MERS-CoV, SARS-CoV, SARS-CoV-2 Agent Information Sheet

Boston University
Research Occupational Health Program (ROHP)
617-358-7647

Agent

Coronaviruses are a large family of RNA viruses that are common in many different species of animals, including camels, cattle, cats, bats, and are cause of several epidemic and the recent SARS-CoV-2 pandemic. The name corona virus derives from the characteristic crown/spike appearance on electron micrographs. There are four major subtypes of coronaviruses relevant to humans: alpha, beta, gamma and delta. Human coronaviruses were first identified in the mid-1960s.

The seven coronaviruses that can infect people are:

Common human coronaviruses (worldwide incidence)

-229E (alpha coronavirus)

-NL63 (alpha coronavirus)

-OC43 (beta coronavirus)

-HKU1 (beta coronavirus)

Less common but highly pathogenic human coronaviruses:

-MERS-CoV (beta coronavirus causes Middle East Respiratory Syndrome, (MERS)

-SARS-CoV (beta coronavirus that causes severe acute respiratory syndrome, (SARS)

-SARS-CoV-2 (beta coronavirus that causes COVID-19)

Transmission occurs year-round in most parts of the world and novel coronaviruses can emerge from animal reservoirs and rapidly become epidemic.

Disease/Infection

COVID-19

SARS

MERS

Common cold

Pathogenicity

Approximately 20% of COVID-19 infections result in severe illness; the case fatality rate is thought to be around 2% but data is evolving. The 2003 SARS outbreak had a case fatality rate of 9.6% The 2012 MERS outbreak had a case fatality rate was 34%. The spectrum of disease includes mild and asymptomatic infections that may not be detected resulting in an overestimate of case fatality rates.

Biosafety Information

Risk Group/BSL
Risk Group 3
Biosafety Level 3 practices

Modes of Transmission

	Transmission
Skin Exposure (Needlestick, animal bite, or scratch):	Yes
Mucous Membrane Exposure Splash to Eye(s), Nose or Mouth:	Yes
Inhalation:	Transmission via droplets is the main route of exposure, for COVID19 airborne has not been ruled out
Ingestion:	Unlikely in laboratory setting

Host Range/Reservoir

Bats (SARS and SARS-COV-2), camels intermediate host (MERS), civets and humans.

Symptoms

For confirmed COVID-19 infections, reported illnesses have ranged from mild URI symptoms to severe illness and death from lower respiratory infection. Symptoms can include:

Fever
Cough
Shortness of breath

Incubation Period

2-14 days (possibly up to 20 days). Most case onset is 5 days following exposure.

Viability

Susceptible to: 62-71% ethanol, 0.5% hydrogen peroxide, 0.1% sodium hypochlorite, 5% MICRO-CHEM PLUS

Survival Outside Host

May persist on dry surfaces up to 24 hours or more. Under ideal temperature and humidity conditions, coronavirus in the research setting can persist up to 9 days.

Information for Lab Workers

Laboratory PPE

Personal protective equipment includes but is not limited to laboratory coats or gowns, surgical masks, disposable gloves, safety glasses, face shield if risk of splash, and respirator (PAPR or N-95) if aerosol risk.

Containment

All work with infectious virus must be performed in BSL-3/ABSL-3 containment.

In Case of Exposure/Disease

For injuries in the lab which are major medical emergencies (heart attacks, seizures, etc…):
Medical Campus: call or have a coworker call the Control Center at 617-414–6666.
You will be referred to or transported to the appropriate health care location by the emergency response team.
For lab exposures (needle sticks, bite, cut, scratch, splash, etc…) involving animals or infectious agents, or for unexplained symptoms or illness

Call the ROHP 24/7 hour number (1-617-358-ROHP (7647); or, 8-ROHP (7647) if calling from an on-campus location)

to be connected with the BU Research Occupational Health Program (ROHP) medical officer. ROHP will refer you to the appropriate health care location.

Under any of these scenarios, always inform the physician of your work in the laboratory and the agent(s) that you work with.
Provide the wallet-size agent ID card to the physician.

Vaccination

None FDA approved vaccines for SARS, COVID19 or MERS.

Information for First Responders/Medical Personnel

Public Health Issues

After exposure: Immediately following an exposure to corona virus, the lab worker is not considered infectious. He/she can be cared for with standard PPE. In case of a lab worker presenting to Boston Medical Center Emergency Department or other outside medical facility, either the exposed worker or the caring physicians should immediately contact ROHP for further instructions.

In case of (suspected) illness: Lab worker should contact ROHP directly. The worker should be assessed for the severity of disease and dispositioned to the appropriate level of medical care or home quarantine as indicated based on consultation with the local public health department.

Person-to-person transmission is expected after symptoms occur and may be possible before the exposed worker is symptomatic based on the incubation period.

Diagnosis/Surveillance

Viral detection is performed via Polymerase Chain Reaction (PCR).

Potential alternate diagnoses with similar presentation should be considered, such as influenza or other respiratory viruses.

Surveillance should be performed based on the current recommendations of the local public health department.

First Aid/Post Exposure Prophylaxis

Standard management of potential exposure to coronaviruses is solely based on observation, potential isolation and with symptomatic and supportive treatments.

No approved post exposure prophylaxis or post exposure vaccination is FDA approved.

Perform one of the following actions:

Skin Exposure (Needlestick or scratch):	Immediately go to the sink and thoroughly wash the wound with soap and water for 15 minutes. Decontaminate any exposed skin surfaces with an antiseptic scrub solution.
Mucous Membrane Splash to Eye(s), Nose or Mouth:	Exposure should be irrigated vigorously.
Splash Affecting Garments:	Remove garments that may have become soiled or contaminated and place them in a double red plastic bag.

Treatment

Treatment is aggressive supportive care for severe illness and can be targeted towards symptom management for mild illness. There are no antivirals known to be effective.

References

Uptodate – Coronaviruses, https://www.uptodate.com/contents/coronaviruses

Uptodate – Coronavirus disease 2019 (COVID-19), https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19

Kampf, G, Todt, D, Pfaender, S, Steinmann, E. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. J Hosp Infect. 2020 Feb 6 pii: S0195-6701(20)30046-3. Foi 10.1016/j.jhin.2020.01.22

CDC. (2020). Interim Laboratory Biosafety Guidelines: Covid-19. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/lab/lab-biosafety-guidelines.html

DHHS, CDC & NIH. Biosafety in Microbiological and Biomedical Laboratories, 5th edn. (US Government Printing Office, Washington, DC, 2007). http://www.cdc.gov/OD/OHS/biosafety/bmbl5/bmbl5toc.htm p224-227.

Fields, B. N., Knipe, D. M., Howley, P. M., & Griffin, D. E. (2013). Coronaviruses Fields virology. Philadelphia: Lippincott Williams & Wilkins. Ch 28.