MERS-CoV: Practical Tips for Disinfection
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is slowly spreading through the Middle East and Asia. Transmission, so far, seems to happen when a close contact with an infected individual occurs. This type of transmission has led to many healthcare associated infections to this day. As an example, a patient that waited for 2.5 days in a Seoul emergency department, end up transmitting the disease to 55 persons.
So far, the case-fatality rate is around 36 %, which is very high. However, this number may not be representative of a normal population and its kill rate is likely to be overestimated. A bias might exist when looking at the population who acquired the virus in Korea. Of the 171 cases, many had underlying medical conditions and have a median age of 55.
CDC and Health Canada issued a few recommendations on infection control and prevention so far, and more is likely to be available soon. Regardless of their recommendations few data are available on environmental hygiene and disinfection practice regarding MERS-CoV in healthcare settings. Also, the transmission through the environment is not well known for this virus.
How to disinfect?
Regarding disinfection few information are available. Coronaviruses are non-enveloped virus which makes them more resistant to certain disinfectant. As an example, it is known that a 400 ppm solution of quaternary ammonium compounds is ineffective against those viruses. Sodium hypochlorite at a minimum of 1,000 ppm seems to be sufficient, however a higher concentration would be optimal in healthcare settings. Very few data exist regarding other disinfectant technology.
At this moment, isolation with contact-droplets precaution is advised. In spite of the fact that it was suggested during the SARS outbreak that this type isolation might not be sufficient. Even though these two viruses are similar, we must remember that many differences exist. Thus we must be careful with extrapolation of data.