, 15 were PCR-confirmed MERS cases in study hospitals. Serologic analysis was performed for 737 participants. ELISA was positive in five participants and borderline for seven. IIFT was positive for two (0.3%) of these 12 participants. Among the participants who did not use appropriate personal protective equipment (PPE), seropositivity was 0.7% (2/294) compared to 0% (0/443) in cases with appropriate PPE use. The incidence of MERS infection in HCWs was 1.5% (17/1169). The seroprevalence of MERS-CoV IgG among HCWs was higher among participants who did not use appropriate PPE.

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Kim CJ
Department of Internal Medicine, Division of Infectious Diseases, Ewha Womans University School of Medicine, South Korea.
Choi WS
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
Jung Y
Department of Internal Medicine, Konyang University Hospital, South Korea.
Kiem S
Department of Internal Medicine, Inje University Haeundae Paik Hospital, South Korea.
Seol HY
Department of Internal Medicine, Good GangAn Hospital, South Korea.
Woo HJ
Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, South Korea.
Choi YH
Department of Internal Medicine, Ajou University Hospital, South Korea.
Son JS
Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, South Korea.
Kim KH
Department of Internal Medicine, Pusan National University Hospital, South Korea.
Kim YS
Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, South Korea.
Kim ES
Department of Internal Medicine, Seoul National University Bundang Hospital, South Korea.
Park SH
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, South Korea.
Yoon JH
Department of Internal Medicine, Eulji University Hospital, South Korea.
Choi SM
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, South Korea.
Lee H
Division of Infectious Diseases, Dong-A University Hospital, South Korea.
Oh WS
Department of Internal Medicine, Kangwon National University Hospital, South Korea.
Choi SY
Department of Neurology, Dae Cheong Hospital, South Korea.
Kim NJ
Department of Internal Medicine, Seoul National University Hospital, South Korea.
Choi JP
Department of Internal Medicine, Seoul Medical Center, South Korea.
Park SY
Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, South Korea.
Kim J
Department of Internal Medicine, Hanyang University Guri Hospital, South Korea.
Jeong SJ
Department of Internal Medicine, Gangnam Severance Hospital, South Korea.
Lee KS
Department of Internal Medicine, Myongji Hospital, South Korea.
Jang HC
Department of Internal Medicine, Chonnam National University Hospital, South Korea.
Rhee JY
Department of Internal Medicine, Dankook University Hospital, South Korea.
Kim BN
Department of Internal Medicine, Inje University Sanggye Paik Hospital, South Korea.
Bang JH
Department of Internal Medicine, Borame Medical Center, South Korea.
Lee JH
Department of Internal Medicine, Wonkwang University Hospital, South Korea.
Park S
Department of Family Medicine, Seobuk Hospital Seoul Metropolitan Government, South Korea.
Kim HY
Department of Internal Medicine, Wonju Severance Christian Hospital, South Korea.
Choi JK
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, South Korea.
Wi YM
Department of Internal Medicine, Samsung Changwon Hospital, South Korea.
Choi HJ
Department of Internal Medicine, Division of Infectious Diseases, Ewha Womans University School of Medicine, South Korea. Electronic address: heechoi@ewha.ac.kr.

MeSH

AdolescentAdultAgedCoronavirus InfectionsFemaleHealth PersonnelHealth SurveysHumansIncidenceInfectious Disease Transmission, Patient-to-ProfessionalMaleMiddle AgedMiddle East Respiratory Syndrome CoronavirusPopulation SurveillanceSeroepidemiologic StudiesYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27475739

