title: Multifacility Outbreak of Middle East Respiratory Syndrome in Taif, Saudi Arabia.
abstract: Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) is a novel respiratory pathogen first reported in 2012. During September 2014-January 2015, an outbreak of 38 cases of MERS was reported from 4 healthcare facilities in Taif, Saudi Arabia; 21 of the 38 case-patients died. Clinical and public health records showed that 13 patients were healthcare personnel (HCP). Fifteen patients, including 4 HCP, were associated with 1 dialysis unit. Three additional HCP in this dialysis unit had serologic evidence of MERS-CoV infection. Viral RNA was amplified from acute-phase serum specimens of 15 patients, and full spike gene-coding sequencing was obtained from 10 patients who formed a discrete cluster; sequences from specimens of 9 patients were closely related. Similar gene sequences among patients unlinked by time or location suggest unrecognized viral transmission. Circulation persisted in multiple healthcare settings over an extended period, underscoring the importance of strengthening MERS-CoV surveillance and infection-control practices.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Assiri
authors.forename: Glen R
authors.initials: GR
authors.lastname: Abedi
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Bin Saeed
authors.forename: Mutwakil A
authors.initials: MA
authors.lastname: Abdalla
authors.forename: Malak
authors.initials: M
authors.lastname: al-Masry
authors.forename: Abdul Jamil
authors.initials: AJ
authors.lastname: Choudhry
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Lu
authors.forename: Dean D
authors.initials: DD
authors.lastname: Erdman
authors.forename: Kathleen
authors.initials: K
authors.lastname: Tatti
authors.forename: Alison M
authors.initials: AM
authors.lastname: Binder
authors.forename: Jessica
authors.initials: J
authors.lastname: Rudd
authors.forename: Jerome
authors.initials: J
authors.lastname: Tokars
authors.forename: Congrong
authors.initials: C
authors.lastname: Miao
authors.forename: Hussain
authors.initials: H
authors.lastname: Alarbash
authors.forename: Randa
authors.initials: R
authors.lastname: Nooh
authors.forename: Mark
authors.initials: M
authors.lastname: Pallansch
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
authors.forename: John T
authors.initials: JT
authors.lastname: Watson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000821:virology*; D003428:Cross Infection / Q000453:epidemiology / Q000821:virology; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000235:genetics* / Q000302:isolation & purification*; D012367:RNA, Viral / Q000235:genetics; D012529:Saudi Arabia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012367:RNA, Viral
keywords: MERS; MERS-CoV; Middle East respiratory syndrome; Saudi Arabia; coronavirus; epidemiology; genetic sequencing; respiratory infections; serum; viruses