Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission
Identifieur interne : 002195 ( Main/Curation ); précédent : 002194; suivant : 002196Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission
Auteurs : Benoit Guery [France] ; Julien Poissy [France] ; Loubna El Mansouf [France] ; Caroline Sejourne [France] ; Nicolas Ettahar [France] ; Xavier Lemaire [France] ; Fanny Vuotto [France] ; Anne Goffard [France] ; Sylvie Behillil [France] ; Vincent Enouf [France] ; Valérie Caro [France] ; Alexandra Mailles [France] ; Didier Che [France] ; Jean-Claude Manuguerra [France] ; Daniel Mathieu [France] ; Arnaud Fontanet [France] ; Sylvie Van Der Werf [France]Source :
- Lancet : (British edition) [ 0140-6736 ] ; 2013.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Coronavirus (génétique), France (épidémiologie), Humains, Infection croisée (diagnostic), Infection croisée (imagerie diagnostique), Infection croisée (transmission), Infection croisée (virologie), Infections à coronavirus (diagnostic), Infections à coronavirus (imagerie diagnostique), Infections à coronavirus (transmission), Infections à coronavirus (virologie), Issue fatale, Mâle, Poumon (imagerie diagnostique), Période d'incubation de maladie infectieuse, Radiographie, Réaction de polymérisation en chaine en temps réel, Voyage.
- MESH :
- diagnostic : Infection croisée, Infections à coronavirus.
- génétique : Coronavirus.
- imagerie diagnostique : Infection croisée, Infections à coronavirus, Poumon.
- virologie : Infection croisée, Infections à coronavirus.
- épidémiologie : France, Infection croisée, Infections à coronavirus.
- Pascal (Inist)
- Adulte d'âge moyen, Humains, Issue fatale, Mâle, Période d'incubation de maladie infectieuse, Radiographie, Réaction de polymérisation en chaine en temps réel, Symptomatologie, Forme clinique, Virose, Virus, Diagnostic, Infection nosocomiale, Moyen Orient, Appareil respiratoire, Voie respiratoire, Syndrome, Coronavirus, Compte rendu, Transmission, Médecine, Voyage.
- Wicri :
- topic : Médecine.
English descriptors
- KwdEn :
- Clinical form, Coronavirus, Coronavirus (genetics), Coronavirus Infections (diagnosis), Coronavirus Infections (diagnostic imaging), Coronavirus Infections (transmission), Coronavirus Infections (virology), Cross Infection (diagnosis), Cross Infection (diagnostic imaging), Cross Infection (transmission), Cross Infection (virology), Diagnosis, Fatal Outcome, France (epidemiology), Humans, Infectious Disease Incubation Period, Lung (diagnostic imaging), Male, Medicine, Middle Aged, Middle east, Nosocomial infection, Radiography, Real-Time Polymerase Chain Reaction, Report, Respiratory system, Respiratory tract, Symptomatology, Syndrome, Transmission, Travel, Viral disease, Virus.
- MESH :
- diagnosis : Coronavirus Infections, Cross Infection.
- diagnostic imaging : Coronavirus Infections, Cross Infection, Lung.
- epidemiology : France.
- genetics : Coronavirus.
- transmission : Coronavirus Infections, Cross Infection.
- virology : Coronavirus Infections, Cross Infection.
- Fatal Outcome, Humans, Infectious Disease Incubation Period, Male, Middle Aged, Radiography, Real-Time Polymerase Chain Reaction, Travel.
Abstract
Background Human infection with a novel coronavirus named Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia and the Middle East in September, 2012, with 44 laboratory-confirmed cases as of May 23, 2013. We report detailed clinical and virological data for two related cases of MERS-CoV disease, after nosocomial transmission of the virus from one patient to another in a French hospital. Methods Patient 1 visited Dubai in April, 2013; patient 2 lives in France and did not travel abroad. Both patients had underlying immunosuppressive disorders. We tested specimens from the upper (nasopharyngeal swabs) or the lower (bronchoalveolar lavage, sputum) respiratory tract and whole blood, plasma, and serum specimens for MERS-CoV by real-time RT-PCR targeting the upE and Orf1A genes of MERS-CoV. Findings Initial clinical presentation included fever, chills, and myalgia in both patients, and for patient 1, diarrhoea. Respiratory symptoms rapidly became predominant with acute respiratory failure leading to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Both patients developed acute renal failure. MERS-CoV was detected in lower respiratory tract specimens with high viral load (eg, cycle threshold [Ct] values of 22.9 for upE and 24 for Orf1a for a bronchoalveolar lavage sample from patient 1; Ct values of 22.5 for upE and 23.9 for Orf1a for an induced sputum sample from patient 2), whereas nasopharyngeal specimens were weakly positive or inconclusive. The two patients shared the same room for 3 days. The incubation period was estimated at 9-12 days for the second case. No secondary transmission was documented in hospital staff despite the absence of specific protective measures before the diagnosis of MERS-CoV was suspected. Patient 1 died on May 28, due to refractory multiple organ failure. Interpretation Patients with respiratory symptoms returning from the Middle East or exposed to a confirmed case should be isolated and investigated for MERS-CoV with lower respiratory tract sample analysis and an assumed incubation period of 12 days. Immunosuppression should also be taken into account as a risk factor. Funding French Institute for Public Health Surveillance, ANR grant Labex Integrative Biology of Emerging Infectious Diseases, and the European Community's Seventh Framework Programme projects EMPERIE and PREDEMICS.
