Middle East respiratory syndrome coronavirus infection risk factors: Difference between revisions

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==Overview==
==Overview==
Risk factors  for the development of either MERS-CoV infection or MERS-CoV-associated complications include recent travel to the Arabian Peninsula, exposure to patients with suspected or confirmed MERS-CoV infection, immunocompromised status, and history of prior systemic comorbidities, such as diabetes mellitus, hypertension, active malignancy, chronic kidney disease, respiratory disease, liver disease, and chronic cardiac disease.


==Risk Factors==
==Risk Factors==
The following are risk factors for the development of either MERS-CoV infection or MERS-CoV-associated complications:


===Recent Travelers from the Arabian Peninsula===
===Recent Travelers from the Arabian Peninsula===
If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in or near the Arabian Peninsula, you should call ahead to a healthcare provider and mention your recent travel. While sick, stay home from work or school and delay future travel to reduce the possibility of spreading illness to others. <ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref>
*The majority of MERS-CoV cases have been reported in the Arabian Peninsula.<ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref>


===Close Contacts of an Ill Traveler from the Arabian Peninsula===
===Close Contacts of an Ill Traveler from the Arabian Peninsula===
If you have had close contact with someone who recently traveled from a country in or near the Arabian Peninsula, and the traveler has/had fever and symptoms of respiratory illness, such as cough or shortness of breath, you should monitor your health for 14 days, starting from the day you were last exposed to the ill person.
*During the viral incubation period, individuals remain asymptomatic for up to 2 weeks following exposure and transmission.<ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref>


If you develop fever and symptoms of respiratory illness, such as cough or shortness of breath, you should call ahead to a healthcare provider and mention your recent contact with the traveler. While sick, stay home from work or school and delay future travel to reduce the possibility of spreading illness to others. <ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref>
===Close Contacts of a Confirmed or Probable Case of MERS-CoV===
*It is not confirmed if human-to-human MERS-CoV transmission is possible. Nonetheless, the majority of infected patients had not reported a recent exposure to animals that might suggest zoonotic activity. Accordingly, exposure to infected patients is suspected to increase the risk of MERS-CoV infection.<ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref><ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref><ref name="AssiriMcGeer2013">{{cite journal|last1=Assiri|first1=Abdullah|last2=McGeer|first2=Allison|last3=Perl|first3=Trish M.|last4=Price|first4=Connie S.|last5=Al Rabeeah|first5=Abdullah A.|last6=Cummings|first6=Derek A.T.|last7=Alabdullatif|first7=Zaki N.|last8=Assad|first8=Maher|last9=Almulhim|first9=Abdulmohsen|last10=Makhdoom|first10=Hatem|last11=Madani|first11=Hossam|last12=Alhakeem|first12=Rafat|last13=Al-Tawfiq|first13=Jaffar A.|last14=Cotten|first14=Matthew|last15=Watson|first15=Simon J.|last16=Kellam|first16=Paul|last17=Zumla|first17=Alimuddin I.|last18=Memish|first18=Ziad A.|title=Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus|journal=New England Journal of Medicine|volume=369|issue=5|year=2013|pages=407–416|issn=0028-4793|doi=10.1056/NEJMoa1306742}}</ref>


===Close Contacts of a Confirmed or Probable Case of MERS===
===Immunocompromised Status===
If you have had close contact with someone who has a probable or confirmed MERS-CoV infection, you should contact a healthcare provider for an evaluation. Your healthcare provider may request laboratory testing and outline additional recommendations, depending on the findings of your evaluation and whether you have symptoms. You most likely will be asked to monitor your health for 14 days, starting from the day you were last exposed to the ill person. Watch for these symptoms:
*Immunocompromised patients are at increased risk of developing MERS-CoV infection and MERS-CoV infection-associated complications.
*Fever (100° Fahrenheit or higher). Take your temperature twice a day.
===Systemic Comorbidities===
*Coughing
*The rates of MERS-CoV infection and MERS-CoV-associated complications are significantly higher among patients with chronic systemic comorbidities, such as:
*Shortness of breath
*Diabetes mellitus
*Other early symptoms to watch for are chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and runny nose.
*Hypertension
 
