TY - JOUR AU - Fagbo, Shamsudeen AU - Skakni, Leila AU - Chu, Daniel K.W. AU - Garbati, Musa AU - Joseph, Mercy AU - Hakawi, Ahmed T1 - Molecular Epidemiology of Hospital Outbreak of Middle East Respiratory Syndrome, Riyadh, Saudi Arabia, 2014 T2 - Emerging Infectious Disease journal PY - 2015 VL - 21 IS - 11 SP - 1981 SN - 1080-6059 AB - We investigated an outbreak of Middle East respiratory syndrome (MERS) at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, during March 29–May 21, 2014. This outbreak involved 45 patients: 8 infected outside KFMC, 13 long-term patients at KFMC, 23 health care workers, and 1 who had an indeterminate source of infection. Sequences of full-length MERS coronavirus (MERS-CoV) from 10 patients and a partial sequence of MERS-CoV from another patient, when compared with other MERS-CoV sequences, demonstrated that this outbreak was part of a larger outbreak that affected multiple health care facilities in Riyadh and possibly arose from a single zoonotic transmission event that occurred in December 2013 (95% highest posterior density interval November 8, 2013–February 10, 2014). This finding suggested continued health care–associated transmission for 5 months. Molecular epidemiology documented multiple external introductions in a seemingly contiguous outbreak and helped support or refute transmission pathways suspected through epidemiologic investigation. KW - Middle East respiratory syndrome KW - MERS KW - Middle East respiratory syndrome coronavirus KW - MERS-CoV KW - coronavirus KW - viruses KW - transmission KW - molecular epidemiology KW - nosocomial infection KW - health care workers KW - phylogeny KW - mutation KW - respiratory infections KW - zoonoses KW - Saudi Arabia DO - 10.3201/eid2111.150944 UR - https://wwwnc.cdc.gov/eid/article/21/11/15-0944_article ER - End of Reference