Url:
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000059
- to stream PascalFrancis, to step Curation: Pour aller vers cette notice dans l'étape Curation :000035
- to stream PascalFrancis, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :000059
- to stream Main, to step Merge: Pour aller vers cette notice dans l'étape Curation :002220
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000F08
- to stream Pmc, to step Curation: Pour aller vers cette notice dans l'étape Curation :000F08
- to stream Pmc, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :001252
- to stream PubMed, to step Corpus: Pour aller vers cette notice dans l'étape Curation :001C87
- to stream PubMed, to step Curation: Pour aller vers cette notice dans l'étape Curation :001C87
- to stream PubMed, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :001B86
- to stream Ncbi, to step Merge: Pour aller vers cette notice dans l'étape Curation :000A53
- to stream Ncbi, to step Curation: Pour aller vers cette notice dans l'étape Curation :000A53
- to stream Ncbi, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :000A53
- to stream Hal, to step Corpus: Pour aller vers cette notice dans l'étape Curation :000001
- to stream Hal, to step Curation: Pour aller vers cette notice dans l'étape Curation :000001
- to stream Hal, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :000023
- to stream Main, to step Merge: Pour aller vers cette notice dans l'étape Curation :002061
Links to Exploration step
Pascal:13-0220381Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission</title>
<author><name sortKey="Guery, Benoit" sort="Guery, Benoit" uniqKey="Guery B" first="Benoit" last="Guery">Benoit Guery</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Poissy, Julien" sort="Poissy, Julien" uniqKey="Poissy J" first="Julien" last="Poissy">Julien Poissy</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="El Mansouf, Loubna" sort="El Mansouf, Loubna" uniqKey="El Mansouf L" first="Loubna" last="El Mansouf">Loubna El Mansouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sejourne, Caroline" sort="Sejourne, Caroline" uniqKey="Sejourne C" first="Caroline" last="Sejourne">Caroline Sejourne</name>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Service de Reanimation, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ettahar, Nicolas" sort="Ettahar, Nicolas" uniqKey="Ettahar N" first="Nicolas" last="Ettahar">Nicolas Ettahar</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes</s1>
<s2>Valenciennes</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Valenciennes</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, Xavier" sort="Lemaire, Xavier" uniqKey="Lemaire X" first="Xavier" last="Lemaire">Xavier Lemaire</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vuotto, Fanny" sort="Vuotto, Fanny" uniqKey="Vuotto F" first="Fanny" last="Vuotto">Fanny Vuotto</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Goffard, Anne" sort="Goffard, Anne" uniqKey="Goffard A" first="Anne" last="Goffard">Anne Goffard</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Regional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Behillil, Sylvie" sort="Behillil, Sylvie" uniqKey="Behillil S" first="Sylvie" last="Behillil">Sylvie Behillil</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Enouf, Vincent" sort="Enouf, Vincent" uniqKey="Enouf V" first="Vincent" last="Enouf">Vincent Enouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caro, Valerie" sort="Caro, Valerie" uniqKey="Caro V" first="Valérie" last="Caro">Valérie Caro</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mailles, Alexandra" sort="Mailles, Alexandra" uniqKey="Mailles A" first="Alexandra" last="Mailles">Alexandra Mailles</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Che, Didier" sort="Che, Didier" uniqKey="Che D" first="Didier" last="Che">Didier Che</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Manuguerra, Jean Claude" sort="Manuguerra, Jean Claude" uniqKey="Manuguerra J" first="Jean-Claude" last="Manuguerra">Jean-Claude Manuguerra</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mathieu, Daniel" sort="Mathieu, Daniel" uniqKey="Mathieu D" first="Daniel" last="Mathieu">Daniel Mathieu</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name>
<affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Conservatoire National des Arts et Métiers</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Institut Pasteur, Emerging Diseases Epidemiology Unit</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Der Werf, Sylvie Van" sort="Der Werf, Sylvie Van" uniqKey="Der Werf S" first="Sylvie Van" last="Der Werf">Sylvie Van Der Werf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">13-0220381</idno>
<date when="2013">2013</date>
<idno type="stanalyst">PASCAL 13-0220381 INIST</idno>
<idno type="RBID">Pascal:13-0220381</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">000059</idno>
<idno type="wicri:Area/PascalFrancis/Curation">000035</idno>
<idno type="wicri:Area/PascalFrancis/Checkpoint">000059</idno>
<idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000059</idno>
<idno type="wicri:doubleKey">0140-6736:2013:Guery B:clinical:features:and</idno>
<idno type="wicri:Area/Main/Merge">002220</idno>
<idno type="wicri:source">PMC</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159298</idno>
<idno type="RBID">PMC:7159298</idno>
<idno type="wicri:Area/Pmc/Corpus">000F08</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F08</idno>
<idno type="wicri:Area/Pmc/Curation">000F08</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000F08</idno>
<idno type="wicri:Area/Pmc/Checkpoint">001252</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001252</idno>
<idno type="wicri:source">PubMed</idno>
<idno type="RBID">pubmed:23727167</idno>
<idno type="wicri:Area/PubMed/Corpus">001C87</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001C87</idno>
<idno type="wicri:Area/PubMed/Curation">001C87</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001C87</idno>
<idno type="wicri:Area/PubMed/Checkpoint">001B86</idno>
<idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001B86</idno>
<idno type="wicri:Area/Ncbi/Merge">000A53</idno>
<idno type="wicri:Area/Ncbi/Curation">000A53</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">000A53</idno>
<idno type="wicri:doubleKey">0140-6736:2013:Guery B:clinical:features:and</idno>
<idno type="wicri:source">HAL</idno>
<idno type="RBID">Hal:hal-02266768</idno>
<idno type="url">https://hal.archives-ouvertes.fr/hal-02266768</idno>
<idno type="wicri:Area/Hal/Corpus">000001</idno>
<idno type="wicri:Area/Hal/Curation">000001</idno>
<idno type="wicri:Area/Hal/Checkpoint">000023</idno>
<idno type="wicri:explorRef" wicri:stream="Hal" wicri:step="Checkpoint">000023</idno>
<idno type="wicri:doubleKey">0923-7577:2013:Guery B:clinical:features:and</idno>
<idno type="wicri:Area/Main/Merge">002061</idno>
<idno type="wicri:Area/Main/Curation">002195</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission</title>
