# 7337
From The Lancet today, our first good look at the details of an apparent nosocomial transmission of the novel coronavirus at a hospital in France. First a link to the report, then a link to a Helen Branswell article on the prolonged incubation period observed in this case.
Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission
Benoit Guery, Julien Poissy, Loubna el Mansouf, Caroline Séjourné, Nicolas Ettahar, Xavier Lemaire, Fanny Vuotto, Anne Goffard, Sylvie Behillil, Vincent Enouf, Valérie Caro, Alexandra Mailles, Didier Che, Jean-Claude Manuguerra, Daniel Mathieu, Arnaud Fontanet, Sylvie van der Werf, and the MERS-CoV study group*
Summary
Background Human infection with a novel coronavirus named Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia and the Middle East in September, 2012, with 44 laboratory-confirmed cases as of May 23, 2013. We report detailed clinical and virological data for two related cases of MERS-CoV disease, after nosocomial transmission of the virus from one patient to another in a French hospital.Findings
(Excerpt)
The two patients shared the same room for 3 days. The incubation period was estimated at 9–12 days for the second case. No secondary transmission was documented in hospital staff despite the absence of specific protective measures before the diagnosis of MERS-CoV was suspected. Patient 1 died on May 28, due to refractory multiple organ failure.
Interpretation Patients with respiratory symptoms returning from the Middle East or exposed to a confirmed case should be isolated and investigated for MERS-CoV with lower respiratory tract sample analysis and an assumed incubation period of 12 days. Immunosuppression should also be taken into account as a risk factor
The article (which is of most interest to clinicians) provides a detailed review of the clinical findings on both patients, including lab results, radiographs and CT scans, and genetic analysis of specimens.
Helen Branswell, who can always be counted upon to cut through the clutter, looks at one of the key findings – that the incubation period for the second patient may have been as long as 12 days.
MERS incubation period may be longer than suspected, study of French cases hints
By: Helen Branswell, The Canadian Press
Wednesday, May. 29, 2013 at 11:10 AMTORONTO - A new study suggests the incubation period for the new MERS coronavirus may be longer than has been believed up until now.
French doctors report that a man who caught the virus from an infected patient he shared a hospital room may have gone 12 days before developing symptoms.
They suggest people who have symptoms of the disease and have travelled to the Middle East or have been in contact with a known MERS patient within the past 12 days should be isolated and investigated as a possible case.
