A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) in a Hospital Setting Through Bioaerosols

Risk Analysis

Volumn 39, Issue 12, 2019, Pages 2608-2624

  Adhikari, Umesh ^a   Chabrelie, Alexandre ^a   Weir, Mark ^b   Boehnke, Kevin ^c   McKenzie, Erica ^d   Ikner, Luisa ^e   Wang, Meng ^f   Wang, Qing ^g   Young, Kyana ^h   Haas, Charles N ⁱ   Rose, Joan ^h   Mitchell, Jade ^a  

^a Michigan State University   (United States)

^b OHIO STATE UNIVERSITY   (United States)

^c UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

^d Temple University   (United States)

^e UNIVERSITY OF ARIZONA   (United States)

^f University of South Florida   (United States)

^g UNIVERSITY OF DELAWARE   (United States)

^h MICHIGAN STATE UNIVERSITY   (United States)

ⁱ Drexel University   (United States)

Author keywords

Hospital; MERS CoV; mitigation; QMRA; risk characterization

Indexed keywords

AEROSOLS; ATMOSPHERIC MOVEMENTS; HOSPITALS; INTELLIGENT SYSTEMS; MONTE CARLO METHODS; NURSING; PATIENT TREATMENT; RISK PERCEPTION; SENSITIVITY ANALYSIS; UNCERTAINTY ANALYSIS; VIRUSES;

AEROSOL TRANSPORT MODEL; HEALTHCARE WORKERS; MERS-COV; MITIGATION; QMRA; QUANTITATIVE MICROBIAL RISK ASSESSMENT; RISK CHARACTERIZATION; VIRAL CONCENTRATION;

RISK ASSESSMENT;

AEROSOL; DISEASE TRANSMISSION; HEALTH CARE; HOSPITAL SECTOR; INDOOR AIR; RESPIRATION; RISK ASSESSMENT; UNCERTAINTY ANALYSIS; VIRUS;

CORONAVIRUS;

AEROSOL; BIOLOGICAL MODEL; COMPUTER SIMULATION; CORONAVIRUS INFECTION; CROSS INFECTION; DISEASE TRANSMISSION; EPIDEMIC; HEALTH CARE PERSONNEL; HUMAN; MASK; MICROBIOLOGY; MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS; MONTE CARLO METHOD; PREVENTION AND CONTROL; PROCEDURES; RISK ASSESSMENT; RISK MANAGEMENT; SALIVA; SOUTH KOREA; VIROLOGY;

AEROSOLS; AIR MICROBIOLOGY; COMPUTER SIMULATION; CORONAVIRUS INFECTIONS; CROSS INFECTION; DISEASE OUTBREAKS; HEALTH PERSONNEL; HUMANS; INFECTIOUS DISEASE TRANSMISSION, PATIENT-TO-PROFESSIONAL; MASKS; MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS; MODELS, BIOLOGICAL; MONTE CARLO METHOD; REPUBLIC OF KOREA; RISK ASSESSMENT; RISK MANAGEMENT; SALIVA;

EID: 85073832023     PISSN: 02724332     EISSN: 15396924     Source Type: Journal    
DOI: 10.1111/risa.13389     Document Type: Article

References (66)

