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Paradigm Shift Intervention Monitoring
Illinois MERS Transmission By Casual Contact At
Prior to being admitted to the hospital, the Indiana patient had extended face-to-face contact on April 25th with a business associate in Illinois. The two had another brief contact on April 26th. This business associate, who is an Illinois resident,
The above comments (in red) indicate the MERS index case (a US health care worker, HCW, working at a hospital in Riyadh) in the Indiana/Illinois cluster flew from Riyadh to London to Chicago, arriving at O’Hara Airport in the late morning of April 24 for a scienticfic conference. He took a bus to a residence in Munster, Indiana, a Chicago suburb, which is 30-45 minutes from downtown Chicago, where a scientific conference (10th Annual Meeting of American Physician Scientists Association) was beginning with a meet and greet that evening.
The two full days of the conference were April 25 and April 26, the same two days that the index case had contact with the Illinois case. Since the index case was an HCW, an Illinois “business associate” would be a likely attendee at the conference and the face to face between colleagues could be described as a “business meeting”.
The above quote (in blue) is from the CDC transcript of the presser on the sero-conversion of the above “business associate.” The CDC refused to provide additional detail in the Q&A other than the approximate length of the two meetings and a characterization of the face to face contact as a “business meeting".
However, the earlier comments in red suggest the “meeting” was at the conference, and the sero-conversion supports MERS transmission by casual contact, since the only physical contact between the two lab confirmed cases was reported as a handshake(s).
The withholding of the location of the meeting, as well as obfuscation on details of the meeting, raise serious transparency concerns. The relative ease of MERS transmission suggest more infections occurred and remarks at the end of the presser suggested more cases may be confirmed in Indiana contacts.
The Illinois case was identified by a positive serum sample in a May 16 test. Serological tests are most accurate if paired samples are tested because antibody levels take 2-4 weeks to peak, and an initial sample sets a baseline and is used to show that the subsequent increase in antibody levels is due to a recent infection.
Thus, antibody levels in infected contacts will peak in the next 1-2 weeks, when more positives are likely to arise. Similarly, another collection in that time frame from the Illinois case will likely produce a higher titer and provide a stronger indication that the Illinois case was infected at the meeting/conference.