One of our recent blog posts talked about the ratcheted need for improved Infection Prevention and Control through lessons learned in the devastating West Africa Ebola outbreak. A key determinant involved mitigating the transmission of serious infections to health care workers who treat patients with unknown illnesses. Another new and ongoing outbreak only reinforces this need: MERS-CoV - Middle East Respiratory Syndrome (Corona Virus). To briefly review, this is a newly discovered virus first identified in the Middle East in 2012 and thought to have camels as the animal reservoir. Subsequently, human-to-human transmissions have been found...especially in health centers in South Korea.
The index patient in South Korea appears to have been an elderly South Korean man with respiratory symptoms who returned from the Middle East. Unsatisfied with his initial care, he ended up visiting 2 outpatient centers and two hospitals - creating a wake of exposed health care workers and neighboring patients, some of whom may have had exposure for as little as 5 minutes. Subsequently, 165 cases have been confirmed in South Korea (as of 19June15) with 24 deaths - some from the initial exposure by the index case and the rest by second order human-to-human transmissions.
And again, official recommendations have been to quarantine confirmed or probable patients (due to the likely airborne transmission) and for healthcare workers to protect themselves through proper IPC:
Droplet precautions should be added to standard precautions when providing care to all patients with symptoms of acute respiratory infection. Contact precautions and eye protection should be added when caring for suspected or confirmed cases of MERS‐CoV infection. Airborne precautions should be applied when performing aerosol‐generating procedures. (see here for definitions)
At this point in our history, where novel infectious diseases are emerging and the patient-clinician interface is a particularly high-risk encounter, this level of proper IPC seems to a necessary to even continue providing health care. As Liberia exemplified in the Ebola outbreak, when health care workers succumb to a disease, it puts the entire health care system at risk.