MERS-Exposed Healthcare Workers Test Negative So Far

May 14, 2014

An official with the Florida Department of Health (FDOH) today declared that a case of Middle East Respiratory Syndrome (MERS) in his state — the nation's second — represents "a contained infection," based on negative tests so far for healthcare workers and others in Orlando who were exposed to the virus.

"There is no broad risk to the community from MERS [coronavirus]," said Kevin Sherin, MD, MPH, the FDOH's director for Orange County, Florida, in a news conference today. "The general public is safe to travel in…the Orlando area, throughout our community, throughout central Florida."

Twenty healthcare workers were exposed to a man who had travelled from Saudi Arabia — the hotbed of the often deadly MERS coronavirus (CoV) — to Orlando to visit family only to be admitted to Dr. P. Phillips Hospital on May 9 and later diagnosed with the infection. Fifteen workers there were exposed to the patient, himself a healthcare worker in Saudi Arabia, and of these, 2 became ill. Another 5 healthcare workers at sister hospital Orlando Regional Medical Center were exposed when the man accompanied a patient there earlier in the month.

At the news conference, Dr. Sherin said that the 2 symptomatic healthcare workers at Dr. P. Phillips Hospital, one of whom was admitted, conclusively tested negative for MERS-CoV. Testing of the other 18 healthcare workers wasn't complete, but preliminary results have all come back negative, he said, adding that none of them had developed MERS symptoms, which include fever, cough, and shortness of breath.

Dr. Sherin explained that testing for MERS is biologically piecemeal, with separate examinations of nasal and mouth swabs, blood, sputum, and fecal samples.

In an interview with Medscape Medical News, FDOH spokesperson Dain Weister said that a series of tests were necessary because a nasal swab sample may be negative only for a sputum sample afterward to test positive.

The FDOH extended MERS testing to the infected patient's relatives and friends who also were exposed to the virus. That testing was complete, said Weister, and the results were negative.

The man being treated for MERS at Dr. P. Phillips Hospital, although still in isolation, was improving, and currently fever-free, Dr. Sherin said at the news conference.

So far, the MERS case in Orlando has been just as dead-ended as the one in Indiana, where another healthcare worker from Saudi Arabia was hospitalized with the virus in late April and later released. Healthcare workers and others who came in close contact with the man tested negative.

As of May 12, 536 laboratory-confirmed cases of MERS and 145 deaths had been reported to the World Health Organization (WHO), according to the May 14 issue of Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention (CDC). Most of the cases and deaths have been in or near the Arabian Peninsula, where the virus was first detected in 2012.

Public health authorities, including the CDC, stress that the virus poses only a minor threat to the general public because it does not spread easily from person to person in community settings. For that reason, WHO announced today that the worldwide outbreak of MERS-CoV had not yet risen to the level of a "public health emergency of international concern."

The virus spreads more readily, however, in close quarters where someone is caring for an infected person at home or in a hospital, and measures to prevent and control infection are lax. Healthcare workers account for 20% of cases worldwide.

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