<author><name sortKey="Guery, Benoit" sort="Guery, Benoit" uniqKey="Guery B" first="Benoit" last="Guery">Benoit Guery</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Poissy, Julien" sort="Poissy, Julien" uniqKey="Poissy J" first="Julien" last="Poissy">Julien Poissy</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="El Mansouf, Loubna" sort="El Mansouf, Loubna" uniqKey="El Mansouf L" first="Loubna" last="El Mansouf">Loubna El Mansouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sejourne, Caroline" sort="Sejourne, Caroline" uniqKey="Sejourne C" first="Caroline" last="Sejourne">Caroline Sejourne</name>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Service de Reanimation, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ettahar, Nicolas" sort="Ettahar, Nicolas" uniqKey="Ettahar N" first="Nicolas" last="Ettahar">Nicolas Ettahar</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes</s1>
<s2>Valenciennes</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Valenciennes</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, Xavier" sort="Lemaire, Xavier" uniqKey="Lemaire X" first="Xavier" last="Lemaire">Xavier Lemaire</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vuotto, Fanny" sort="Vuotto, Fanny" uniqKey="Vuotto F" first="Fanny" last="Vuotto">Fanny Vuotto</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Goffard, Anne" sort="Goffard, Anne" uniqKey="Goffard A" first="Anne" last="Goffard">Anne Goffard</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Regional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Behillil, Sylvie" sort="Behillil, Sylvie" uniqKey="Behillil S" first="Sylvie" last="Behillil">Sylvie Behillil</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Enouf, Vincent" sort="Enouf, Vincent" uniqKey="Enouf V" first="Vincent" last="Enouf">Vincent Enouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caro, Valerie" sort="Caro, Valerie" uniqKey="Caro V" first="Valérie" last="Caro">Valérie Caro</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mailles, Alexandra" sort="Mailles, Alexandra" uniqKey="Mailles A" first="Alexandra" last="Mailles">Alexandra Mailles</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Che, Didier" sort="Che, Didier" uniqKey="Che D" first="Didier" last="Che">Didier Che</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Manuguerra, Jean Claude" sort="Manuguerra, Jean Claude" uniqKey="Manuguerra J" first="Jean-Claude" last="Manuguerra">Jean-Claude Manuguerra</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mathieu, Daniel" sort="Mathieu, Daniel" uniqKey="Mathieu D" first="Daniel" last="Mathieu">Daniel Mathieu</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name>
<affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Conservatoire National des Arts et Métiers</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Institut Pasteur, Emerging Diseases Epidemiology Unit</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Der Werf, Sylvie Van" sort="Der Werf, Sylvie Van" uniqKey="Der Werf S" first="Sylvie Van" last="Der Werf">Sylvie Van Der Werf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical form</term>
<term>Coronavirus</term>
<term>Coronavirus (genetics)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (diagnostic imaging)</term>
<term>Coronavirus Infections (transmission)</term>
<term>Coronavirus Infections (virology)</term>
<term>Cross Infection (diagnosis)</term>
<term>Cross Infection (diagnostic imaging)</term>
<term>Cross Infection (transmission)</term>
<term>Cross Infection (virology)</term>
<term>Diagnosis</term>
<term>Fatal Outcome</term>
<term>France (epidemiology)</term>
<term>Humans</term>
<term>Infectious Disease Incubation Period</term>
<term>Lung (diagnostic imaging)</term>
<term>Male</term>
<term>Medicine</term>
<term>Middle Aged</term>
<term>Middle east</term>
<term>Nosocomial infection</term>
<term>Radiography</term>
<term>Real-Time Polymerase Chain Reaction</term>
<term>Report</term>
<term>Respiratory system</term>
<term>Respiratory tract</term>
<term>Symptomatology</term>
<term>Syndrome</term>
<term>Transmission</term>
<term>Travel</term>
<term>Viral disease</term>
<term>Virus</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Coronavirus (génétique)</term>
<term>France (épidémiologie)</term>
<term>Humains</term>
<term>Infection croisée (diagnostic)</term>
<term>Infection croisée (imagerie diagnostique)</term>
<term>Infection croisée (transmission)</term>
<term>Infection croisée (virologie)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (imagerie diagnostique)</term>
<term>Infections à coronavirus (transmission)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Issue fatale</term>
<term>Mâle</term>
<term>Poumon (imagerie diagnostique)</term>
<term>Période d'incubation de maladie infectieuse</term>
<term>Radiographie</term>
<term>Réaction de polymérisation en chaine en temps réel</term>
<term>Voyage</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
<term>Lung</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>France</term>
</keywords>
<keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
<term>Poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>France</term>
<term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Fatal Outcome</term>
<term>Humans</term>
<term>Infectious Disease Incubation Period</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Radiography</term>
<term>Real-Time Polymerase Chain Reaction</term>
<term>Travel</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Humains</term>
<term>Issue fatale</term>
<term>Mâle</term>
<term>Période d'incubation de maladie infectieuse</term>
<term>Radiographie</term>
<term>Réaction de polymérisation en chaine en temps réel</term>
<term>Symptomatologie</term>
<term>Forme clinique</term>
<term>Virose</term>
<term>Virus</term>
<term>Diagnostic</term>
<term>Infection nosocomiale</term>
<term>Moyen Orient</term>
<term>Appareil respiratoire</term>
<term>Voie respiratoire</term>
<term>Syndrome</term>
<term>Coronavirus</term>
<term>Compte rendu</term>
<term>Transmission</term>
<term>Médecine</term>
<term>Voyage</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background Human infection with a novel coronavirus named Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia and the Middle East in September, 2012, with 44 laboratory-confirmed cases as of May 23, 2013. We report detailed clinical and virological data for two related cases of MERS-CoV disease, after nosocomial transmission of the virus from one patient to another in a French hospital. Methods Patient 1 visited Dubai in April, 2013; patient 2 lives in France and did not travel abroad. Both patients had underlying immunosuppressive disorders. We tested specimens from the upper (nasopharyngeal swabs) or the lower (bronchoalveolar lavage, sputum) respiratory tract and whole blood, plasma, and serum specimens for MERS-CoV by real-time RT-PCR targeting the upE and Orf1A genes of MERS-CoV. Findings Initial clinical presentation included fever, chills, and myalgia in both patients, and for patient 1, diarrhoea. Respiratory symptoms rapidly became predominant with acute respiratory failure leading to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Both patients developed acute renal failure. MERS-CoV was detected in lower respiratory tract specimens with high viral load (eg, cycle threshold [Ct] values of 22.9 for upE and 24 for Orf1a for a bronchoalveolar lavage sample from patient 1; Ct values of 22.5 for upE and 23.9 for Orf1a for an induced sputum sample from patient 2), whereas nasopharyngeal specimens were weakly positive or inconclusive. The two patients shared the same room for 3 days. The incubation period was estimated at 9-12 days for the second case. No secondary transmission was documented in hospital staff despite the absence of specific protective measures before the diagnosis of MERS-CoV was suspected. Patient 1 died on May 28, due to refractory multiple organ failure. Interpretation Patients with respiratory symptoms returning from the Middle East or exposed to a confirmed case should be isolated and investigated for MERS-CoV with lower respiratory tract sample analysis and an assumed incubation period of 12 days. Immunosuppression should also be taken into account as a risk factor. Funding French Institute for Public Health Surveillance, ANR grant Labex Integrative Biology of Emerging Infectious Diseases, and the European Community's Seventh Framework Programme projects EMPERIE and PREDEMICS.</div>