1. Al-Abdallar, M. (2014). Hospital-associated outbreak of Middle East respiratory syndrome coronavirus: A serologic, epidemiologic, and clinical description. Clinical Infectious Diseases, 59(9), 1–9. http://doi.org/10.1093/cid/ciu359.Hospital-Associated
2. Al-Tawfiq, J. A. (2013). Middle East respiratory syndrome-coronavirus infection: An overview. Journal of Infection and Public Health, 6(5), 319–322. http://doi.org/10.1016/j.jiph.2013.06.001
3. Al-Tawfiq, J. A., & Perl, T. M. (2015). Middle East respiratory syndrome coronavirus in healthcare settings. Current Opinion in Infectious Diseases, 28(4), 392–396. http://doi.org/10.1097/QCO.0000000000000178
4. Bałazy, A., Toivola, M., Adhikari, A., Sivasubramani, S. K., Reponen, T., & Grinshpun, S. A. (2006). Do N95 respirators provide 95% protection level against airborne viruses, and how adequate are surgical masks? American Journal of Infection Control, 34(2), 51–57. http://doi.org/10.1016/j.ajic.2005.08.018
5. Bałazy, A., Toivola, M., Reponen, T., Podgórski, A., Zimmer, A., & Grinshpun, S. A. (2006). Manikin-based performance evaluation of N95 filtering-facepiece respirators challenged with nanoparticles. Annals of Occupational Hygiene, 50(3), 259–269. http://doi.org/10.1093/annhyg/mei058
6. Banik, G. R., Khandaker, G., & Rashid, H. (2015). Middle East respiratory syndrome coronavirus “MERS-CoV”: Current knowledge gaps. Paediatric Respiratory Reviews, 16(3), 197–202. http://doi.org/10.1016/j.prrv.2015.04.002
7. Borkow, G., Zhou, S. S., Page, T., & Gabbay, J. (2010). A novel anti-influenza copper oxide containing respiratory face mask. PLoS One, 5(6), 1–8. http://doi.org/10.1371/journal.pone.0011295
8. Breban, R., Riou, J., & Fontanet, A. (2013). Interhuman transmissibility of Middle East respiratory syndrome coronavirus: Estimation of pandemic risk. The Lancet, 382(9893), 694–699. http://doi.org/10.1016/S0140-6736(13)61492-0
9. CDC. (2017a). Implementing home care and isolation or quarantine of people not requiring hospitalization for MERS-CoV. Retrieved from https://www.cdc.gov/coronavirus/mers/hcp/home-care.html
10. CDC. (2017b). Preventing MERS-CoV from spreading to others in homes and communities. Retrieved from https://www.cdc.gov/coronavirus/mers/hcp/home-care-patient.html
11. Chabrelie, A., Mitchell, J., Rose, J., Charbonneau, D., & Ishida, Y. (2018). Evaluation of the influenza risk reduction from antimicrobial spray application on porous surfaces. Risk Analysis, 38(7), 1502–1517. http://doi.org/10.1111/risa.12952
12. Chan, J. F. W., Lau, S. K. P., To, K. K. W., Cheng, V. C. C., Woo, P. C. Y., & Yue, K. Y. (2015). Middle East respiratory syndrome coronavirus: Another zoonotic betacoronavirus causing SARS-like disease. Clinical Microbiology Reviews, 28(2), 465–522. http://doi.org/10.1128/CMR.00102-14
13. Cho, S. Y., Kang, J. M., Ha, Y. E., Park, G. E., Lee, J. Y., Ko, J. H., … Kim, Y. J. (2016). MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: An epidemiological outbreak study. The Lancet, 388(10048), 994–1001. http://doi.org/10.1016/S0140-6736(16)30623-7
14. Cohen, B., Hyman, S., Rosenberg, L., & Larson, E. (2012). Frequency of patient contact with health care personnel and visitors: Implications for infection prevention. Journal of Investigative Dermatology, 38(12), 560–565. http://doi.org/10.1038/jid.2014.371
15. Corman, V. M., Albarrak, A. M., Omrani, A. S., Albarrak, M. M., Farah, M. E., Almasri, M., … Memish, Z. A. (2015). Viral shedding and antibody response in 37 patients with Middle East respiratory syndrome coronavirus infection. Clinical Infectious Diseases, 62(4), 477–483. http://doi.org/10.1093/cid/civ951
16. Cowling, B. J., Park, M., Fang, V. J., Wu, P., Leung, G. M., & Wu, J. T. (2015). Preliminary epidemiologic assessment of MERS-CoV outbreak in South Korea, May–June 2015. Euro Surveillance, 20(25), 7–13. http://doi.org/10.1002/nbm.3369.Three