Citation

Kim, C-J, et al. "Surveillance of the Middle East Respiratory Syndrome (MERS) Coronavirus (CoV) Infection in Healthcare Workers After Contact With Confirmed MERS Patients: Incidence and Risk Factors of MERS-CoV Seropositivity." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 22, no. 10, 2016, pp. 880-886.
Kim CJ, Choi WS, Jung Y, et al. Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity. Clin Microbiol Infect. 2016;22(10):880-886.
Kim, C. J., Choi, W. S., Jung, Y., Kiem, S., Seol, H. Y., Woo, H. J., Choi, Y. H., Son, J. S., Kim, K. H., Kim, Y. S., Kim, E. S., Park, S. H., Yoon, J. H., Choi, S. M., Lee, H., Oh, W. S., Choi, S. Y., Kim, N. J., Choi, J. P., ... Choi, H. J. (2016). Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 22(10), 880-886. https://doi.org/10.1016/j.cmi.2016.07.017
Kim CJ, et al. Surveillance of the Middle East Respiratory Syndrome (MERS) Coronavirus (CoV) Infection in Healthcare Workers After Contact With Confirmed MERS Patients: Incidence and Risk Factors of MERS-CoV Seropositivity. Clin Microbiol Infect. 2016;22(10):880-886. PubMed PMID: 27475739.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity. AU - Kim,C-J, AU - Choi,W S, AU - Jung,Y, AU - Kiem,S, AU - Seol,H Y, AU - Woo,H J, AU - Choi,Y H, AU - Son,J S, AU - Kim,K-H, AU - Kim,Y-S, AU - Kim,E S, AU - Park,S H, AU - Yoon,J H, AU - Choi,S-M, AU - Lee,H, AU - Oh,W S, AU - Choi,S-Y, AU - Kim,N-J, AU - Choi,J-P, AU - Park,S Y, AU - Kim,J, AU - Jeong,S J, AU - Lee,K S, AU - Jang,H C, AU - Rhee,J Y, AU - Kim,B-N, AU - Bang,J H, AU - Lee,J H, AU - Park,S, AU - Kim,H Y, AU - Choi,J K, AU - Wi,Y-M, AU - Choi,H J, Y1 - 2016/07/27/ PY - 2016/03/25/received PY - 2016/07/11/revised PY - 2016/07/16/accepted PY - 2016/8/1/pubmed PY - 2017/3/3/medline PY - 2016/8/1/entrez KW - Healthcare personnel KW - IgG KW - Incidence KW - Middle East respiratory syndrome KW - Personal protective equipment SP - 880 EP - 886 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 22 IS - 10 N2 - Given the mode of transmission of Middle East respiratory syndrome (MERS), healthcare workers (HCWs) in contact with MERS patients are expected to be at risk of MERS infections. We evaluated the prevalence of MERS coronavirus (CoV) immunoglobulin (Ig) G in HCWs exposed to MERS patients and calculated the incidence of MERS-affected cases in HCWs. We enrolled HCWs from hospitals where confirmed MERS patients had visited. Serum was collected 4 to 6 weeks after the last contact with a confirmed MERS patient. We performed an enzyme-linked immunosorbent assay (ELISA) to screen for the presence of MERS-CoV IgG and an indirect immunofluorescence test (IIFT) to confirm MERS-CoV IgG. We used a questionnaire to collect information regarding the exposure. We calculated the incidence of MERS-affected cases by dividing the sum of PCR-confirmed and serology-confirmed cases by the number of exposed HCWs in participating hospitals. In total, 1169 HCWs in 31 hospitals had contact with 114 MERS patients, and among the HCWs, 15 were PCR-confirmed MERS cases in study hospitals. Serologic analysis was performed for 737 participants. ELISA was positive in five participants and borderline for seven. IIFT was positive for two (0.3%) of these 12 participants. Among the participants who did not use appropriate personal protective equipment (PPE), seropositivity was 0.7% (2/294) compared to 0% (0/443) in cases with appropriate PPE use. The incidence of MERS infection in HCWs was 1.5% (17/1169). The seroprevalence of MERS-CoV IgG among HCWs was higher among participants who did not use appropriate PPE. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/27475739/Surveillance_of_the_Middle_East_respiratory_syndrome__MERS__coronavirus__CoV__infection_in_healthcare_workers_after_contact_with_confirmed_MERS_patients:_incidence_and_risk_factors_of_MERS_CoV_seropositivity_ DB - PRIME DP - Unbound Medicine ER -