scholarly journals Exploring the risk of Middle East Respiratory Syndrome- coronavirus among expatriate healthcare workers. A comparative epidemiological study of Saudi Arabian and South Korean healthcare workers

2019 ◽  
Author(s):  
Mohammed Owais Qureshi ◽  
Abrar Chughtai ◽  
Holly Seale
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Infectious Diseases ◽  
South Korea ◽  
Healthcare Workers ◽  
Saudi Arabian ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Healthcare Sector ◽  
Healthcare Associated

Abstract Background In comparison to South Korea, which was able to contain the outbreak of Middle East respiratory syndrome corona virus (MERS-CoV) in 2015, new cases are still emerging in the Kingdom of Saudi Arabia. The Saudi Arabian healthcare sector, which is dependent on the expatriate workforce to cater to its growing local healthcare demands, has been reporting multiple healthcare-associated MERS-CoV outbreaks since 2012. In this paper, we compare the epidemiology of MERS-CoV among healthcare workers (HCWs) in Saudi Arabia and South Korea and to ascertain the risks of MERS-CoV among expatriate HCWs. Methods Data were collected from publicly available resources such as World Health Organization and health department websites. A line list of all reported cases of MERS-CoV among HCWs in Saudi Arabia and South Korea was prepared and analysed. Results Among the total infected HCWs in Saudi Arabia, 84.6% (n=192/227) were expatriates. The mean age of infected HCWs in both settings was similar (Saudi Arabia 38 years, South Korea 39 years). Female HCWs were more likely to be infected, while male HCWs were more likely to die. In Saudi Arabia, 36.5% (n= 68/186) of HCWs with MERS-CoV were asymptomatic, compared to 7% (n=2/28) HCWs in South Korea. Most of the expatriate HCWs in Saudi Arabia were asymptomatic (78%, n=53/68) to MERS-CoV. Unlike South Korea, in Saudi Arabia, a diversity of HCWs other than doctors, and nurses were also infected with MERS-CoV. Conclusions A high proportion of expatriate HCWs were infected with MERS-CoV in Saudi Arabia which highlights the need for adequate training and education in this group about emerging infectious diseases and the appropriate strategies to prevent acquisition. Also, we did not find any policy statements restricting the contact of HCWs, vulnerable to MERS-CoV like pregnant HCW, HCWs over the age 60, HCWs with underlying comorbidity etc, from getting in proximity with a suspected or potential MERS-CoV infected patient. Policy development in this regard should be a priority, to contain healthcare-associated transmission of emerging and remerging infectious diseases like MERS-CoV. Further studies should be conducted to determine social, cultural and other factors contributing to high infection rate among expatriate HCWs.

scholarly journals The Healthcare Sector Employer’s Duty of Care: Implications for Worker Well-Being

2021 ◽  
Vol 18 (11) ◽  
pp. 6015
Author(s):  
Melissa McDiarmid ◽  
Marian Condon ◽  
Joanna Gaitens
Keyword(s):  
Middle East ◽  
Healthcare Workers ◽  
Care Program ◽  
Well Being ◽  
Middle East Respiratory Syndrome ◽  
Worker Safety ◽  
Healthcare Sector ◽  
Duty Of Care ◽  
Protective Equipment ◽  
Extreme Risk

Pandemic diseases of this century have differentially targeted healthcare workers globally. These infections include Severe Acute Respiratory Syndrome SARS, the Middle East respiratory syndrome coronavirus Middle East respiratory syndrome coronavirus (MERS-CoV) and Ebola. The COVID-19 pandemic has continued this pattern, putting healthcare workers at extreme risk. Just as healthcare workers have historically been committed to the service of their patients, providing needed care, termed their “duty of care”, so too do healthcare employers have a similar ethical duty to provide care toward their employees arising from historical common law requirements. This paper reports on results of a narrative review performed to assess COVID-19 exposure and disease development in healthcare workers as a function of employer duty of care program elements adopted in the workplace. Significant duty of care deficiencies reported early in the pandemic most commonly involved lack of personal protective equipment (PPE) availability. Beyond worker safety, we also provide evidence that an additional benefit of employer duty of care actions is a greater sense of employee well-being, thus aiding in the prevention of healthcare worker burnout.

scholarly journals Middle East Respiratory Syndrome

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Novie H. Rampengan
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
World Health Organization ◽  
Antiviral Agents ◽  
Supportive Therapy ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Infected People ◽  
Corona Virus ◽  
Health Organization

