Article ID Journal Published Year Pages File Type
5866465 American Journal of Infection Control 2016 7 Pages PDF
Abstract

•B-IC used in conjunction with A-IC may reduce the risk of pathogen spread to HCWs.•Full personal protective equipment use for advanced airway management in ED.•Hospital epidemic and ED contingency plan implementation.•On-site MERS-CoV real time polymerase chain reaction (PCR) testing capability.

BackgroundTransmission of Middle East respiratory syndrome-coronavirus (MERS-CoV) among health care workers (HCWs) and patients has been documented with mortality rate approximating 36%. We propose advanced infection control measures (A-IC) used in conjunction with basic infection control measures (B-IC) help reduce pathogen transmission. B-IC include standard and transmission-based precautions. A-IC are initiatives implemented within our center to enhance effectiveness of B-IC.ObjectiveStudy effectiveness of combining B-IC and A-IC to prevent transmission of MERS-CoV to HCWs.MethodsA retrospective observational study was undertaken. A-IC measures include administrative support with daily rounds; infection control risk assessment; timely screening, isolation, and specimen analysis; collaboration; epidemic planning; stockpiling; implementation of contingency plans; full personal protective equipment use for advanced airway management; use of a real-time electronic isolation flagging system; infection prevention and control team on-call protocols; pretransfer MERS-CoV testing; and education.ResultsA total of 874 real-time polymerase chain reaction MERS-CoV tests were performed during the period beginning July 1, 2013, and ending January 31, 2015. Six hundred ninety-four non-HCWs were tested, of these 16 tested positive for MERS-CoV and their infection was community acquired. Sixty-nine percent of the confirmed MERS-CoV-positive cases were men, with an average age of 56 years (range, 19-84 years). Of the total tested for MERS-CoV, 180 individuals were HCWs with zero positivity.ConclusionsAdhering to a combination of B-IC and A-IC reduces the risk of MERS-CoV transmission to HCWs.

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