Lack of Transmission among Close Contacts of Patient with Case of Middle East Respiratory Syndrome Imported into the United States, 2014

Breakwell, Lucy; Pringle, Kimberly; Chea, Nora; Allen, Donna; Allen, Steve; Richards, Shawn; Pantones, Pam; Sandoval, Michelle; Liu, Lixia; Vernon, Michael; Conover, Craig; Chugh, Rashmi; DeMaria, Alfred; Burns, Rachel; Smole, Sandra; Gerber, Susan I.; Cohen, Nicole J; Kuhar, David; Haynes, Lia M.; Schneider, Eileen; Kumar, Alan; Kapoor, Minal; Madrigal, Marlene; Swerdlow, David L.; Feikin, Daniel R.

In May 2014, a traveler from the Kingdom of Saudi Arabia was the first person identified with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the United States. To evaluate transmission risk, we determined the type, duration, and frequency of patient contact among health care personnel (HCP), household, and community contacts by using standard questionnaires and, for HCP, global positioning system (GPS) tracer tag logs. Respiratory and serum samples from all contacts were tested for MERS-CoV. Of 61 identified contacts, 56 were interviewed. HCP exposures occurred most frequently in the emergency department (69%) and among nurses (47%); some HCP had contact with respiratory secretions. Household and community contacts had brief contact (e.g., hugging). All laboratory test results were negative for MERS-CoV. This contact investigation found no secondary cases, despite case-patient contact by 61 persons, and provides useful information about MERS-CoV transmission risk. Compared with GPS tracer tag recordings, self-reported contact may not be as accurate.