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Outbreak Investigation of the Middle East Respiratory Syndrome (MERS-CoV) cases in Al-Hayat National Hospital in Khames Mushait City, Asir Province, January 2020.


On February 4, 2020, a Middle East Respiratory Syndrome-CoV(MERS-CoV) healthcare-associated Outbreak of 6 confirmed cases in Al-Hayat National Hospital(ANH) in Khamis Mushait City, Asir Province, were reported. The Field Epidemiology Training Program (FETP) team investigated the outbreak. The goals were to identify the infection source, mode of transmission, follow up the cases, evaluate the hospital Infection and control measures during the outbreak, and exclude COVID-19 infection.


Descriptive Study (case series) for all confirmed MERS-CoV cases using (rRT-PCR) for the nasopharyngeal swabs. The investigation was done by reviewing the medical records and the MOH investigation forms of the cases and contacts, and IPC records and measures in (ANH). Meetings with concerned officials in (ANH)and Asir public Health Department were held.


After diagnosing the 1st case (healthcare worker (HCW)) as a confirmed MERS-CoV in (ANH). 228 HCWs contacts had been screened and tested for MERS-CoV, where 2 (33%)asymptomatic cases were identified (secondary attack rate(SAR) 0.86%). The 3 community cases who had contact with 1st and 2ed cases (2 patients and 1 visitor) were diagnosed in other different hospitals). The total number of community contacts was 85((SAR) 3.4%). The age ranged from 26-65 years old. 4(66%)female,3(50%)Saudi,3 (50%) cases have chronic conditions. 3(50%) cases needed ICU admission and intubation, two recoveries, and one death. Case Fatality Rate (CFR16%). No history of camel contact or travel outside Saudi Arabia.


The FETP team investigation suggested that the 1st case gets infected by an asymptomatic MERS-CoV patient how entered the Hospital without recognition. In addition to the weak adherence to IPC measures by some HCWs. However, the defects' redress limited the infection's spread to 5 secondary cases. The existence of chronic diseases for 3 cases led to complications in their conditions, ICU admission, and one death. COVID-19 was excluded. The Hospital should adhere to MOH guidelines to detect and manage MERS-COV cases along with IPC measures.