(HealthDay News) – Person-to-person transmission of the novel Middle East respiratory syndrome coronavirus (MERS-CoV) has been described in a cluster of health care-associated infections in Saudi Arabia, according to research published online June 19 in the New England Journal of Medicine.

Abdullah Assiri, MD, from the Al-Faisal University in Riyadh, Saudi Arabia, and colleagues reviewed medical records and interviewed case patients and contacts in a cluster of 23 cases of health care-acquired MERS-CoV infection reported in an eastern province of Saudi Arabia between April 1 and May 23, 2013.

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The researchers found that symptoms included fever, cough, shortness of breath, and gastrointestinal symptoms, and 20 of the patients presented with abnormal chest radiographs. Fifteen of the patients had died, six had recovered, and two were still hospitalized as of June 12. There was a 5.2-day median intervention period and the serial interval was 7.6 days.

Twenty-one cases were acquired by person-to-person transmission in three different health care facilities, in hemodialysis, intensive care, and in-patient units. A single monophyletic clade was identified in four isolates. MERS-CoV infection developed in five family members (three laboratory-confirmed cases) and two health care workers (both laboratory confirmed).

“Person-to-person transmission of MERS-CoV can occur in health care settings and may be associated with considerable morbidity,” the authors write. “Surveillance and infection-control measures are critical to a global public health response.”

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