17. De Albuquerque, N., Baig, E., Ma, X., Zhang, J., He, W., Rowe, A., … Levy, G. A. (2006). Murine hepatitis virus strain 1 produces a clinically relevant model of severe acute respiratory syndrome in A/J mice. Journal of Virology, 80(21), 10382–10394. http://doi.org/10.1128/JVI.00747-06
18. DeDiego, M. L., Pewe, L., Alvarez, E., Rejas, M. T., Perlman, S., & Enjuanes, L. (2008). Pathogenicity of severe acute respiratory coronavirus deletion mutants in hACE-2 transgenic mice. Virology, 376(2), 379–389. http://doi.org/10.1016/j.virol.2008.03.005
19. de Groot, R. J., Baker, S. C., Baric, R. S., Brown, C. S., Drosten, C., Enjuanes, L., … Ziebuhr, J. (2013). Middle East respiratory syndrome coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group. Journal of Virology, 87(14), 7790–7792. http://doi.org/10.1128/JVI.01244-13
20. Drosten, C., Muth, D., Corman, V. M., Hussain, R., Al Masri, M., HajOmar, W., … Memish, Z. A. (2015). An observational, laboratory-based study of outbreaks of Middle East respiratory syndrome coronavirus in Jeddah and Riyadh, Kingdom of Saudi Arabia, 2014. Clinical Infectious Diseases, 60(3), 369–377. http://doi.org/10.1093/cid/ciu812
21. Duguid, J. P. (1946). The size and the duration of air-carriage of respiratory droplets and droplet-nuclei. The Journal of Hygiene, 44(6), 471–479. http://doi.org/10.1017/S0022172400019288
22. EPA, US. (2011). Exposure factors handbook 2011 edition (final). Washington, DC. Retrieved from https://cfpub.epa.gov/ncea/risk/recordisplay.cfm?deid=236252
23. Gupta, S. (2011). Surgical masks vs. N95 respirator masks for protecting health care professionals. Indian Journal of Pediatrics, 78(2), 242–243. http://doi.org/10.1007/s12098-010-0264-1
24. Haas, C., Rose, J., & Gerba, C. (2014). Quantitative microbial risk assessment. In C. Haas, J. Rose, & C. Gerba (Eds.), Quantitative microbial risk assessment (2nd ed., pp. 323–373). Hoboken, NJ: John Wiley & Sons, Inc. Retrieved from https://onlinelibrary.wiley.com/doi/book/10.1002/9781118910030
25. Han, H.-J., Wen, H.-I., Zhou, C.-M., Chen, F.-F., Luo, L.-M., Liu, J., & Yu, X.-J. (2015). Bats as reservoirs of severe emerging infectious diseases. Virus Research, 205, 1–6. http://doi.org/10.1016/j.virusres.2015.05.006
26. Hilgenfeld, R., & Peiris, M. (2013). From SARS to MERS: 10 years of research on highly pathogenic human coronaviruses. Antiviral Research, 100(1), 286–295. http://doi.org/10.1016/j.antiviral.2013.08.015
27. Houng, H. S. H., Norwood, D., Ludwig, G. V., Sun, W., Lin, M., & Vaughn, D. W. (2004). Development and evaluation of an efficient 3′-noncoding region based SARS coronavirus (SARS-CoV) RT-PCR assay for detection of SARS-CoV infections. Journal of Virological Methods, 120(1), 33–40. http://doi.org/10.1016/j.jviromet.2004.04.008
28. Huang, Y. (2013). SARS: Dose response models. Retrieved from http://qmrawiki.canr.msu.edu/index.php/SARS:_Dose_Response_Models#_9f6e9f18777d09a3e4569b0d5784d92f
29. Ijaz, M. K., Brunner, A. H., Sattar, S. A., Nair, R. C., & Johnson-Lussenburg, C. M. (1985). Survival characteristics of airborne human coronavirus 229E. Journal of General Virology, 66(12), 2743–2748. http://doi.org/10.1099/0022-1317-66-12-2743
30. Ki, M. (2015). 2015 MERS outbreak in Korea: Hospital-to-hospital transmission. Epidemiology and Health, 37, 1–4. http://doi.org/10.4178/epih/e2015033
31. Kim, K. M., Ki, M., Cho, S.-I., Sung, M., Hong, J. K., Cheong, H.-K., … Choi, B. Y. (2015). Epidemiologic features of the first MERS outbreak in Korea: Focus on Pyeongtaek St. Mary's Hospital. Epidemiology and Health, 37(October), e2015041. http://doi.org/10.4178/epih/e2015041
32. Loudon, R., & Brown, L. (1967). Droplet expulsion from the respiratory tract. The American Review of Respiratory Disease, 95(3), 435–442. https://www.atsjournals.org/doi/pdf/10.1164/arrd.1967.95.3.435
33. Lu, G., Wang, Q., & Gao, G. F. (2015). Bat-to-human: Spike features determining “host jump” of coronaviruses SARS-CoV, MERS-CoV, and beyond. Trends in Microbiology, 23(8), 468–478. http://doi.org/10.1016/j.tim.2015.06.003
