Infection control influence of Middle East respiratory syndrome coronavirus: A hospital-based analysis

Abstract

Background: Middle East respiratory syndrome coronavirus (MERS-CoV) caused multiple outbreaks. Such outbreaks increase economic and infection control burdens. We studied the infection control influence of MERS-CoV using a hospital-based analysis. Methods: Our hospital had 17 positive and 82 negative cases of MERS-CoV between April 1, 2013, and June 3, 2013. The study evaluated the impact of these cases on the use of gloves, surgical masks, N95 respirators, alcohol-based hand sanitizer, and soap, as well as hand hygiene compliance rates. Results: During the study, the use of personal protective equipment during MERS-CoV compared with the period before MERS-CoV increased dramatically from 2,947.4 to 10,283.9 per 1,000 patient-days (P < .0000001) for surgical masks and from 22 to 232 per 1,000 patient-days (P < .0000001) for N95 masks. The use of alcohol-based hand sanitizer and soap showed a significant increase in utilized amount (P < .0000001). Hand hygiene compliance rates increased from 73% just before the occurrence of the first MERS case to 88% during MERS cases (P = .0001). The monthly added cost was $16,400 for included infection control items. Conclusions: There was a significant increase in the utilization of surgical masks, respirators, soap and alcohol-based hand sanitizers. Such an increase is a challenge and adds cost to the healthcare system.

The first clusters of Middle East respiratory syndrome coronavirus in Oman: Time to act

“…The general clinical characteristics of the MERS-CoV clustered cases observed in this study were consistent with data from other countries in the EMR [39,40,[42][43][44][45]. Healthcare-associated MERS-CoV outbreaks have been reported in several countries, with the largest outbreaks in Saudi Arabia, the United Arab Emirates and the Republic of Korea [2-5,7-9,32-44].…”

“…In these clustered outbreaks, we observed non-linked clusters and sporadic cases, in addition to nosocomial transmission in health care facilities with neither evidence of sustained human-to-human transmission nor community transmission. A similar situation was observed in Saudi Arabia, where up to 50% of MERS-CoV cases were classified as secondary, due to possible human-to-human transmission through contact with asymptomatic or symptomatic individuals infected with MERS-CoV [42]. Furthermore, limited human-to-human transmission of MERS-CoV was observed in several other clusters in other countries, including family members [14][15][16][17][18][19] and patients in health care facilities [39,40,[42][43][44].…”

“…Healthcare-associated MERS-CoV outbreaks have been reported in several countries, with the largest outbreaks in Saudi Arabia, the United Arab Emirates and the Republic of Korea [2-5,7-9,32-44]. Although most MERS-CoV-infected HCWs were asymptomatic [42], serious infections have occurred, and HCWs might have played a critical role in spreading the virus [43]. Several factors could have contributed to transmission in the current outbreak within the healthcare facilities, including delays in suspicion and case detection, delays in timely index case isolation and most importantly, lack of adherence to optimal infection control measures such as: using proper personal protective equipment (PPE) while providing care to the infected patients, proper hand hygiene and lack of proper isolation facilities like negative pressure rooms.…”

The Spatial Allocation of Hospitals With Negative Pressure Isolation Rooms in Korea: Are We Prepared for New Outbreaks?

“…4 The determinants of public health and socioeconomic outcomes of MERS-CoV have been extensively explored and investigated by the global community. [5][6][7] In the regional comparison study of MERS-CoV, the strength of the public health system and effectiveness of outbreak response is one of the critical factors in variation of MERS-CoV outcomes. 1 In an infectious disease outbreak, central or regional government agencies implement a variety of response policies and programs such as immunization, screening, and quarantine in order to limit the spread of disease.…”

MERS-CoV as an emerging respiratory illness: A review of prevention methods

“…During an outbreak, healthcare facilities especially those with limited infection control infrastructure can be strained and even totally paralyzed with huge incremental increase in costs and resources utilization [102][103][104]. Measures needs to be in place to eliminate cross infection that may include increasing manpower, budgets and other resources reallocation [104].…”