Abstract: Middle East Respiratory Syndrome (MERS) is a respiratory disease caused by Corona virus (MERS-CoV). This virus was first reported in 2012 in Saudi Arabia. World Health Organization (WHO) reported that until June 2015 there were 26 countries infected by MERS-CoV with a total of 1,334 laboratory confirmed cases of MERS-CoV infection and 471 deaths. According to WHO as many as 75% of MERS-CoV cases are secondary cases, obtained from other infected people. In mid 2015 it is reported that MERS-CoV attacked South Korea with 172 confirmed cases of MERS-CoV and 27 deaths. There are no approved antiviral agents for the treatment of MERS-CoV infection or vaccine available for the prevention of MERS-CoV. MERS cases are treated with supportive therapy such as hydration, antipyretics, analgesics, respiratory support, and antibiotics in case of secondary infectionKeywords: Middle East Respiratory Syndrome, Corona virus, treatmentAbstrak: Middle East Respiratory Syndrome (MERS) merupakan penyakit saluran napas yang disebabkan oleh Corona virus (MERS-CoV). Virus ini pertama kali dilaporkan pada tahun 2012 di Arab Saudi. WHO melaporkan bahwa sampai Juni 2015 terdapat 26 negara terinfeksi MERS-CoV dengan total 1.334 kasus yang dikonfirmasi laboratorium terinfeksi MERS-CoV dan 471 kematian. Menurut WHO sebanyak 75% dari kasus MERS-CoV merupakan kasus sekunder, yaitu diperoleh dari orang lain yang terinfeksi. Pada pertengahan tahun 2015 dilaporkan MERS-CoV menyerang Korea Selatan dengan 172 kasus yang dikonfirmasi laboratorium terinfeksi MERS-CoV dan 27 kematian. Belum ada antivirus yang disetujui untuk pengobatan infeksi MERS-CoV atau vaksin yang tersedia untuk pencegahan MERS-CoV. Penanganan MERS-CoV dengan terapi suportif berupa hidrasi, antipiretik, analgetik, bantuan pernapasan, dan antibiotik bila terjadi infeksi sekunder.Kata kunci: Middle East Respiratory Syndrome, Corona virus, penanganan

scholarly journals Epidemiology and evolution of Middle East respiratory syndrome coronavirus, 2012–2020

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
An-Ran Zhang ◽  
Wen-Qiang Shi ◽  
Kun Liu ◽  
Xin-Lou Li ◽  
Ming-Jin Liu ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Transportation Network ◽  
Case Fatality ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Spatial Diffusion ◽  
Risk Of Death ◽  
Animal Contact ◽  
History Of

Abstract Background The ongoing transmission of the Middle East respiratory syndrome coronavirus (MERS-CoV) in the Middle East and its expansion to other regions are raising concerns of a potential pandemic. An in-depth analysis about both population and molecular epidemiology of this pathogen is needed. Methods MERS cases reported globally as of June 2020 were collected mainly from World Health Organization official reports, supplemented by other reliable sources. Determinants for case fatality and spatial diffusion of MERS were assessed with Logistic regressions and Cox proportional hazard models, respectively. Phylogenetic and phylogeographic analyses were performed to examine the evolution and migration history of MERS-CoV. Results A total of 2562 confirmed MERS cases with 150 case clusters were reported with a case fatality rate of 32.7% (95% CI: 30.9‒34.6%). Saudi Arabia accounted for 83.6% of the cases. Age of ≥ 65 years old, underlying conditions and ≥ 5 days delay in diagnosis were independent risk factors for death. However, a history of animal contact was associated with a higher risk (adjusted OR = 2.97, 95% CI: 1.10–7.98) among female cases < 65 years but with a lower risk (adjusted OR = 0.31, 95% CI: 0.18–0.51) among male cases ≥ 65 years old. Diffusion of the disease was fastest from its origin in Saudi Arabia to the east, and was primarily driven by the transportation network. The most recent sub-clade C5.1 (since 2013) was associated with non-synonymous mutations and a higher mortality rate. Phylogeographic analyses pointed to Riyadh of Saudi Arabia and Abu Dhabi of the United Arab Emirates as the hubs for both local and international spread of MERS-CoV. Conclusions MERS-CoV remains primarily locally transmitted in the Middle East, with opportunistic exportation to other continents and a potential of causing transmission clusters of human cases. Animal contact is associated with a higher risk of death, but the association differs by age and sex. Transportation network is the leading driver for the spatial diffusion of the disease. These findings how this pathogen spread are helpful for targeting public health surveillance and interventions to control endemics and to prevent a potential pandemic. Graphical abstract

scholarly journals Scope and extent of healthcare-associated Middle East respiratory syndrome coronavirus transmission during two contemporaneous outbreaks in Riyadh, Saudi Arabia, 2017

2018 ◽  
Vol 40 (1) ◽  
pp. 79-88 ◽  
Author(s):  
Khalid H. Alanazi ◽  
Marie E. Killerby ◽  
Holly M. Biggs ◽  
Glen R. Abedi ◽  
Hani Jokhdar ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Outpatient Clinic ◽  
Index Case ◽  
Middle East Respiratory Syndrome ◽  
Contact Tracing ◽  
Care Hospital ◽  
Healthcare Facilities ◽  
Healthcare Associated ◽  
Unique Index

AbstractObjectiveTo investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.DesignOutbreak investigation.SettingCases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.MethodsContact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.ResultsIn total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.ConclusionsWe describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.

