• Seo Yu Bin, Jung Yeon Heo, Min-Suk Song, Jacob Lee, Eun-Ha Kim, Su-Jin Park, Hyeok-Il Kwon, Se Mi Kim, Young-Il Kim, Young-Jae Si, In-Won Lee, Yun Hee Baek, Won-Suk Choi, Jinsoo Min, Hye Won Jeong, and Young Ki Choi.
• Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon.
• Clin. Infect. Dis. 2016 Mar 15; 62 (6): 755-60.

BackgroundAlthough Middle East Respiratory Syndrome coronavirus (MERS-CoV) is characterized by a risk of nosocomial transmission, the detailed mode of transmission and period of virus shedding from infected patients are poorly understood. The aims of this study were to investigate the potential role of environmental contamination by MERS-CoV in healthcare settings and to define the period of viable virus shedding from MERS patients.MethodsWe investigated environmental contamination from 4 patients in MERS-CoV units of 2 hospitals. MERS-CoV was detected by reverse transcription polymerase chain reaction (PCR) and viable virus was isolated by cultures.ResultsMany environmental surfaces of MERS patient rooms, including points frequently touched by patients or healthcare workers, were contaminated by MERS-CoV. Viral RNA was detected up to five days from environmental surfaces following the last positive PCR from patients' respiratory specimens. MERS-CoV RNA was detected in samples from anterooms, medical devices, and air-ventilating equipment. In addition, MERS-CoV was isolated from environmental objects such as bed sheets, bedrails, IV fluid hangers, and X-ray devices. During the late clinical phase of MERS, viable virus could be isolated in 3 of the 4 enrolled patients on day 18 to day 25 after symptom onset.ConclusionsMost of touchable surfaces in MERS units were contaminated by patients and health care workers and the viable virus could shed through respiratory secretion from clinically fully recovered patients. These results emphasize the need for strict environmental surface hygiene practices, and sufficient isolation period based on laboratory results rather than solely on clinical symptoms.© The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

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