34. Memish, Z. A., Assiri, A. M., & Al-Tawfiq, J. A. (2014). Middle East respiratory syndrome coronavirus (MERS-CoV) viral shedding in the respiratory tract: An observational analysis with infection control implications. International Journal of Infectious Diseases, 29, 307–308. http://doi.org/10.1016/j.ijid.2014.10.002
35. Min, C. K., Cheon, S., Ha, N. Y., Sohn, K. M., Kim, Y., Aigerim, A., … Kim, Y. S. (2016). Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity. Scientific Reports, 6(April), 1–12. http://doi.org/10.1038/srep25359
36. Mitchell, J., & Weir, M. (n.d.). SARS. Retrieved from http://www.qmrawiki.org/pathogens/sars
37. Muth, D., Corman, V. M., Meyer, B., Assiri, A., Al-Masri, M., Farah, M., … Memishc, Z. A. (2015). Infectious Middle East respiratory syndrome coronavirus excretion and serotype variability based on live virus isolates from patients in Saudi Arabia. Journal of Clinical Microbiology, 53(9), 2951–2955. http://doi.org/10.1128/JCM.01368-15
38. Nicas, M., & Jones, R. M. (2009). Relative contributions of four exposure pathways to influenza infection risk. Risk Analysis, 29(9), 1292–1303. http://doi.org/10.1111/j.1539-6924.2009.01253.x
39. Nicas, M., Nazaroff, W., & Hubbard, A. (2005). Toward understanding the risk of secondary airborne infection: Emission of respirable pathogens. Journal of Occupational and Environmental Hygiene, 2(3), 143–154. http://doi.org/10.1080/15459620590918466
40. Nichol, K., Bigelow, P., O'Brien-Pallas, L., McGeer, A., Manno, M., & Holness, D. L. (2008). The individual, environmental, and organizational factors that influence nurses’ use of facial protection to prevent occupational transmission of communicable respiratory illness in acute care hospitals. American Journal of Infection Control, 36(7), 481–487. http://doi.org/10.1016/j.ajic.2007.12.004
41. Nishiura, H., Miyamatsu, Y., Chowell, G., & Saitoh, M. (2015). Assessing the risk of observing multiple generations of Middle East respiratory syndrome (MERS) cases given an imported case. Eurosurveillance, 20(27), 6–11. http://doi.org/10.2807/1560-7917.ES2015.20.27.21181
42. Papineni, R. S., & Rosenthal, F. S. (1997). The size distribution of droplets in the exhaled breath of healthy human subjects. Journal of Aerosol Medicine, 10(2), 105–116. http://doi.org/10.1089/jam.1997.10.105
43. Park, B., Peck, A., Kuehnert, M., Newbern, C., Smelser, C., Comer, J. A., … McDonald, C. (2004). Lack of SARS transmission among healthcare workers, United States. Emerging Infectious Diseases, 10(2), 217–224. http://doi.org/10.3201/eid1002.030746
44. Park, H. Y., Lee, E. J., Ryu, Y. W., Kim, Y., Kim, H., Lee, H., & Yi, S. J. (2015). Epidemiological investigation of MERS-CoV spread in a single hospital in South Korea, May to June 2015. Eurosurveillance, 20(25), 1–5. http://doi.org/10.2807/1560-7917.ES2015.20.25.21169
45. Park, J. W., Lee, K. J., Lee, K. H., Lee, S. H., Cho, J. R., Mo, J. W., … Nam, H. S. (2017). Hospital outbreaks of Middle East respiratory syndrome, Daejeon, South Korea, 2015. Emerging Infectious Diseases, 23(6), 898–905. http://doi.org/10.3201/eid2306.160120
46. Park, S. H., Kim, Y. S., Jung, Y., Choi, S. young, Cho, N. H., Jeong, H. W., … Sohn, K. M. (2016). Outbreaks of Middle East respiratory syndrome in two hospitals initiated by a single patient in Daejeon, South Korea. Infection and Chemotherapy, 48(2), 99–107. http://doi.org/10.3947/ic.2016.48.2.99
47. Poletto, C., Pelat, C., Lévy-Bruhl, D., Boelle, P. Y., & Colizza, V. (2016). Assessment of the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic in the Middle East and risk of international spread using a novel maximum likelihood analysis approach. Eurosurveillance, 19(6), 1–10. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES2014.19.23.20824
48. Rengasamy, A., Zhuang, Z., & Berryann, R. (2004). Respiratory protection against bioaerosols: Literature review and research needs. American Journal of Infection Control, 32(6), 345–354. http://doi.org/10.1016/j.ajic.2004.04.199