</front>
</TEI>
<double idat="0140-6736:2013:Guery B:clinical:features:and"><INIST><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission</title>
<author><name sortKey="Guery, Benoit" sort="Guery, Benoit" uniqKey="Guery B" first="Benoit" last="Guery">Benoit Guery</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Poissy, Julien" sort="Poissy, Julien" uniqKey="Poissy J" first="Julien" last="Poissy">Julien Poissy</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="El Mansouf, Loubna" sort="El Mansouf, Loubna" uniqKey="El Mansouf L" first="Loubna" last="El Mansouf">Loubna El Mansouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sejourne, Caroline" sort="Sejourne, Caroline" uniqKey="Sejourne C" first="Caroline" last="Sejourne">Caroline Sejourne</name>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Service de Reanimation, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ettahar, Nicolas" sort="Ettahar, Nicolas" uniqKey="Ettahar N" first="Nicolas" last="Ettahar">Nicolas Ettahar</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes</s1>
<s2>Valenciennes</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Valenciennes</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, Xavier" sort="Lemaire, Xavier" uniqKey="Lemaire X" first="Xavier" last="Lemaire">Xavier Lemaire</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vuotto, Fanny" sort="Vuotto, Fanny" uniqKey="Vuotto F" first="Fanny" last="Vuotto">Fanny Vuotto</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Goffard, Anne" sort="Goffard, Anne" uniqKey="Goffard A" first="Anne" last="Goffard">Anne Goffard</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Regional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Behillil, Sylvie" sort="Behillil, Sylvie" uniqKey="Behillil S" first="Sylvie" last="Behillil">Sylvie Behillil</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Enouf, Vincent" sort="Enouf, Vincent" uniqKey="Enouf V" first="Vincent" last="Enouf">Vincent Enouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caro, Valerie" sort="Caro, Valerie" uniqKey="Caro V" first="Valérie" last="Caro">Valérie Caro</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mailles, Alexandra" sort="Mailles, Alexandra" uniqKey="Mailles A" first="Alexandra" last="Mailles">Alexandra Mailles</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Che, Didier" sort="Che, Didier" uniqKey="Che D" first="Didier" last="Che">Didier Che</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Manuguerra, Jean Claude" sort="Manuguerra, Jean Claude" uniqKey="Manuguerra J" first="Jean-Claude" last="Manuguerra">Jean-Claude Manuguerra</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mathieu, Daniel" sort="Mathieu, Daniel" uniqKey="Mathieu D" first="Daniel" last="Mathieu">Daniel Mathieu</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name>
<affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Conservatoire National des Arts et Métiers</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Institut Pasteur, Emerging Diseases Epidemiology Unit</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Der Werf, Sylvie Van" sort="Der Werf, Sylvie Van" uniqKey="Der Werf S" first="Sylvie Van" last="Der Werf">Sylvie Van Der Werf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">13-0220381</idno>
<date when="2013">2013</date>
<idno type="stanalyst">PASCAL 13-0220381 INIST</idno>
<idno type="RBID">Pascal:13-0220381</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">000059</idno>
<idno type="wicri:Area/PascalFrancis/Curation">000035</idno>
<idno type="wicri:Area/PascalFrancis/Checkpoint">000059</idno>
<idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000059</idno>
<idno type="wicri:doubleKey">0140-6736:2013:Guery B:clinical:features:and</idno>
<idno type="wicri:Area/Main/Merge">002220</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission</title>
<author><name sortKey="Guery, Benoit" sort="Guery, Benoit" uniqKey="Guery B" first="Benoit" last="Guery">Benoit Guery</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Poissy, Julien" sort="Poissy, Julien" uniqKey="Poissy J" first="Julien" last="Poissy">Julien Poissy</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="El Mansouf, Loubna" sort="El Mansouf, Loubna" uniqKey="El Mansouf L" first="Loubna" last="El Mansouf">Loubna El Mansouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sejourne, Caroline" sort="Sejourne, Caroline" uniqKey="Sejourne C" first="Caroline" last="Sejourne">Caroline Sejourne</name>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Service de Reanimation, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ettahar, Nicolas" sort="Ettahar, Nicolas" uniqKey="Ettahar N" first="Nicolas" last="Ettahar">Nicolas Ettahar</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes</s1>
<s2>Valenciennes</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Valenciennes</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, Xavier" sort="Lemaire, Xavier" uniqKey="Lemaire X" first="Xavier" last="Lemaire">Xavier Lemaire</name>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Maladies Infectieuses, Centre Hospitalier de Douai</s1>
<s2>Douai</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vuotto, Fanny" sort="Vuotto, Fanny" uniqKey="Vuotto F" first="Fanny" last="Vuotto">Fanny Vuotto</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Members listed at end of paper Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavilion Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Goffard, Anne" sort="Goffard, Anne" uniqKey="Goffard A" first="Anne" last="Goffard">Anne Goffard</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Regional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Behillil, Sylvie" sort="Behillil, Sylvie" uniqKey="Behillil S" first="Sylvie" last="Behillil">Sylvie Behillil</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Enouf, Vincent" sort="Enouf, Vincent" uniqKey="Enouf V" first="Vincent" last="Enouf">Vincent Enouf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caro, Valerie" sort="Caro, Valerie" uniqKey="Caro V" first="Valérie" last="Caro">Valérie Caro</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mailles, Alexandra" sort="Mailles, Alexandra" uniqKey="Mailles A" first="Alexandra" last="Mailles">Alexandra Mailles</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Che, Didier" sort="Che, Didier" uniqKey="Che D" first="Didier" last="Che">Didier Che</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Institut de veille Sanitaire</s1>
