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?:abstract
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Objectives: On 1 March 2017 Wadi Al-Dawasir General Hospital\'s (WDGH) emergency department received a patient on hemodialysis, with severe pneumonia symptoms, from a rehabilitation facility On 2 March the patient tested positive for Middle East respiratory syndrome coronavirus (MERS-CoV) On 9 March six additional laboratory-confirmed MERS-CoV cases were reported from WDGH The study describes the scope of the outbreak and identifies risk factors that led to the transmission of MERS-CoV Method(s): Using PCR, dialysis patients, relatives of cases, and all WDGH staff were screened to identify additional MERS-CoV cases Renal dialysis unit staff were questioned about infection control practices and cases interviewed, together with relatives, about possible sources of MERS-CoV infection Cases\' medical records were examined using a standard chart abstraction form to collect information on symptoms and the course of the illness Result(s): Between 15 February and 15 March 2017, 10 laboratory confirmed MERS-CoV cases were identified and one probable case epidemiologically linked Six cases were asymptomatic when they were identified Patients on hemodialysis were significantly more likely to develop symptoms (p-value 0 050) Symptomatic cases were significantly older than asymptomatic cases (p-value 0 050) All five symptomatic cases sought medical help from at least one emergency department Only one case was identified on initial presentation A second case was identified only after multiple visits Conclusion(s): Many cases were not diagnosed when they sought care, highlighting the continued importance of considering MERS-CoV infection among patients with respiratory illness in Saudi Arabia Rapid identification and isolation of MERS-CoV cases is essential in preventing healthcare associated infections
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