Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards

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.

Evaluation of bioaerosol samplers for the detection and quantification of influenza virus from artificial aerosols and influenza virus–infected ferrets

“…The merits of bioaerosol sampling for respiratory viruses are coming to the forefront as researchers have used this approach to detect virus from air emitted by individuals with laboratory‐confirmed influenza, during severe acute respiratory syndrome coronavirus (SARS‐CoV) and Middle East respiratory syndrome coronavirus (MERS‐CoV) outbreaks, and to assess the environmental burden of avian influenza viruses in wet markets . In this study, we evaluated three portable samplers using artificial aerosols and a translational, in vivo model.…”

New and emerging infectious diseases (Ebola, Middle Eastern respiratory syndrome coronavirus, carbapenem-resistant Enterobacteriaceae, Candida auris): Focus on environmental survival and germicide susceptibility

“…Extensive environmental contamination has been documented by both culture and RT-PCR in clinical areas housing MERS patients. 84,85 Positive sites have included patient room surfaces (eg, bed sheets, bedrails, intravenous fluid hangers), anteroom surfaces, medical devices (eg, portable x-ray machines, thermometers), and air-ventilating equipment. Touchable surfaces have been found to be contaminated through respiratory secretions from clinically fully recovered patients.…”

An opportunistic Pathogen Afforded Ample Opportunities: Middle East Respiratory Syndrome Coronavirus

“…[43] Virus remains viable for at least 48 hour on plastic and steel surfaces, presumably underpinning the extensive contamination of air and surfaces in hospitals housing patients with MERS. [64][65][66][67][68][69] The virus appears sensitive to standard heat and chemical inactivation measures. [70,71] Antibodies to MERS-CoV have been found in camel sera as far back as 1983.…”