<s2>Saint-Maurice</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
<wicri:noRegion>Institut de veille Sanitaire</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Manuguerra, Jean Claude" sort="Manuguerra, Jean Claude" uniqKey="Manuguerra J" first="Jean-Claude" last="Manuguerra">Jean-Claude Manuguerra</name>
<affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mathieu, Daniel" sort="Mathieu, Daniel" uniqKey="Mathieu D" first="Daniel" last="Mathieu">Daniel Mathieu</name>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Pôle de Reanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2</s1>
<s2>Lille</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Lille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name>
<affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Conservatoire National des Arts et Métiers</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Institut Pasteur, Emerging Diseases Epidemiology Unit</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Der Werf, Sylvie Van" sort="Der Werf, Sylvie Van" uniqKey="Der Werf S" first="Sylvie Van" last="Der Werf">Sylvie Van Der Werf</name>
<affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Centre National de la Recherche Scientifique UMR3569</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical form</term>
<term>Coronavirus</term>
<term>Diagnosis</term>
<term>Medicine</term>
<term>Middle east</term>
<term>Nosocomial infection</term>
<term>Report</term>
<term>Respiratory system</term>
<term>Respiratory tract</term>
<term>Symptomatology</term>
<term>Syndrome</term>
<term>Transmission</term>
<term>Viral disease</term>
<term>Virus</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Symptomatologie</term>
<term>Forme clinique</term>
<term>Virose</term>
<term>Virus</term>
<term>Diagnostic</term>
<term>Infection nosocomiale</term>
<term>Moyen Orient</term>
<term>Appareil respiratoire</term>
<term>Voie respiratoire</term>
<term>Syndrome</term>
<term>Coronavirus</term>
<term>Compte rendu</term>
<term>Transmission</term>
<term>Médecine</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Médecine</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background Human infection with a novel coronavirus named Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia and the Middle East in September, 2012, with 44 laboratory-confirmed cases as of May 23, 2013. We report detailed clinical and virological data for two related cases of MERS-CoV disease, after nosocomial transmission of the virus from one patient to another in a French hospital. Methods Patient 1 visited Dubai in April, 2013; patient 2 lives in France and did not travel abroad. Both patients had underlying immunosuppressive disorders. We tested specimens from the upper (nasopharyngeal swabs) or the lower (bronchoalveolar lavage, sputum) respiratory tract and whole blood, plasma, and serum specimens for MERS-CoV by real-time RT-PCR targeting the upE and Orf1A genes of MERS-CoV. Findings Initial clinical presentation included fever, chills, and myalgia in both patients, and for patient 1, diarrhoea. Respiratory symptoms rapidly became predominant with acute respiratory failure leading to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Both patients developed acute renal failure. MERS-CoV was detected in lower respiratory tract specimens with high viral load (eg, cycle threshold [Ct] values of 22.9 for upE and 24 for Orf1a for a bronchoalveolar lavage sample from patient 1; Ct values of 22.5 for upE and 23.9 for Orf1a for an induced sputum sample from patient 2), whereas nasopharyngeal specimens were weakly positive or inconclusive. The two patients shared the same room for 3 days. The incubation period was estimated at 9-12 days for the second case. No secondary transmission was documented in hospital staff despite the absence of specific protective measures before the diagnosis of MERS-CoV was suspected. Patient 1 died on May 28, due to refractory multiple organ failure. Interpretation Patients with respiratory symptoms returning from the Middle East or exposed to a confirmed case should be isolated and investigated for MERS-CoV with lower respiratory tract sample analysis and an assumed incubation period of 12 days. Immunosuppression should also be taken into account as a risk factor. Funding French Institute for Public Health Surveillance, ANR grant Labex Integrative Biology of Emerging Infectious Diseases, and the European Community's Seventh Framework Programme projects EMPERIE and PREDEMICS.</div>
</front>
</TEI>
</INIST>
<PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission</title>
<author><name sortKey="Guery, Benoit" sort="Guery, Benoit" uniqKey="Guery B" first="Benoit" last="Guery">Benoit Guery</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Poissy, Julien" sort="Poissy, Julien" uniqKey="Poissy J" first="Julien" last="Poissy">Julien Poissy</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="El Mansouf, Loubna" sort="El Mansouf, Loubna" uniqKey="El Mansouf L" first="Loubna" last="El Mansouf">Loubna El Mansouf</name>
<affiliation wicri:level="3"><nlm:aff id="aff3">Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sejourne, Caroline" sort="Sejourne, Caroline" uniqKey="Sejourne C" first="Caroline" last="Séjourné">Caroline Séjourné</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Service de Réanimation, Centre Hospitalier de Douai, Douai, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Réanimation, Centre Hospitalier de Douai, Douai</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ettahar, Nicolas" sort="Ettahar, Nicolas" uniqKey="Ettahar N" first="Nicolas" last="Ettahar">Nicolas Ettahar</name>
<affiliation wicri:level="3"><nlm:aff id="aff5">Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes, Valenciennes, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes, Valenciennes</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Valenciennes</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, Xavier" sort="Lemaire, Xavier" uniqKey="Lemaire X" first="Xavier" last="Lemaire">Xavier Lemaire</name>
<affiliation wicri:level="3"><nlm:aff id="aff3">Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vuotto, Fanny" sort="Vuotto, Fanny" uniqKey="Vuotto F" first="Fanny" last="Vuotto">Fanny Vuotto</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Goffard, Anne" sort="Goffard, Anne" uniqKey="Goffard A" first="Anne" last="Goffard">Anne Goffard</name>
