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Jung Wan Park 1 Article
Healthcare worker infected with Middle East Respiratory Syndrome during cardiopulmonary resuscitation in Korea, 2015
Hae-Sung Nam, Mi-Yeon Yeon, Jung Wan Park, Jee-Young Hong, Ji Woong Son
Epidemiol Health. 2017;39:e2017052.   Published online November 12, 2017
DOI: https://doi.org/10.4178/epih.e2017052
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Summary
Korean summary
2015년 한국의 Middle East respiratory syndrome (MERS) 유행 기간 중 질병관리본부는 MERS 환자 심폐소생술(cardio–pulmonary resuscitation, CPR)에 참여한 간호사에서 MERS를 확진하였다. 이 사례에 대해 대전광역시 메르스 대응 민간역학조사지원단에서 심층역학조사를 실시한 결과 (1) CPR 수행 중 MERS-CoV에 오염된 에어로졸의 호흡기 침투, (2) MERS-CoV에 오염된 땀의 점막 침투, (3) 보호구 탈의 과정에서 MERS-Cov에 오염 등이 가능한 감염 경로로 파악되었다. 본 사례는 MERS 환자에 대한 CPR 수행 및 수행자의 보호구 착용과 관련하여 MERS 관리 지침의 개정이 필요함을 시사한다.
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