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Correspondence
August 7, 2013DOI: 10.1056/NEJMc1308698
- Article
To the Editor:
A majority of the 94 cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection that have been reported to date have occurred in Saudi Arabia. Patients with this infection have presented with serious respiratory disease and have required hospitalization.1,2 However, there have been case reports of less severe disease within family3,4 and hospital2 clusters, and the clinical spectrum of MERS-CoV infections may extend to asymptomatic and subclinical cases. Therefore, the epidemiologic and clinical characteristics of this infection need further definition. The patterns of the spread of MERs-CoV among family3,4 or hospital2 clusters suggest that transmission occurs through droplets or contact. We previously reported two cases of MERS-CoV infection in health care workers,2 one of which was fatal.
The presence of asymptomatic or subclinical MERS-CoV infections in the community or among health care workers could have important public health implications, since these infections may be sources of transmission to close contacts in the community or to patients with coexisting medical conditions. The close proximity of health care workers to patients and the handling of human biologic material (sputum, respiratory secretions, feces, urine, or blood) may increase the risk of transmission, and health care workers may be particularly at risk for MERS-CoV infections.
The Saudi Arabian Ministry of...
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