<affiliation wicri:level="1"><nlm:aff id="aff6">Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Behillil, Sylvie" sort="Behillil, Sylvie" uniqKey="Behillil S" first="Sylvie" last="Behillil">Sylvie Behillil</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff8">Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff9">Centre National de la Recherche Scientifique UMR3569, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre National de la Recherche Scientifique UMR3569, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Enouf, Vincent" sort="Enouf, Vincent" uniqKey="Enouf V" first="Vincent" last="Enouf">Vincent Enouf</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff8">Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff9">Centre National de la Recherche Scientifique UMR3569, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre National de la Recherche Scientifique UMR3569, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caro, Valerie" sort="Caro, Valerie" uniqKey="Caro V" first="Valérie" last="Caro">Valérie Caro</name>
<affiliation wicri:level="3"><nlm:aff id="aff10">Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mailles, Alexandra" sort="Mailles, Alexandra" uniqKey="Mailles A" first="Alexandra" last="Mailles">Alexandra Mailles</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">Institut de veille Sanitaire, Saint-Maurice, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de veille Sanitaire, Saint-Maurice</wicri:regionArea>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Che, Didier" sort="Che, Didier" uniqKey="Che D" first="Didier" last="Che">Didier Che</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">Institut de veille Sanitaire, Saint-Maurice, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de veille Sanitaire, Saint-Maurice</wicri:regionArea>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Manuguerra, Jean Claude" sort="Manuguerra, Jean Claude" uniqKey="Manuguerra J" first="Jean-Claude" last="Manuguerra">Jean-Claude Manuguerra</name>
<affiliation wicri:level="3"><nlm:aff id="aff10">Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mathieu, Daniel" sort="Mathieu, Daniel" uniqKey="Mathieu D" first="Daniel" last="Mathieu">Daniel Mathieu</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name>
<affiliation wicri:level="3"><nlm:aff id="aff12">Conservatoire National des Arts et Métiers, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Conservatoire National des Arts et Métiers, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff13">Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Van Der Werf, Sylvie" sort="Van Der Werf, Sylvie" uniqKey="Van Der Werf S" first="Sylvie" last="Van Der Werf">Sylvie Van Der Werf</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff8">Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff9">Centre National de la Recherche Scientifique UMR3569, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre National de la Recherche Scientifique UMR3569, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">23727167</idno>
<idno type="pmc">7159298</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159298</idno>
<idno type="RBID">PMC:7159298</idno>
<idno type="doi">10.1016/S0140-6736(13)60982-4</idno>
<date when="2013">2013</date>
<idno type="wicri:Area/Pmc/Corpus">000F08</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F08</idno>
<idno type="wicri:Area/Pmc/Curation">000F08</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000F08</idno>
<idno type="wicri:Area/Pmc/Checkpoint">001252</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001252</idno>
<idno type="wicri:source">PubMed</idno>
<idno type="RBID">pubmed:23727167</idno>
<idno type="wicri:Area/PubMed/Corpus">001C87</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001C87</idno>
<idno type="wicri:Area/PubMed/Curation">001C87</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001C87</idno>
<idno type="wicri:Area/PubMed/Checkpoint">001B86</idno>
<idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001B86</idno>
<idno type="wicri:Area/Ncbi/Merge">000A53</idno>
<idno type="wicri:Area/Ncbi/Curation">000A53</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">000A53</idno>
<idno type="wicri:doubleKey">0140-6736:2013:Guery B:clinical:features:and</idno>
<idno type="wicri:source">HAL</idno>
<idno type="RBID">Hal:hal-02266768</idno>
<idno type="url">https://hal.archives-ouvertes.fr/hal-02266768</idno>
<idno type="wicri:Area/Hal/Corpus">000001</idno>
<idno type="wicri:Area/Hal/Curation">000001</idno>
<idno type="wicri:Area/Hal/Checkpoint">000023</idno>
<idno type="wicri:explorRef" wicri:stream="Hal" wicri:step="Checkpoint">000023</idno>
<idno type="wicri:doubleKey">0923-7577:2013:Guery B:clinical:features:and</idno>
<idno type="wicri:Area/Main/Merge">002061</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission</title>
<author><name sortKey="Guery, Benoit" sort="Guery, Benoit" uniqKey="Guery B" first="Benoit" last="Guery">Benoit Guery</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Poissy, Julien" sort="Poissy, Julien" uniqKey="Poissy J" first="Julien" last="Poissy">Julien Poissy</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="El Mansouf, Loubna" sort="El Mansouf, Loubna" uniqKey="El Mansouf L" first="Loubna" last="El Mansouf">Loubna El Mansouf</name>
<affiliation wicri:level="3"><nlm:aff id="aff3">Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Sejourne, Caroline" sort="Sejourne, Caroline" uniqKey="Sejourne C" first="Caroline" last="Séjourné">Caroline Séjourné</name>
<affiliation wicri:level="3"><nlm:aff id="aff4">Service de Réanimation, Centre Hospitalier de Douai, Douai, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Réanimation, Centre Hospitalier de Douai, Douai</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ettahar, Nicolas" sort="Ettahar, Nicolas" uniqKey="Ettahar N" first="Nicolas" last="Ettahar">Nicolas Ettahar</name>
<affiliation wicri:level="3"><nlm:aff id="aff5">Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes, Valenciennes, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Unité de Maladies Infectieuses, Centre Hospitalier de Valenciennes, Valenciennes</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Valenciennes</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lemaire, Xavier" sort="Lemaire, Xavier" uniqKey="Lemaire X" first="Xavier" last="Lemaire">Xavier Lemaire</name>
<affiliation wicri:level="3"><nlm:aff id="aff3">Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Maladies Infectieuses, Centre Hospitalier de Douai, Douai</wicri:regionArea>
<placeName><region type="region">Hauts-de-France</region>
<region type="old region">Nord-Pas-de-Calais</region>
<settlement type="city">Douai</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vuotto, Fanny" sort="Vuotto, Fanny" uniqKey="Vuotto F" first="Fanny" last="Vuotto">Fanny Vuotto</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Service de Gestion du Risque Infectieux, Vigilances et Infectiologie, Hopital Huriez, Pavillon Fourrier, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Goffard, Anne" sort="Goffard, Anne" uniqKey="Goffard A" first="Anne" last="Goffard">Anne Goffard</name>
