Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014

Arwady, M. Allison; Alraddadi, Basem; Basler, Colin; Azhar, Esam I.; Abuelzein, Eltayb; Sindy, Abdulfattah I.; Sadiq, Bakr M. Bin; Althaqafi, Abdulhakeem; Shabouni, Omaima I.; Banjar, Ayman; Haynes, Lia M.; Gerber, Susan I.; Feikin, Daniel R.; Madani, Tariq A.

doi:10.3201/eid2208.152015

Cited by 49 publications

(68 citation statements)

References 20 publications

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“…MERS-CoV does not seem to be easily transmitted from person to person unless contact with patients infected with MERS-CoV is close. [43][44][45] Human to human transmission has been described within primary community settings and households, 20,32,45,46 but has been more striking within health-care settings. [28][29][30][31][47][48][49][50][51] Healthcare associated outbreaks have occurred in several countries, with the largest outbreaks seen in Saudi Arabia, the United Arab Emirates, and South Korea.…”

Section: Person-to-person Transmissionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

Hui

Azhar

Kim

et al. 2018

The Lancet Infectious Diseases

394

327

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Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonosis that causes death in 35·7% of cases. As of Feb 28, 2018, 2182 cases of MERS-CoV infection (with 779 deaths) in 27 countries were reported to WHO worldwide, with most being reported in Saudi Arabia (1807 cases with 705 deaths). MERS-CoV features prominently in the WHO blueprint list of priority pathogens that threaten global health security. Although primary transmission of MERS-CoV to human beings is linked to exposure to dromedary camels (Camelus dromedarius), the exact mode by which MERS-CoV infection is acquired remains undefined. Up to 50% of MERS-CoV cases in Saudi Arabia have been classified as secondary, occurring from human-to-human transmission through contact with asymptomatic or symptomatic individuals infected with MERS-CoV. Hospital outbreaks of MERS-CoV are a hallmark of MERS-CoV infection. The clinical features associated with MERS-CoV infection are not MERS-specific and are similar to other respiratory tract infections. Thus, the diagnosis of MERS can easily be missed, unless the doctor or health-care worker has a high degree of clinical awareness and the patient undergoes specific testing for MERS-CoV. The largest outbreak of MERS-CoV outside the Arabian Peninsula occurred in South Korea in May, 2015, resulting in 186 cases with 38 deaths. This outbreak was caused by a traveller with undiagnosed MERS-CoV infection who became ill after returning to Seoul from a trip to the Middle East. The traveller visited several health facilities in South Korea, transmitting the virus to many other individuals long before a diagnosis was made. With 10 million pilgrims visiting Saudi Arabia each year from 182 countries, watchful surveillance by public health systems, and a high degree of clinical awareness of the possibility of MERS-CoV infection is essential. In this Review, we provide a comprehensive update and synthesis of the latest available data on the epidemiology, determinants, and risk factors of primary, household, and nosocomial transmission of MERS-CoV, and suggest measures to reduce risk of transmission.

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Section: Person-to-person Transmissionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

Hui

Azhar

Kim

et al. 2018

The Lancet Infectious Diseases

394

327

View full text Add to dashboard Cite

show abstract

“…Recent data suggest that although MERS-CoV is widespread among dromedary camels in the Middle East and Africa, zoonotic transmission of MERS-CoV from camels to humans is relatively uncommon, and human disease is not directly proportional to potential exposure. MERS-CoV does not transmit easily from person-to-person unless there is close contact, such as occurs when providing care to a patient in the household 25 or nosocomial setting when the diagnosis of MERS-CoV has not yet been recognized and there are lapses in instituting infection control measures. 2,3,6,7…”

Section: Risk Factors For Primary Middle East Respiratory Syndrome Comentioning

confidence: 99%

“…Human-to-human transmission in the community or in those living in large households and family compounds has been described. 25,[50][51][52][53][54] An investigation of 280 household contacts of 26 index MERS-CoV-infected Saudi Arabian patients, with follow-up serologic analysis in 44 contacts performed in 2014 to determine the rate of "silent or subclinical" secondary infection after exposure to primary cases of MERS-CoV infection, found there were 12 probable cases of secondary transmission (4%; 95% confidence interval, 2-7). 51 There have been several reports of MERS-CoV carriage after exposure to patients with MERS.…”

Section: Household Transmissionmentioning

confidence: 99%

The Middle East Respiratory Syndrome (MERS)

Azhar

Hui

Memish

et al. 2019

Infectious Disease Clinics of North America

Self Cite

243

208

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KEYWORDS Middle East respiratory syndrome coronavirus MERS-CoV Epidemiology diagnosis Treatment KEY POINTSThe Middle East respiratory syndrome (MERS) is a novel lethal zoonotic disease of humans endemic to The Middle East, caused by the MERS coronavirus (MERS-CoV). Humans are thought to acquire MERS-CoV though contact with camels or camel products. MERS carries a 35% mortality rate. There is no specific treatment for MERS. Person-toperson spread causes hospital and household outbreaks of MERS-CoV. Millions of visitors travel to Saudi Arabia each year from across the world, thus watchful surveillance and a high degree of clinical awareness and early diagnosis with rapid implementation of infection control measures in returning travelers is important.Infect Dis Clin N Am 33 (2019) 891-905

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“…23 Person-to-person spread has also been documented within households, where patient respiratory secretions and close proximity carry the highest risk of tranmission. 24 For these reasons, patients with symptoms and epidemiological features suggestive of MERS should be rapidly quarantined and tested for viral infection.…”

Section: Etiology Epidemiology and Clinical Presentationmentioning

confidence: 99%

Emerging respiratory infections: The infectious disease pathology of SARS, MERS, pandemic influenza, and Legionella

Bradley

Bryan

2019

Seminars in Diagnostic Pathology

112

126

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A B S T R A C TLower respiratory infections remain one of the top global causes of death and the emergence of new diseases continues to be a concern. In the first two decades of the 21st century, we have born witness to the emergence of newly recognized coronaviruses that have rapidly spread around the globe, including severe acute respiratory syndrome virus (SARS) and Middle Eastern respiratory syndrome virus (MERS). We have also experienced the emergence of a novel H1N1 pandemic influenza strain in 2009 that caused substantial morbidity and mortality around the world and has transitioned into a seasonal strain. Although we perhaps most frequently think of viruses when discussing emerging respiratory infections, bacteria have not been left out of the mix, as we have witnessed an increase in the number of infections from Legionella spp. since the organisms' initial discovery in 1976. Here, we explore the basic epidemiology, clinical presentation, histopathology, and clinical laboratory diagnosis of these four pathogens and emphasize themes in humans' evolving relationship with our natural environment that have contributed to the infectious burden. Histology alone is rarely diagnostic for these infections, but has been crucial to bettering our understanding of these diseases. Together, we rely on the diagnostic acumen of pathologists to identify the clinicopathologic features that raise the suspicion of these diseases and lead to the early control of the spread in our populations. (A. Bryan). Seminars in DiagnosticPathology 36 (2019) 152-159 0740-2570/

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Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014

Abstract: Casual contact was not associated with transmission, and serologic methods were more sensitive than real-time reverse transcription-PCR.

Cited by 49 publications

References 20 publications

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

The Middle East Respiratory Syndrome (MERS)

Emerging respiratory infections: The infectious disease pathology of SARS, MERS, pandemic influenza, and Legionella

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