49. Sampath, R., Hofstadler, S. A., Blyn, L. B., Eshoo, M. W., Hall, T. A., Massire, C., … Ecker, D. J. (2005). Rapid identification of emerging pathogens: Coronavirus. Emerging Infectious Diseases, 11(3), 373–379. http://doi.org/10.3201/eid1103.040629
50. Seto, W. H. (2015). Airborne transmission and precautions: Facts and myths. Journal of Hospital Infection, 89(4), 225–228. http://doi.org/10.1016/j.jhin.2014.11.005
51. Seto, W., Tsang, D., Yung, R., Ching, T., Ng, T., Ho, M., … Peiris, J. (2003). Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). The Lancet, 361(9368), 1519–1520. http://doi.org/10.1016/S0140-6736(03)13168-6
52. Stilianakis, N. I., & Drossinos, Y. (2010). Dynamics of infectious disease transmission by inhalable respiratory droplets. Journal of the Royal Society, 7(50), 1355–1366. http://doi.org/10.1098/rsif.2010.0026
53. Sutton, T. C., & Subbarao, K. (2015). Development of animal models against emerging coronaviruses: From SARS to MERS coronavirus. Virology, 479–480, 247–258. http://doi.org/10.1016/j.virol.2015.02.030
54. Thompson, K. A., Pappachan, J. V., Bennett, A. M., Mittal, H., Macken, S., Dove, B. K., … Thomson, G. (2013). Influenza Aerosols in UK Hospitals during the H1N1 (2009) Pandemic—The risk of aerosol generation during medical procedures. PLoS One, 8(2), 1–15. http://doi.org/10.1371/journal.pone.0056278
55. Tran, K., Cimon, K., Severn, M., Pessoa-Silva, C. L., & Conly, J. (2012). Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: A systematic review. PLoS One, 7(4), 1–8. http://doi.org/10.1371/journal.pone.0035797
56. Van Doremalen, N., & Munster, V. J. (2015). Animal models of Middle East respiratory syndrome coronavirus infection. Antiviral Research, 122, 28–38. http://doi.org/10.1016/j.antiviral.2015.07.005
57. Watanabe, T., Bartrand, T. A., Weir, M. H., Omura, T., & Haas, C. N. (2010). Development of a dose-response model for SARS coronavirus. Risk Analysis, 30(7), 1129–1138. http://doi.org/10.1111/j.1539-6924.2010.01427.x
58. Wen, Z., Yu, L., Yang, W., Hu, L., Li, N., Wang, J., … Zhang, K. (2013). Assessment the protection performance of different level personal respiratory protection masks against viral aerosol. Aerobiologia, 29(3), 365–372. http://doi.org/10.1007/s10453-012-9286-7
59. Widagdo, W., Okba, N. M. A., Stalin Raj, V., & Haagmans, B. L. (2017). MERS-coronavirus: From discovery to intervention. One Health, 3, 11–16. http://doi.org/10.1016/j.onehlt.2016.12.001
60. World Health Organization. (2015). Middle East respiratory syndrome coronavirus (MERS-CoV): Summary and risk assessment of current situation in the Republic of Korea and China—As of 19 June 2015. Retrieved from who.int/csr/disease/coronavirus_infections/risk-assessment-19june2015/en/
61. World Health Organization. (2018). WHO MERS global summary and assessment of risk. Retrieved from http://www.who.int/csr/disease/coronavirus_infections/risk-assessment-august-2018.pdf
62. Xia, S., Liu, Q., Wang, Q., Sun, Z., Su, S., Du, L., … Jiang, S. (2014). Middle East respiratory syndrome coronavirus (MERS-CoV) entry inhibitors targeting spike protein. Virus Research, 194, 200–210. http://doi.org/10.1016/j.virusres.2014.10.007
63. Xiao, S., Li, Y., Sung, M., Wei, J., & Yang, Z. (2018). A study of the probable transmission routes of MERS-CoV during the first hospital outbreak in the Republic of Korea. Indoor Air, 28(1), 51–63. http://doi.org/10.1111/ina.12430
64. Yin, Y., Gupta, J. K., Zhang, X., Liu, J., & Chen, Q. (2011). Distributions of respiratory contaminants from a patient with different postures and exhaling modes in a single-bed inpatient room. Building and Environment, 46(1), 75–81. http://doi.org/10.1016/j.buildenv.2010.07.003
65. Zhou, J., Chu, H., Chan, J. F.-W., & Yuen, K.-Y. (2015). Middle East respiratory syndrome coronavirus infection: Virus-host cell interactions and implications on pathogenesis. Virology Journal, 12(1), 218. http://doi.org/10.1186/s12985-015-0446-6
66. Zumla, A., & Hui, D. S. (2014). Infection control and MERS-CoV in health-care workers. The Lancet, 383(9932), 1869–1871. http://doi.org/10.1016/S0140-6736(14)60852-7