<affiliation wicri:level="1"><nlm:aff id="aff6">Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Laboratoire de Virologie, Centre de Biologie Pathologie, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Behillil, Sylvie" sort="Behillil, Sylvie" uniqKey="Behillil S" first="Sylvie" last="Behillil">Sylvie Behillil</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff8">Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff9">Centre National de la Recherche Scientifique UMR3569, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre National de la Recherche Scientifique UMR3569, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Enouf, Vincent" sort="Enouf, Vincent" uniqKey="Enouf V" first="Vincent" last="Enouf">Vincent Enouf</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff8">Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff9">Centre National de la Recherche Scientifique UMR3569, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre National de la Recherche Scientifique UMR3569, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Caro, Valerie" sort="Caro, Valerie" uniqKey="Caro V" first="Valérie" last="Caro">Valérie Caro</name>
<affiliation wicri:level="3"><nlm:aff id="aff10">Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mailles, Alexandra" sort="Mailles, Alexandra" uniqKey="Mailles A" first="Alexandra" last="Mailles">Alexandra Mailles</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">Institut de veille Sanitaire, Saint-Maurice, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de veille Sanitaire, Saint-Maurice</wicri:regionArea>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Che, Didier" sort="Che, Didier" uniqKey="Che D" first="Didier" last="Che">Didier Che</name>
<affiliation wicri:level="1"><nlm:aff id="aff11">Institut de veille Sanitaire, Saint-Maurice, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut de veille Sanitaire, Saint-Maurice</wicri:regionArea>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
<wicri:noRegion>Saint-Maurice</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Manuguerra, Jean Claude" sort="Manuguerra, Jean Claude" uniqKey="Manuguerra J" first="Jean-Claude" last="Manuguerra">Jean-Claude Manuguerra</name>
<affiliation wicri:level="3"><nlm:aff id="aff10">Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, Cellule d'Intervention Biologique d'Urgence, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mathieu, Daniel" sort="Mathieu, Daniel" uniqKey="Mathieu D" first="Daniel" last="Mathieu">Daniel Mathieu</name>
<affiliation wicri:level="1"><nlm:aff id="aff2">Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Pôle de Réanimation, Hôpital Roger Salengro, Centre Hospitalier Régional et Universitaire de Lille, Université de Lille 2, Lille Cedex</wicri:regionArea>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
<wicri:noRegion>Lille Cedex</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name>
<affiliation wicri:level="3"><nlm:aff id="aff12">Conservatoire National des Arts et Métiers, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Conservatoire National des Arts et Métiers, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff13">Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Van Der Werf, Sylvie" sort="Van Der Werf, Sylvie" uniqKey="Van Der Werf S" first="Sylvie" last="Van Der Werf">Sylvie Van Der Werf</name>
<affiliation wicri:level="3"><nlm:aff id="aff7">Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Institut Pasteur, National Reference Center for Influenza Viruses and Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff8">Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Université Paris Diderot Sorbonne Paris Cité, Unit of Molecular Genetics of RNA Viruses, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="aff9">Centre National de la Recherche Scientifique UMR3569, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Centre National de la Recherche Scientifique UMR3569, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Lancet (London, England)</title>
<idno type="ISSN">0140-6736</idno>
<idno type="eISSN">1474-547X</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Coronavirus (genetics)</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (diagnostic imaging)</term>
<term>Coronavirus Infections (transmission)</term>
<term>Coronavirus Infections (virology)</term>
<term>Cross Infection (diagnosis)</term>
<term>Cross Infection (diagnostic imaging)</term>
<term>Cross Infection (transmission)</term>
<term>Cross Infection (virology)</term>
<term>Fatal Outcome</term>
<term>France (epidemiology)</term>
<term>Humans</term>
<term>Infectious Disease Incubation Period</term>
<term>Lung (diagnostic imaging)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Radiography</term>
<term>Real-Time Polymerase Chain Reaction</term>
<term>Travel</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Coronavirus (génétique)</term>
<term>France (épidémiologie)</term>
<term>Humains</term>
<term>Infection croisée (diagnostic)</term>
<term>Infection croisée (imagerie diagnostique)</term>
<term>Infection croisée (transmission)</term>
<term>Infection croisée (virologie)</term>
<term>Infections à coronavirus (diagnostic)</term>
<term>Infections à coronavirus (imagerie diagnostique)</term>
<term>Infections à coronavirus (transmission)</term>
<term>Infections à coronavirus (virologie)</term>
<term>Issue fatale</term>
<term>Mâle</term>
<term>Poumon (imagerie diagnostique)</term>
<term>Période d'incubation de maladie infectieuse</term>
<term>Radiographie</term>
<term>Réaction de polymérisation en chaine en temps réel</term>
<term>Voyage</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
<term>Lung</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>France</term>
</keywords>
<keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
<term>Poumon</term>
</keywords>
<keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Cross Infection</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>France</term>
<term>Infection croisée</term>
<term>Infections à coronavirus</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Fatal Outcome</term>
<term>Humans</term>
<term>Infectious Disease Incubation Period</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Radiography</term>
<term>Real-Time Polymerase Chain Reaction</term>
<term>Travel</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Humains</term>
<term>Issue fatale</term>
<term>Mâle</term>
<term>Période d'incubation de maladie infectieuse</term>
<term>Radiographie</term>
<term>Réaction de polymérisation en chaine en temps réel</term>
<term>Voyage</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><title>Summary</title>
<sec><title>Background</title>
<p>Human infection with a novel coronavirus named Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia and the Middle East in September, 2012, with 44 laboratory-confirmed cases as of May 23, 2013. We report detailed clinical and virological data for two related cases of MERS-CoV disease, after nosocomial transmission of the virus from one patient to another in a French hospital.</p>
</sec>
<sec><title>Methods</title>
<p>Patient 1 visited Dubai in April, 2013; patient 2 lives in France and did not travel abroad. Both patients had underlying immunosuppressive disorders. We tested specimens from the upper (nasopharyngeal swabs) or the lower (bronchoalveolar lavage, sputum) respiratory tract and whole blood, plasma, and serum specimens for MERS-CoV by real-time RT-PCR targeting the upE and Orf1A genes of MERS-CoV.</p>
</sec>
<sec><title>Findings</title>