scholarly journals Atypical presentation of Middle East respiratory syndrome coronavirus in a Lebanese patient returning from Saudi Arabia

2018 ◽  
Vol 12 (09) ◽  
pp. 808-811 ◽  
Author(s):  
Saeed El Zein ◽  
Jinane Khraibani ◽  
Nada Zahreddine ◽  
Rami Mahfouz ◽  
Nada Ghosn ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Medical Center ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
American University ◽  
American University Of Beirut ◽  
Persistent Symptoms ◽  
First Case ◽  
Health Organization

Around 2090 confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) from 27 countries have been reported to the World Health Organization (WHO) between September 2012 and October 2017, the majority of whom occurring in countries in the Arabian Peninsula, mainly in Saudi Arabia. MERS- CoV can have atypical and misleading presentations resulting in delays in diagnosis and is associated with a high mortality rate especially in elderly patients with multiple comorbidities. Herein, we present the first case of confirmed MERS-CoV infection diagnosed at the American University of Beirut Medical Center (AUBMC) - Lebanon in June 2017 presenting without any respiratory symptoms. This is the second confirmed case of MERS-CoV infection in Lebanon since 2014. The first case presented with a febrile respiratory infection with persistent symptoms despite antibiotic treatment.

scholarly journals Middle East Respiratory Syndrome Coronavirus epidemic impact on healthcare workers’ risk perceptions, work and personal lives

2019 ◽  
Vol 13 (10) ◽  
pp. 920-926 ◽  
Author(s):  
Sarah Alsubaie ◽  
Mohamad Hani Temsah ◽  
Ayman A Al-Eyadhy ◽  
Ibrahim Gossady ◽  
Gamal M Hasan ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Healthcare Workers ◽  
Severe Disease ◽  
Significant Proportion ◽  
Middle East Respiratory Syndrome ◽  
Anxiety Score ◽  
University Hospital

Introduction: Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause frequent outbreaks in hospitals in Saudi Arabia. Since healthcare workers (HCWs) have a higher risk of acquiring and spreading MERS-CoV, we aimed to evaluate the perceived risk and anxiety level of HCWs in Saudi Arabia regarding MERS. Methodology: An anonymous, self-administered questionnaire was sent online to HCWs at King Khalid University Hospital in Saudi Arabia. The total knowledge and anxiety scores were calculated. Logistic regression analyses were used to identify predictors of high anxiety scores. Results: Of 591 (70%) HCWs that responded, 284 (55%), 164 (32%), and 68 (13.2%) were physicians, nurses, and technicians, respectively. Physicians obtained a lower median knowledge score (6/9) compared to other professions (7/9). The mean anxiety score was similar for physicians and other HCWs (3/5); however, non-physicians expressed higher levels of anxiety toward the risk of transmitting MERS-CoV to their families, with an anxiety score of 4/5. The ability of the virus to cause severe disease or death was the most frequently reported reason for worry by physicians (89.7%) and non-physicians (87.2%). Overall, 80% of physicians and 90% of non-physicians reported improvement in adherence to hand hygiene and standard precautions while in hospital (p = 0.002). Concern over transmitting MERS-CoV to family members was the most predictive factor for anxiety among non-physician HCWs. Conclusion: A significant proportion of HCWs expressed anxiety about the risk of acquiring MERS-CoV infection. Healthcare institutions need to develop an integrated psychological response for HCWs to the occupational and psychological challenge of MERS-CoV outbreaks.

scholarly journals The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Outbreak at King Abdul-Aziz Medical City-Riyadh from Emergency Medical Services Perspective

2020 ◽  
Vol 35 (4) ◽  
pp. 457-461
Author(s):  
Abdullah Alabdali ◽  
Kharsan Almakhalas ◽  
Faisal Alhusain ◽  
Saad Albaiz ◽  
Khalid Almutairi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Emergency Medical Services ◽  
Lessons Learned ◽  
Middle East Respiratory Syndrome ◽  
World Health ◽  
Medical Services ◽  
Emergency Medical ◽  
Medical City ◽  
Health Organization

AbstractMiddle East Respiratory Syndrome Coronavirus (MERS-CoV) is a form of an infectious respiratory disease, discovered in November 2012 in Saudi Arabia. According to the World Health Organization (WHO; Geneva, Switzerland) reports, a total of 2,519 laboratory-confirmed cases and 866 MERS-CoV-related deaths were recorded as of March 5, 2016.1 The majority of reported cases originated from Saudi Arabia (2,121 cases). Also, MERS-CoV is believed to be of zoonotic origin and has been linked to camels in the Arabian area.1,2 In this report, the authors discuss the lessons learned from the MERS-CoV outbreak at King Abdul-Aziz Medical City-Riyadh (KAMC-R) from August through September 2015 from the Emergency Medical Services (EMS) perspective. The discussion includes the changes in policies and paramedic’s practice, the training and education in infection control procedures, and the process of transportation of these cases. The authors hope to share their experience in this unique situation and highlight the preparedness and response efforts that took place by the division of EMS during the outbreak.

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