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Volume 20, Number 4—April 2014

Research

Contact Investigation for Imported Case of Middle East Respiratory Syndrome, Germany

Annicka ReussComments to Author , Annette Litterst, Christian Drosten, Michael Seilmaier, Merle Böhmer1, Petra Graf, Hermann Gold, Clemens-Martin Wendtner, Arina Zanuzdana, Lars Schaade, Walter Haas, and Udo Buchholz
Author affiliations: Robert Koch Institute, Berlin, Germany (A. Reuss, M. Böhmer, A. Zanuzdana, L. Schaade, W. Haas, U. Buchholz); Department of Health and Environment, Munich, Germany (A. Litterst, P. Graf, H. Gold); University of Bonn Medical Centre Institute of Virology, Bonn, Germany (C. Drosten); Hospital Schwabing, Munich, Germany (M. Seilmaier, C.-M. Wendtner); Bavarian Health and Food Safety Authority, Oberschleißheim, Germany (M. Böhmer)

Main Article

Table

Results of contact investigation of patient with imported MERS-CoV infection, Germany, 2013*

Data category No. (%) contacts† No. (%) close-distance contacts, n = 69‡ No. (%) less-close- distance contacts, n = 14‡ p value§
Contacts, n = 83 0.103
Physicians 16 (19) 11 (69) 5 (31)
Nursing staff 25 (30) 24 (1) 1 (4)
Laboratory personnel 20 (24) 17 (85) 3 (15)
Family members 4 (5) 4 (100) 0
Other
18 (22)
13 (72)
5 (28)

Response to questionnaire 61 (73) 55 (90) 6 (10) 0.004
Aerosol exposure
15 (18)
15 (100)
0
0.054
Symptoms 0.006
Symptomatic 10 (12) 9 (90) 1 (10)
Nonsymptomatic¶ 71 (86) 60 (85) 11 (15)
Unknown
2 (2)
0
2 (100)

Swab samples, symptomatic contacts, n = 10 0.725
Swab sample collected 9 (90) 8 (89) 1 (11)
No swab sample collected
1 (10)
1 (100)
0

PCR results for symptomatic contacts with swab samples, n = 9 NA
MERS-CoV positive 0 NA NA
MERS-CoV negative 9 (100) 8 (89) 1 (11)
HCoV-NL63 positive 1 (11) 1 (100) 0
Rhinovirus positive
2 (22)
2 (100)
0

Serologic test results 0.007
MERS-CoV positive 0 NA NA
MERS-CoV negative 60 (72) 54 (90) 6 (10)
Not done
23 (28)
15 (65)
8 (35)

Serologic testing among symptomatic contacts, n = 10 0.107
MERS-CoV positive 0 NA NA
MERS-CoV negative 7 (70) 7 (100) 0
Not done
3 (30)
2 (67)
1 (33)

Serologic testing among nonsymptomatic¶ contacts, n = 71 0.095
MERS-CoV positive 0 NA NA
MERS-CoV negative 53 (75) 47 (89) 6 (11)
Not done 18 (25) 13 (72) 5 (28)

*Definitions of close-distance and less-close-distance contacts provided in article text. MERS-CoV, Middle East respiratory syndrome coronavirus; NA, not applicable.
†Percentages are of contacts (N = 83) unless otherwise indicated.
‡Percentages are of category total.
§Probability that the distribution as indicated occurs by chance given the column and row totals.
¶Nonsymptomatic contacts are asymptomatic persons and those who were symptomatic before exposure.

Main Article

1Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany, associated with European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden.

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