*Active malignancy
If you develop symptoms, call your healthcare provider as soon as possible. Before your medical appointment, call the healthcare provider and tell him or her about your possible exposure to MERS-CoV. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department. <ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref>
*Chronic kidney disease (CKD), especially end-stage renal disease (ESRD)
 
*Chronic cardiac disease
===Healthcare Personnel Not Using Recommended Infection-Control Precautions===
*Chronic liver disease
Healthcare personnel should adhere to recommended infection control measures, including standard, contact, and airborne precautions, while managing symptomatic close contacts, patients under investigation, and patients who have probable or confirmed MERS-CoV infections. Recommended infection control precautions should also be utilized when collecting specimens.
*Respiratory disease (e.g. COPD or cystic fibrosis)
 
Healthcare personnel who had close contact with a confirmed or probable case of MERS while the case was ill, if not using recommended infection control precautions (e.g. appropriate use of personal protective equipment), are at increased risk of developing MERS-CoV infection and should be evaluated and monitored by a healthcare professional with a higher index of suspicion. For more information, see Interim Infection Prevention and Control Recommendations for Hospitalized Patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <ref name="CDC-MERS"> {{cite web | title= CDC MERS Interim Guidance for Health Professionals | url=http://www.cdc.gov/coronavirus/mers/risk.html}} </ref>


==References==
==References==
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2], Alejandro Lemor, M.D. [3]

Overview

Risk factors for the development of either MERS-CoV infection or MERS-CoV-associated complications include recent travel to the Arabian Peninsula, exposure to patients with suspected or confirmed MERS-CoV infection, immunocompromised status, and history of prior systemic comorbidities, such as diabetes mellitus, hypertension, active malignancy, chronic kidney disease, respiratory disease, liver disease, and chronic cardiac disease.

Risk Factors

The following are risk factors for the development of either MERS-CoV infection or MERS-CoV-associated complications:

Recent Travelers from the Arabian Peninsula

  • The majority of MERS-CoV cases have been reported in the Arabian Peninsula.[1]

Close Contacts of an Ill Traveler from the Arabian Peninsula

  • During the viral incubation period, individuals remain asymptomatic for up to 2 weeks following exposure and transmission.[1]

Close Contacts of a Confirmed or Probable Case of MERS-CoV

  • It is not confirmed if human-to-human MERS-CoV transmission is possible. Nonetheless, the majority of infected patients had not reported a recent exposure to animals that might suggest zoonotic activity. Accordingly, exposure to infected patients is suspected to increase the risk of MERS-CoV infection.[1][2][3]

Immunocompromised Status

  • Immunocompromised patients are at increased risk of developing MERS-CoV infection and MERS-CoV infection-associated complications.

Systemic Comorbidities

  • The rates of MERS-CoV infection and MERS-CoV-associated complications are significantly higher among patients with chronic systemic comorbidities, such as:
  • Diabetes mellitus
  • Hypertension
  • Active malignancy
  • Chronic kidney disease (CKD), especially end-stage renal disease (ESRD)
  • Chronic cardiac disease
  • Chronic liver disease
  • Respiratory disease (e.g. COPD or cystic fibrosis)

References

  1. 1.0 1.1 1.2 "CDC MERS Interim Guidance for Health Professionals".
  2. Perlman, S. (2013). "The Middle East Respiratory Syndrome--How Worried Should We Be?". mBio. 4 (4): e00531–13–e00531–13. doi:10.1128/mBio.00531-13. ISSN 2150-7511.
  3. Assiri, Abdullah; McGeer, Allison; Perl, Trish M.; Price, Connie S.; Al Rabeeah, Abdullah A.; Cummings, Derek A.T.; Alabdullatif, Zaki N.; Assad, Maher; Almulhim, Abdulmohsen; Makhdoom, Hatem; Madani, Hossam; Alhakeem, Rafat; Al-Tawfiq, Jaffar A.; Cotten, Matthew; Watson, Simon J.; Kellam, Paul; Zumla, Alimuddin I.; Memish, Ziad A. (2013). "Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus". New England Journal of Medicine. 369 (5): 407–416. doi:10.1056/NEJMoa1306742. ISSN 0028-4793.

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