APIC 2014: Saudi IPs say MERS is ‘our challenge’ but tide is turning

March 18th, 2015

The wider availability of PCR tests to rapidly detect MERS coronavirus is enabling hospitals in Saudi Arabia to better identify cases and prevent transmission to patients and health care workers, infection preventionists from the Kingdom told Hospital Infection Control & Prevention.

Rather than crestfallen at the global attention on the emergence of the novel coronavirus, the Saudi clinicians expressed confidence and a surprising level of pride that it is their fate to be at the epicenter of a possible pandemic.

“It is our challenge -- we in infection control and prevention,” says Mercy Joseph, BSN, CIC, an infection preventionist at King Fahad Medical City in Riyadh. “Now we have be ready around the clock. It is a good challenge for us and we enjoy our work a lot. We know we are doing something for the public.”

In an exclusive interview in Anaheim at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC), the Saudi clinicians said they are close to turning the tide of MERS and have recently stopped transmission in their hospitals.

“We have gone three weeks with zero cases,” Joseph says.

Concurring was Dr. Areej Taher Ben Sadek, an infection preventionist at King Fahad Hospital in Jeddah. “For the last six weeks -- and among health care workers for the last two months -- we have zero reported cases,” she said.

While both Saudi IPs confirmed that they have had MERS transmission in the past to patients and health care workers, one of the key differences now is wider availability of PCR tests that can confirm or rule out MERS in no more than six hours.

“Before there was only one center in one city where they were testing,” says Fiaz Ahamed, MD, MBBS, infection preventionist at Al Rass General Hospital. ”Now there are many [testing] centers and there are implementing efficient specimen test protocols to guarantee the validity of tests.”

Delays in getting confirmed test results have likely led to unprotected exposures to patients and health care workers, he said. Asked about reported breakdowns in infection control in Saudi Hospitals, Ahamed said failure to follow all precautions for unconfirmed cases has been part of the problem.

“Sometimes there are breaches in infection control strategies -- they may have not been wearing masks or something,” he told HIC. “Actually, the infection control programs are very strong in Saudi Arabia. Once the patient is confirmed there is 100% infection control. “

But exposures may occur from suspect patients because until recently, test results may not have been available for 2 to 3 days at many hospitals. “Confirmed cases are placed under isolation that includes negative pressure air ventilation,” Ahamed said. “But only the confirmed cases are there, and the suspect cases during this time period could be a source of infection.”

The first two MERS cases in the U.S. were health care workers who traveled from Saudi Arabia, drawing attention to the large number of workers from other nations who provide medical care in the Kingdom. Health care workers who travel from Saudi Arabia to other nations should be aware of any signs and symptoms of MERS, which has an incubation period for as long as two weeks, Joseph said.

“We know the main important factor is to give them more education,” she said. “We tell them if you are leaving this country you have to self-observe for yourself. Even us coming here, we are also exposed to the patients, so we have to do the proper precautions and self-observe.”

For more on this story and all of our APIC coverage see the July 2014 issue of Hospital Infection Control & Prevention