TY - JOUR T1 - Middle East respiratory syndrome coronavirus transmission among health care workers: Implication for infection control. AU - Alfaraj,Sarah H, AU - Al-Tawfiq,Jaffar A, AU - Altuwaijri,Talal A, AU - Alanazi,Marzouqa, AU - Alzahrani,Nojoom, AU - Memish,Ziad A, Y1 - 2017/09/25/ PY - 2017/07/10/received PY - 2017/08/11/revised PY - 2017/08/11/accepted PY - 2017/9/30/pubmed PY - 2019/2/26/medline PY - 2017/9/30/entrez KW - Infection control KW - MERS-CoV KW - Middle East respiratory syndrome coronavirus KW - Outbreak SP - 165 EP - 168 JF - American journal of infection control JO - Am J Infect Control VL - 46 IS - 2 N2 - BACKGROUND: Many outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred in health care settings and involved health care workers (HCWs). We describe the occurrence of an outbreak among HCWs and attempt to characterize at-risk exposures to improve future infection control interventions. METHODS: This study included an index case and all HCW contacts. All contacts were screened for MERS-CoV using polymerase chain reaction. RESULTS: During the study period in 2015, the index case was a 30-year-old Filipino nurse who had a history of unprotected exposure to a MERS-CoV-positive case on May 15, 2015, and had multiple negative tests for MERS-CoV. Weeks later, she was diagnosed with pulmonary tuberculosis and MERS-CoV infection. A total of 73 staff were quarantined for 14 days, and nasopharyngeal swabs were taken on days 2, 5, and 12 postexposure. Of those contacts, 3 (4%) were confirmed positive for MERS-CoV. An additional 18 staff were quarantined and had MERS-CoV swabs. A fourth case was confirmed positive on day 12. Subsequent contact investigations revealed a fourth-generation transmission. Only 7 (4.5%) of the total 153 contacts were positive for MERS-CoV. CONCLUSIONS: The role of HCWs in MERS-CoV transmission is complex. Although most MERS-CoV-infected HCWs are asymptomatic or have mild disease, fatal infections can occur and HCWs can play a major role in propagating health care facility outbreaks. This investigation highlights the need to continuously review infection control guidance relating to the role of HCWs in MERS-CoV transmission in health care outbreaks, especially as it relates to the complex questions on definition of risky exposures, who to test, and the frequency of MERS-CoV testing; criteria for who to quarantine and for how long; and clearance and return to active duty criteria. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/28958446/Middle_East_respiratory_syndrome_coronavirus_transmission_among_health_care_workers:_Implication_for_infection_control_ DB - PRIME DP - Unbound Medicine ER -