Middle East respiratory syndrome in children: Dental considerations

Al-Sehaibany, Fares S.

Middle East Respiratory Syndrome Coronavirus is a novel beta coronavirus of the Coronaviridae family that causes a severe respiratory disease with a high fatality rate. [3] [4] [5] [6] As of January 2016, 1633 laboratoryconfirmed cases of MERS-CoV infection and 587 related deaths have been reported by the World Health Organization (WHO) globally. 7 The male-to-female ratio of the affected patients was 2:1, with a median age of 49 years. 8 The incubation period for human-tohuman transmission ranges from 2-15 days. 9 The symptoms of MERS-CoV infection range from being asymptomatic to severe pneumonia, acute respiratory distress syndrome, septic shock, and multi-organ failure, leading to death. The symptomatic patients may have fever, cough, chills, throat soreness, myalgia, arthralgia, vomiting, or diarrhea. 10 Furthermore, men over 45 years of age, patients with comorbidities, and healthcare workers have been reported to be high-risk groups for MERS-CoV infection. 11 The virus has been detected in respiratory, gastrointestinal and other bodily secretions, 12, 13 as well as in air samples, which indicates the possibility for airborne transmission. 14 Several studies have reported MERS-CoV infections among healthcare workers 4,6,15,16 and children. 1, 17 Viral infections, such as severe acute respiratory syndrome Saudi Med J 2017; Vol. 38 (4) www.smj.org.sa (SARS-CoV), may be transmitted to healthcare workers from infected patients through aerosols. 18 Considering that several types of dental equipment, such as handpieces, air-water syringes and ultrasonic scalers, produce considerable amounts of aerosols, the potential for the spread of infections from patients to dentists or dental assistants is high. 19 This review is an attempt to discuss MERS-CoV infection among children and those providing dental treatment to them, including precautions and considerations pertaining to the practice of pediatric dentistry.