Al-Tawfiq Jaffar A, Perl Trish M
aJohns Hopkins Aramco Healthcare, Dhahran, Kingdom of Saudi Arabia bIndiana University School of Medicine, Indianapolis, Indiana cDivision of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Curr Opin Infect Dis. 2015 Aug;28(4):392-6. doi: 10.1097/QCO.0000000000000178.
Attracting global attention, Middle East respiratory syndrome coronavirus (MERS-CoV) continues to cause sporadic cases and a potential risk of healthcare-associated infections. In this review, we highlight what is known about the risk of transmission within healthcare facilities and discuss interventions to halt its transmission within healthcare.
MERS-CoV causes a wide range of infections from asymptomatic infections, mild or moderately symptomatic cases, to fatal disease. Two years after the initial reported case, MERS-CoV has caused limited disease outside the Arabian Peninsula with several cases in Europe, Asia, and the United States. Epidemiologically, these infections are linked to exposures from the region and their diagnosis outside is related to travel. Several reported clusters of disease report multiple transmissions of MERS-CoV within healthcare settings that have been attributed to poor compliance with the basic infection control measures. Factors contributing to the spread and control of MERS-CoV within healthcare settings have not been elucidated so far. Data suggest the overcrowding, late recognition of MERS-CoV cases, and inadequate infection control practices contribute significantly to the transmission.
Understanding factors contributing to the spread and the dynamic of MERS-CoV transmission within healthcare settings would further enhance the control of the disease in and outside the healthcare setting.
中东呼吸综合征冠状病毒（MERS-CoV）持续引发散发病例，并存在医疗相关感染的潜在风险，这引起了全球关注。在本综述中，我们着重介绍已知的医疗机构内传播风险，并讨论在医疗环境中阻止其传播的干预措施。
MERS-CoV可引发多种感染，包括无症状感染、轻症或中症病例以及致命疾病。在首例报告病例出现两年后，MERS-CoV在阿拉伯半岛以外地区引发的疾病有限，在欧洲、亚洲和美国有少数病例。从流行病学角度来看，这些感染与来自该地区的接触有关，而在其他地区的诊断与旅行相关。有几起报告的疾病聚集性事件显示，MERS-CoV在医疗机构内发生了多次传播，这归因于对基本感染控制措施的依从性差。目前尚未阐明导致MERS-CoV在医疗机构内传播和控制的因素。数据表明，过度拥挤、对MERS-CoV病例的延迟识别以及感染控制措施不足是传播的重要因素。
了解导致MERS-CoV在医疗机构内传播及其动态变化的因素，将进一步加强对医疗机构内外该疾病的控制。
