Outbreaks of Middle East Respiratory Syndrome in Two Hospitals Initiated by a Single Patient in Daejeon, South Korea

Park, Sun Hee; Kim, Yeon-Sook; Jung, Younghee; Choi, Soo young; Cho, Nam-Hyuk; Jeong, Hye Won; Heo, Jung Yeon; Yoon, Ji Hyun; Lee, Jacob; Cheon, Shinhye; Sohn, Kyung Mok

Close contacts were defined as individuals who 1) had any contact within 2 meters or were in the same care area as confirmed cases without wearing personal protective equipment (PPE; gowns, gloves, respirators, and eye protection); 2) had direct contact with respiratory secretions from MERS cases; or 3) shared hospital equipment with confirmed cases or received care from a healthcare worker (HCW) who was caring for confirmed cases [11] . The risk of transmission from asymptomatic cases was assumed to be negligible. The time of symptom onset was defined as the first identified time of persistent fever (≥37.5°C) [11] >24 hours among febrile patients and as the first day of new relevant symptoms among afebrile patients. Based on the duration and proximity of contact, symptoms of cases, and adequacy of PPE, the level of infection risk was assessed, and the most likely source of exposure was determined for those who had been possibly exposed to more than one symptomatic case (Supplementary Table 1 ) [12] The duration of exposure days was defined as the total number of hospital days of those who stayed in the same ward as the index case.