Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine, Daejeon, Korea.
Division of Infectious Disease Surveillance, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
Epidemiol Health. 2017 Nov 12;39:e2017052. doi: 10.4178/epih.e2017052. eCollection 2017.
During the outbreak of the Middle East Respiratory Syndrome (MERS) in Korea in 2015, the Korea Centers for Disease Control and Prevention (KCDC) confirmed a case of MERS in a healthcare worker in Daejeon, South Korea. To verify the precise route of infection for the case, we conducted an in-depth epidemiological investigation in cooperation with the KCDC.
We reviewed the MERS outbreak investigation report of the KCDC, and interviewed the healthcare worker who had recovered from MERS. Using the media interview data, we reaffirmed and supplemented the nature of the exposure.
The healthcare worker, a nurse, was infected while performing cardiopulmonary resuscitation (CPR) for a MERS patient in an isolation room. During the CPR which lasted for an hour, a large amount of body fluid was splashed. The nurse was presumed to have touched the mask to adjust its position during the CPR. She suggested that she was contaminated with the MERS patient's body fluids by wiping away the sweat from her face during the CPR.
The possible routes of infection may include the following: respiratory invasion of aerosols contaminated with MERS-coronavirus (MERS-CoV) through a gap between the face and mask; mucosal exposure to sweat contaminated with MERS-CoV; and contamination during doffing of personal protective equipment. The MERS guidelines should reflect this case to decrease the risk of infection during CPR.
2015 年韩国中东呼吸综合征（MERS）疫情爆发期间，韩国疾病管理本部（KCDC）在大田市确认了一名医护人员感染 MERS。为了验证该病例确切的感染途径，我们与 KCDC 合作开展了深入的流行病学调查。
我们查阅了 KCDC 的 MERS 疫情调查报告，并对已康复的 MERS 医护人员进行了访谈。利用媒体采访资料，我们再次确认并补充了暴露的性质。
这名医护人员是一名护士，她在隔离病房对一名 MERS 患者进行心肺复苏（CPR）时被感染。在持续 1 小时的 CPR 过程中，大量体液溅出。护士在 CPR 过程中推测曾触摸过口罩以调整其位置，她表示在 CPR 过程中擦汗时可能接触到了 MERS 患者的体液。
可能的感染途径包括：面罩和面部之间的间隙吸入含有 MERS-CoV 的气溶胶而导致呼吸道感染；接触到含有 MERS-CoV 的汗液导致粘膜暴露；以及在脱卸个人防护装备时受到污染。MERS 指南应反映该病例，以降低 CPR 过程中的感染风险。
