title: Preventing healthcare-associated transmission of the Middle East Respiratory Syndrome (MERS): Our Achilles heel.
abstract: Middle East Respiratory Syndrome (MERS) coronavirus is the most recent among the Coronaviridae family to jump species and infect humans. Major healthcare associated MERS outbreaks have occurred in the Middle East and Korea that affected both patients and healthcare workers. These outbreaks were characterized by intra and inter-hospital spread and were exacerbated specifically by overcrowding, delayed diagnosis and appropriate use of personal protective equipment. Recent experience with this virus emphasizes the importance of compliance with infection control practices and with other interventions addressing patient triage, placement and flow within and between healthcare facilities. Our Achilles heel remains compliance with the best infection prevention practices and their harmonization with patient flow. Both infection prevention compliance and maintenance of patient flow are critical in preventing healthcare-associated transmission of many of these emerging infectious diseases, including MERS.
authors.affiliation: Paediatric Infectious Diseases, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh 11426, Saudi Arabia; Infection Prevention and Control, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia; GCC Center for Infection Control, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. Electronic address: balkhyh@hotmail.com.
authors.forename: Hanan H
authors.initials: HH
authors.lastname: Balkhy
authors.affiliation: Johns Hopkins School of Medicine, United States; Bloomberg School of Public Health, United States; Johns Hopkins Medicine, United States. Electronic address: tperl@jhmi.edu.
authors.forename: Trish M
authors.initials: TM
authors.lastname: Perl
authors.affiliation: Intensive Care Department, MC 1425, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. Electronic address: yaseenarabi@yahoo.com.
authors.forename: Yaseen M
authors.initials: YM
authors.lastname: Arabi
mesh_terms: D018352:Coronavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D019983:Guideline Adherence; D006268:Health Facilities; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007723:Korea / Q000453:epidemiology; D008877:Middle East / Q000453:epidemiology
keywords: Corona; Emerging pathogens; IHR; Infection control; MERS; Saudi Arabia