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R Soc Open Sci. 2019 Mar 13;6(3):181164. doi: 10.1098/rsos.181164. eCollection 2019 Mar.

Airflow analysis of Pyeongtaek St Mary's Hospital during hospitalization of the first Middle East respiratory syndrome patient in Korea.

Author information

Department of Architectural Engineering, Sejong University, Seoul, South Korea.
Department of HVAC and Firefighting Engineering, Gachon University, Gyeonggi-do, South Korea.
Division of Vectors and Parasitic Diseases, Korea Centers for Disease Control and Prevention, Cheongju, South Korea.
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea.
Department of Preventive Medicine, Hanyang University Medical College, Seoul, South Korea.


Middle East respiratory syndrome (MERS) is known to be transmitted through close contact. However, epidemiological surveys of MERS in Korea indicated that some secondary patients were infected without close contact. Therefore, the possibility of other transmission routes must be identified. In this study, the possibility of MERS spreading through airflow was investigated on the eighth floor of Pyeongtaek St Mary's Hospital. Computational fluid dynamics was used to analyse the indoor airflow and passive tracer diffusion during the index patient's stay. Six cases were simulated for different outdoor wind directions and indoor mechanical ventilation operations. When a passive tracer was released in ward 8104, where the index patient was hospitalized, the passive tracer spread through the indoor airflow, which was created by the outdoor airflow. Ward 8109, which had the largest number of infected cases and was far distant from ward 8104, showed passive tracer concentration in all cases. This result indicates that MERS may have spread through airflow. The study results do not imply that the infection pathway of MERS is airborne. However, the results show the possibility of MERS spreading through airflow in specific environments such as poor ventilation environments.


Middle East respiratory syndrome; airflow analysis; computational fluid dynamics; hospital infection; transmission route; ventilation

Conflict of interest statement

The authors declare that there are no competing interests involved.

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