<p>Initial clinical presentation included fever, chills, and myalgia in both patients, and for patient 1, diarrhoea. Respiratory symptoms rapidly became predominant with acute respiratory failure leading to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Both patients developed acute renal failure. MERS-CoV was detected in lower respiratory tract specimens with high viral load (eg, cycle threshold [Ct] values of 22·9 for upE and 24 for Orf1a for a bronchoalveolar lavage sample from patient 1; Ct values of 22·5 for upE and 23·9 for Orf1a for an induced sputum sample from patient 2), whereas nasopharyngeal specimens were weakly positive or inconclusive. The two patients shared the same room for 3 days. The incubation period was estimated at 9–12 days for the second case. No secondary transmission was documented in hospital staff despite the absence of specific protective measures before the diagnosis of MERS-CoV was suspected. Patient 1 died on May 28, due to refractory multiple organ failure.</p>
</sec>
<sec><title>Interpretation</title>
<p>Patients with respiratory symptoms returning from the Middle East or exposed to a confirmed case should be isolated and investigated for MERS-CoV with lower respiratory tract sample analysis and an assumed incubation period of 12 days. Immunosuppression should also be taken into account as a risk factor.</p>
</sec>
<sec><title>Funding</title>
<p>French Institute for Public Health Surveillance, ANR grant Labex Integrative Biology of Emerging Infectious Diseases, and the European Community's Seventh Framework Programme projects EMPERIE and PREDEMICS.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Perlman, S" uniqKey="Perlman S">S Perlman</name>
</author>
<author><name sortKey="Netland, J" uniqKey="Netland J">J Netland</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Van Der Hoek, L" uniqKey="Van Der Hoek L">L van der Hoek</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name>
</author>
<author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name>
</author>
<author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name>
</author>
<author><name sortKey="Osterhaus, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name>
</author>
<author><name sortKey="Fouchier, Ram" uniqKey="Fouchier R">RAM Fouchier</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bermingham, A" uniqKey="Bermingham A">A Bermingham</name>
</author>
<author><name sortKey="Chand, Ma" uniqKey="Chand M">MA Chand</name>
</author>
<author><name sortKey="Brown, Cs" uniqKey="Brown C">CS Brown</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name>
</author>
<author><name sortKey="De Graaf, M" uniqKey="De Graaf M">M de Graaf</name>
</author>
<author><name sortKey="Lauber, C" uniqKey="Lauber C">C Lauber</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Annan, A" uniqKey="Annan A">A Annan</name>
</author>
<author><name sortKey="Baldwin, Hj" uniqKey="Baldwin H">HJ Baldwin</name>
</author>
<author><name sortKey="Corman, Vm" uniqKey="Corman V">VM Corman</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Gulland, A" uniqKey="Gulland A">A Gulland</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="De Groot, Rj" uniqKey="De Groot R">RJ de Groot</name>
</author>
<author><name sortKey="Baker, Sc" uniqKey="Baker S">SC Baker</name>
</author>
<author><name sortKey="Baric, Rs" uniqKey="Baric R">RS Baric</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Peiris, Jsm" uniqKey="Peiris J">JSM Peiris</name>
</author>
<author><name sortKey="Guan, Y" uniqKey="Guan Y">Y Guan</name>
</author>
<author><name sortKey="Yuen, Ky" uniqKey="Yuen K">KY Yuen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Corman, Vm" uniqKey="Corman V">VM Corman</name>
</author>
<author><name sortKey="Muller, Ma" uniqKey="Muller M">MA Müller</name>
</author>
<author><name sortKey="Costabel, U" uniqKey="Costabel U">U Costabel</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Corman, Vm" uniqKey="Corman V">VM Corman</name>
</author>
<author><name sortKey="Eckerle, I" uniqKey="Eckerle I">I Eckerle</name>
</author>
<author><name sortKey="Bleicker, T" uniqKey="Bleicker T">T Bleicker</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cotten, M" uniqKey="Cotten M">M Cotten</name>
</author>
<author><name sortKey="Lam, Tt" uniqKey="Lam T">TT Lam</name>
</author>
<author><name sortKey="Watson, Sj" uniqKey="Watson S">SJ Watson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gomersall, Cd" uniqKey="Gomersall C">CD Gomersall</name>
</author>
<author><name sortKey="Joynt, Gm" uniqKey="Joynt G">GM Joynt</name>
</author>
<author><name sortKey="Lam, P" uniqKey="Lam P">P Lam</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Booth, Cm" uniqKey="Booth C">CM Booth</name>
</author>
<author><name sortKey="Matukas, Lm" uniqKey="Matukas L">LM Matukas</name>
</author>
<author><name sortKey="Tomlinson, Ga" uniqKey="Tomlinson G">GA Tomlinson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Buchholz, U" uniqKey="Buchholz U">U Buchholz</name>
</author>
<author><name sortKey="Muller, Ma" uniqKey="Muller M">MA Müller</name>
</author>
<author><name sortKey="Nitsche, A" uniqKey="Nitsche A">A Nitsche</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cheng, Pkc" uniqKey="Cheng P">PKC Cheng</name>
</author>
<author><name sortKey="Wong, Da" uniqKey="Wong D">DA Wong</name>
</author>
<author><name sortKey="Tong, Lkl" uniqKey="Tong L">LKL Tong</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Peiris, Jsm" uniqKey="Peiris J">JSM Peiris</name>
</author>
<author><name sortKey="Chu, Cm" uniqKey="Chu C">CM Chu</name>
</author>
<author><name sortKey="Cheng, Vcc" uniqKey="Cheng V">VCC Cheng</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lessler, J" uniqKey="Lessler J">J Lessler</name>
</author>
<author><name sortKey="Reich, Ng" uniqKey="Reich N">NG Reich</name>
</author>
<author><name sortKey="Brookmeyer, R" uniqKey="Brookmeyer R">R Brookmeyer</name>
</author>
<author><name sortKey="Perl, Tm" uniqKey="Perl T">TM Perl</name>
</author>
<author><name sortKey="Nelson, Ke" uniqKey="Nelson K">KE Nelson</name>
</author>
<author><name sortKey="Cummings, Dat" uniqKey="Cummings D">DAT Cummings</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Peiris, Jsm" uniqKey="Peiris J">JSM Peiris</name>
</author>
<author><name sortKey="Yuen, Ky" uniqKey="Yuen K">KY Yuen</name>
</author>
<author><name sortKey="Osterhaus, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name>
</author>
<author><name sortKey="Stohr, K" uniqKey="Stohr K">K Stöhr</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mccloskey, B" uniqKey="Mccloskey B">B McCloskey</name>
</author>
<author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name>
</author>
<author><name sortKey="Stephens, G" uniqKey="Stephens G">G Stephens</name>
</author>
<author><name sortKey="Heymann, Dl" uniqKey="Heymann D">DL Heymann</name>
</author>
<author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
</PMC>
</double>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/MersV1/Data/Main/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002195 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Curation/biblio.hfd -nk 002195 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Sante |area= MersV1 |flux= Main |étape= Curation |type= RBID |clé= Pascal:13-0220381 |texte= Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission }}
![]() | This area was generated with Dilib version V0.6.33. | ![]() |