Silent War to Emerging or Re-emerging Respiratory Infection Diseases Badly Kept in Mind

Zheng, Ya-Li; Gao, Zhan-Cheng

Health care-associated infections have become more common and more complex. They are associated with significant morbidity, mortality, and cost. However, the dangerous are not just for patients. A total of 1706 (up to 20%) health care workers (HCWs) were infected in the outbreak of SARS between 2002 and 2003 in China and worldwide, a nightmare in the memories of HCWs who survived over the crisis. [25] Will the nightmare be back again? The early symptoms of MERS are nonspecific and thus MERS patients are not always able to be identified and isolated early, HCWs are at high risk of acquiring this contagious infection while caring for patients or handling with human biologic material (respiratory secretions, blood, urine, or feces). In addition to that, unlike SARS-CoV, the infectors could be asymptomatic or sub-clinical, these cases could contribute to the transmission between patients and HCWs, and thus increase the risk of MERS-CoV infections hugely, as observed in previous study about MERS-CoV clusters, which showed that the relative contribution of hospital-based transmission is over 4 times higher than that of community transmission. [14] HCWs and patients would all be victims of health care-associated infections without strengthening awareness of contagious respiratory diseases in HCWs and general public. We strongly suggest plus droplet precautions (such as negative-pressure ventilating room, if not available, masking the patient, placing the patient in a private room with the door closed, and providing N95 or higher level respirators or masks to HCWs, etc.) to the standard precautions (e.g., hand hygiene, use of personal protective equipment) when providing care to any patient with symptoms of acute febrile respiratory infection. A better understanding of how HCWs are infected in health care settings is urgently needed. In addition to appropriate infection control procedure, early and rapid detection of suspected pathogen and qualified laboratories for assaying the potential contaminated clinical specimens are needed crucially.