title: Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity.
abstract: Given the mode of transmission of Middle East respiratory syndrome (MERS), healthcare workers (HCWs) in contact with MERS patients are expected to be at risk of MERS infections. We evaluated the prevalence of MERS coronavirus (CoV) immunoglobulin (Ig) G in HCWs exposed to MERS patients and calculated the incidence of MERS-affected cases in HCWs. We enrolled HCWs from hospitals where confirmed MERS patients had visited. Serum was collected 4 to 6 weeks after the last contact with a confirmed MERS patient. We performed an enzyme-linked immunosorbent assay (ELISA) to screen for the presence of MERS-CoV IgG and an indirect immunofluorescence test (IIFT) to confirm MERS-CoV IgG. We used a questionnaire to collect information regarding the exposure. We calculated the incidence of MERS-affected cases by dividing the sum of PCR-confirmed and serology-confirmed cases by the number of exposed HCWs in participating hospitals. In total, 1169 HCWs in 31 hospitals had contact with 114 MERS patients, and among the HCWs, 15 were PCR-confirmed MERS cases in study hospitals. Serologic analysis was performed for 737 participants. ELISA was positive in five participants and borderline for seven. IIFT was positive for two (0.3%) of these 12 participants. Among the participants who did not use appropriate personal protective equipment (PPE), seropositivity was 0.7% (2/294) compared to 0% (0/443) in cases with appropriate PPE use. The incidence of MERS infection in HCWs was 1.5% (17/1169). The seroprevalence of MERS-CoV IgG among HCWs was higher among participants who did not use appropriate PPE.
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Ewha Womans University School of Medicine, South Korea.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: W S
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Konyang University Hospital, South Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Inje University Haeundae Paik Hospital, South Korea.
authors.forename: S
authors.initials: S
authors.lastname: Kiem
authors.affiliation: Department of Internal Medicine, Good GangAn Hospital, South Korea.
authors.forename: H Y
authors.initials: HY
authors.lastname: Seol
authors.affiliation: Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, South Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Woo
authors.affiliation: Department of Internal Medicine, Ajou University Hospital, South Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, South Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Son
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, South Korea.
authors.forename: K-H
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, South Korea.
authors.forename: Y-S
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, South Korea.
authors.forename: E S
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, South Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Eulji University Hospital, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, South Korea.
authors.forename: S-M
authors.initials: SM
authors.lastname: Choi
authors.affiliation: Division of Infectious Diseases, Dong-A University Hospital, South Korea.
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kangwon National University Hospital, South Korea.
authors.forename: W S
authors.initials: WS
authors.lastname: Oh
authors.affiliation: Department of Neurology, Dae Cheong Hospital, South Korea.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, South Korea.
authors.forename: N-J
authors.initials: NJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul Medical Center, South Korea.
authors.forename: J-P
authors.initials: JP
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, South Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, South Korea.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Gangnam Severance Hospital, South Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Myongji Hospital, South Korea.
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, South Korea.
authors.forename: H C
authors.initials: HC
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Dankook University Hospital, South Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Rhee
authors.affiliation: Department of Internal Medicine, Inje University Sanggye Paik Hospital, South Korea.
authors.forename: B-N
authors.initials: BN
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Borame Medical Center, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Bang
authors.affiliation: Department of Internal Medicine, Wonkwang University Hospital, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Seobuk Hospital Seoul Metropolitan Government, South Korea.
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Wonju Severance Christian Hospital, South Korea.
authors.forename: H Y
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, South Korea.
authors.forename: J K
authors.initials: JK
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Samsung Changwon Hospital, South Korea.
authors.forename: Y-M
authors.initials: YM
authors.lastname: Wi
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, Ewha Womans University School of Medicine, South Korea. Electronic address: heechoi@ewha.ac.kr.
authors.forename: H J
authors.initials: HJ
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006282:Health Personnel; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000276:immunology*; D011159:Population Surveillance; D016036:Seroepidemiologic Studies; D055815:Young Adult
keywords: Healthcare personnel; IgG; Incidence; Middle East respiratory syndrome; Personal protective equipment