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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

A monster in Munster: First U.S. case of deadly MERS coronavirus is detected by asute clinicians

They system worked.

After months of preparation and educational outreach by the CDC and state health departments, the first documented case of MERS-CoV in the United States showed up, feverish and frail, in the emergency department of a 427-bed Community Hospital in Munster, IN.

Astute clinicians looked at the symptoms and asked a fateful question about travel history. Finding that the patient had just returned from the Middle East, where the novel corona virus is emerging, they implemented isolation procedures and shipped out specimens immediately to the CDC for confirmation. The CDC confirmed the diagnosis on May 2 and the agency is doing a follow up investigation of people who were possibly exposed to the MERS patient during air and bus travel.

The index case is a male American health care worker who flew from Riyadh, Saudi Arabia, to Chicago, IL, on a connecting flight from London on April 24, 2014. He then boarded a bus for a journey of some 50 miles to Munster. The infection may have still been in the incubation phase at this juncture, as it would not be until three days later, on April 27, that symptoms of fever, cough, and breathlessness were severe enough to prompt the emergency room visit.

In order to detect possible secondary cases, family members and health care workers with significant contact with the patient are undergoing daily monitoring for two weeks, which should cover the incubation period of the infection.

For much more on this story see the June 2014 issue of Hospital Infection Control & Prevention.