Infection preventionists on alert for MERS after first U.S. case confirmed

March 18th, 2015

Infection preventionists remain on heightened alert nationwide after the first case of Middle East Respiratory Syndrome (MERS) coronavirus in the United States was recently hospitalized in Munster, IN.

No secondary cases had been reported among contacts to the index case, but the Centers for Disease Control and Prevention is advising clinicians nationwide to increase their index of suspicion for MERS infection in travelers from the Middle East.

“The CDC has received something like 160 notifications of possible MERS cases and specimens have been sent in,” says William Schaffner, MD, chairman of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville, TN. “That means folks are indeed on the alert around the country. Obviously, this case reminds us that everybody that comes in with a pneumonic illness should be asked if they traveled to the Middle East. It’s something we need to be doing comprehensively because it’s a small world out there.”

The first case of MERS infection in the U.S. is a male health care worker who apparently had been working in a hospital in Riyadh, Saudi Arabia.

“The person was providing care in Saudi Arabia and [then] developed symptoms in the United States,” Anne Schuchat, MD, director of CDC's National Center for Immunization and Respiratory Diseases, said at a recent press conference. “The assumption is the person acquired the illness in Saudi Arabia. We can't confirm that it is from the hospital and that would be part of an active investigation. We know there is quite a bit of disease in Saudi Arabia right.”

Health care workers have been infected in hospital outbreaks in the region since MERS first emerged in 2012, so transmission from a patient in the Riyadh hospital may have occurred before the U.S. case returned to America. Likewise, health care workers in contact with the patient in the U.S. hospital before the diagnosis was made are at risk of infection.

“It is very concerning that the virus has spread in hospitals and we should not be surprised if additional cases are identified among the health care providers who had close contact with this patient before the patient was isolated and special precautions were implemented,” Schuchat said.

For more on this story see the June 2014 issue of Hospital Infection Control & Prevention.