[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
Sci Rep. 2019 May 14;9(1):7385. doi: 10.1038/s41598-019-43586-9.
Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017.
Bernard-Stoecklin S1,2, Nikolay B3, Assiri A4, Bin Saeed AA5,6, Ben Embarek PK7, El Bushra H5, Ki M8, Malik MR9, Fontanet A10,11,12, Cauchemez S3, Van Kerkhove MD13,14.
Author information: 1 Formerly Outbreak Investigation Task Force, Centre for Global Health, Institut Pasteur, 75015, Paris, France. 2 Direction of infectious diseases, Santé publique France, Saint-Maurice, 94410, France. 3 Mathematical Modelling of Infectious Diseases, Institut Pasteur, UMR2000, CNRS, 75015, Paris, France. 4 Ministry of Health, Riyadh, Saudi Arabia. 5 Formerly Ministry of Health, Riyadh, Saudi Arabia. 6 Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 7 International Food Safety Authorities Network (INFOSAN) Management, Department of Food Safety and Zoonoses, World Health Organization, Geneva, Switzerland. 8 Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea. 9 Infectious Hazard Management Unit, Department of Health Emergencies, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt. 10 Emerging Diseases Epidemiology Unit, Institut Pasteur, 75015, Paris, France. 11 Centre for Global Health, Institut Pasteur, 75015, Paris, France. 12 Conservatoire National des Arts et Métiers, Paris, France. 13 Formerly Outbreak Investigation Task Force, Centre for Global Health, Institut Pasteur, 75015, Paris, France. email@example.com. 14 Infectious Hazards Management, Health Emergencies Programme, World Health Organization, Geneva, Switzerland. firstname.lastname@example.org.
Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015-2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6-8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3-5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01-0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.
PMID: 31089148 DOI: 10.1038/s41598-019-43586-9
Keywords: MERS-CoV; Nosocomial Outbreaks.