Volume 22, Number 4—April 2016
Research
Transmission of Middle East Respiratory Syndrome Coronavirus Infections in Healthcare Settings, Abu Dhabi
Table 1
Descriptive epidemiology of 30 cases of MERS-CoV infection transmitted in healthcare settings, Abu Dhabi, January 1, 2013–May 9, 2014*
Demographic and clinical characteristic | Source case-patients, n = 3‡ | Healthcare-associated case-patients† |
Signif§ | |||
---|---|---|---|---|---|---|
All HCA case-patients, n = 27 | HCWs, n = 19 | Patients, n = 6 | Visitors, n = 2 | |||
Median age, y (range) | 59 (30–83) | 43 (27–82) | 39 (27–63) | 65 (40–73) | 44 (34–54) | |
Male sex | 3 (100) | 17 (63) | 11 (58) | 5 (83) | 1 (50) | |
Expatriate¶ |
1 (33) |
26 (96) |
18 (95) |
6 (100) |
2 (100) |
0.02 |
Exposures within 14 d before symptom onset# | ||||||
Travel | 0 | 2 (7) | 1 (5) | 0 | 1 (50) | |
Camel |
2 (67) |
0 |
0 |
0 |
0 |
0.01 |
Symptoms | ||||||
Any symptoms reported | 3 (100) | 16 (59) | 10 (53) | 5 (83) | 1 (50) | |
Documented fever or symptom of respiratory illness** | 3 (100) | 13 (48) | 8 (42) | 5 (83) | 0 | |
Documented fever (≥38.5°C) | 3 (100) | 9 (33) | 6 (32) | 3 (50) | 0 | |
Shortness of breath | 3 (100) | 5 (19) | 0 | 5 (83) | 0 | 0.01 |
Fatigue/malaise | 2 (67) | 8 (30) | 4 (21) | 3 (50) | 1 (50) | |
Cough | 2 (67) | 7 (26) | 4 (21) | 3 (50) | 0 | |
Cough with sputum production | 2 (67) | 2 (7) | 0 | 2 (33) | 0 | 0.04 |
Rhinorrhea | 2 (67) | 2 (7) | 2 (11) | 0 | 0 | 0.04 |
Muscle aches | 2 (67 | 7 (26 | 5 (26) | 1 (17) | 1 (50) | |
Chest pain | 1 (33) | 2 (7) | 1 (5) | 1 (17) | 0 | |
Joint pain | 2 (67) | 2 (7) | 2 (11) | 0 | 0 | 0.04 |
Headache | 2 (67) | 4 (15) | 3 (16) | 1 (17) | 0 | |
Sore throat | 1 (33) | 5 (19) | 5 (26) | 0 | 0 | |
Wheezing | 1 (33) | 3 (11) | 1 (5) | 2 (33) | 0 | |
Vomiting/nausea |
1 (33 |
1 (4) |
0 |
1 (17) |
0 |
|
Medical history | ||||||
Any underlying conditions | 2 (67) | 15 (56) | 7 (37) | 6 (100) | 2 (100) | |
Diabetes mellitus | 1 (33) | 6 (22) | 1 (5) | 4 (67) | 1 (50) | |
Dementia | 1 (33) | 0 | 0 | 0 | 0 | |
Malignancy | 1 (33) | 0 | 0 | 0 | 0 | |
Receiving immunosuppressant | 1 (33) | 0 | 0 | 0 | 0 | |
Chronic pulmonary disease | 0 | 2 (7) | 0 | 2 (33) | 0 | |
Renal disease | 0 | 5 (19) | 0 | 4 (67) | 1 (50) | |
Congestive heart failure | 0 | 1 (4) | 0 | 1 (17) | 0 | |
Obese†† | 0 | 2 (7) | 1 (5) | 1 (17) | 0 | |
Hypertension | 0 | 12 (44) | 5 (26) | 5 (83) | 2 (100) | |
Hyperlipidemia | 0 | 7 (26) | 4 (21) | 2 (33) | 1 (50) | |
Asthma | 0 | 2 (7) | 2 (11) | 0 | 0 | |
Ischemic heart disease |
0 |
3 (11) |
1 (5) |
2 (33) |
0 |
|
Severity of symptoms | ||||||
Care in ICU | 3 (100) | 5 (19) | 0 | 5 (83) | 0 | 0.01 |
Supplemental O2 required | 3 (100) | 6 (22) | 0 | 6 (100) | 0 | 0.02 |
Intubated | 3 (100) | 3 (11) | 0 | 3 (50) | 0 | <0.01 |
Died |
2 (67) |
2 (7) |
0 |
2 (33) |
0 |
0.04 |
Reason tested for MERS-CoV | ||||||
Screening as part of contact investigation | 0 | 24 (89) | 19 (100) | 3 (50) | 2 (100) | <0.01 |
Symptoms consistent with MERS-CoV | 3 (100) | 3 (11) | 0 | 3 (50) | 0 | <0.01 |
*Values are no. (%) patients except as indicated. HCA, healthcare-associated; HCWs, healthcare workers; MERS-CoV, Middle East respiratory syndrome coronavirus; Signif, statistically significant.
†HCA case-patients include HCWs, patients, and hospital visitors but does not include source case-patients.
‡Source case-patients are those with the earliest date of onset of symptoms in an HCA cluster of case-patients.
§Comparison between type of case (source case vs. HCA case) determined by Fisher exact test. Only significant values are shown.
¶Nationalities: Philippines, India, Somalia, Bangladesh, Egypt, Jordan, Oman, Pakistan, Sudan, and Syria.
#For case-patients with no reported symptoms, date of positive sample collection was used in place of symptom onset.
**Symptoms of respiratory illness are cough, shortness of breath, or wheezing.
††Obesity status was determined by clinical staff.