Is MERS a Concern for Dental Health-care Workers?

Aug. 14, 2014
According to the CDC, most individuals infected with MERS develop severe respiratory illness with symptoms of fever, cough, and shortness of breath.

By Mary Govoni, CDA, RDA, RDH, MBA

Many news reports are circulating about a respiratory illness called Middle East Respiratory Syndrome (MERS-CoV). MERS is spread through close contact with an infected person, as the Centers for Disease Control and Prevention (CDC) says, from living with or caring for an infected person.

This illness was first reported in Saudi Arabia in 2012, but has not been confirmed in patients in the U.S. until May 2014. All of the reported cases until now have been linked to countries in or near the Arabian Peninsula (Saudi Arabia, Oman, Yemen, Jordan, United Arab Emirates, Qatar, and Kuwait), in people who live in or have visited these countries.

On May 2, 2014, a person traveling from Saudi Arabia to the U.S. was confirmed to have MERS, and was hospitalized in Indiana. On May 11, 2014, another traveler from Saudi Arabia to the U.S. was identified with MERS in Orlando, Florida. The CDC is currently contacting persons who were on the same flights with, as well as health-care workers who treated these two individuals, to determine if any of them have symptoms of MERS.

Why the concern?

First, and most important, MERS has a 30% mortality rate. Second, it is a relatively new virus, and there is currently no vaccine against MERS. According to the CDC, most individuals infected with MERS develop severe respiratory illness with symptoms of fever, cough, and shortness of breath. The CDC reports that some patients who died from MERS also had underlying medical conditions or mild symptoms.

Since MERS can be spread through close contact, dental health-care professionals could certainly be at risk when treating patients with respiratory symptoms. If patients present at the office for treatment and are exhibiting symptoms of respiratory illness, the dentist and team members should evaluate whether it is safe and appropriate to treat the patient at that time. This is especially important if the patient indicates that he or she has been traveling in the Arabian Peninsula.

Although the clinical team is required to wear facemasks, many times masks are not worn correctly (they should not be positioned below the nose), and the facemasks may not provide adequate respiratory filtration. In addition, many dental professionals do not change their facemasks after each patient, in keeping with the CDC guidelines.

The CDC recommendations for respiratory protection for health-care workers who work with MERS patients are for N-95 respirators, the same as the recommended masks for working with tuberculosis patients. These masks were also the types recommended for health-care workers who treated patients with H1N1 influenza. These are not the typical masks worn by dental teams when treating patients.

For the most comprehensive summary of facemasks available for dental professionals, visit the Crosstex website at At the bottom of the page, click on the section called "MaskEnomics: The Crosstex Guide to Face Mask Selection and Use." As I have mentioned in previous columns, this site has a plethora of information regarding the filtration protection and intended use of facemasks. It is an excellent resource for dental teams.

We will undoubtedly learn more information in the coming months regarding MERS. Hopefully, no dental health-care workers will be affected. But we all need to be diligent in screening patients and recommending the rescheduling of treatment for patients who indicate they have respiratory infections, whether they have been traveling outside the country or not.

Mary Govoni, CDA, RDA, RDH, MBA, is the owner of Mary Govoni & Associates, a consulting company based in Michigan. She is a member of the Organization for Safety, Asepsis and Prevention. She can be contacted at [email protected] or

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