Molecular Epidemiology of Hospital Outbreak of Middle East Respiratory Syndrome, Riyadh, Saudi Arabia, 2014.
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.
Shamsudeen F
SF
Fagbo
Leila
L
Skakni
Daniel K W
DK
Chu
Musa A
MA
Garbati
Mercy
M
Joseph
Malik
M
Peiris
Ahmed M
AM
Hakawi
D018352:Coronavirus Infections / Q000453:epidemiology* / Q000235:genetics / Q000635:transmission; D004196:Disease Outbreaks; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D017720:Molecular Epidemiology / Q000379:methods*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000235:genetics / Q000635:transmission; D012529:Saudi Arabia / Q000453:epidemiology
MERS; MERS-CoV; Middle East respiratory syndrome; Middle East respiratory syndrome coronavirus; Saudi Arabia; coronavirus; health care workers; molecular epidemiology; mutation; nosocomial infection; phylogeny; respiratory infections; transmission; viruses; zoonoses