Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017
Identifieur interne : 000657 ( Main/Exploration ); précédent : 000656; suivant : 000658Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017
Auteurs : Sibylle Bernard-Stoecklin [France] ; Birgit Nikolay [France] ; Abdullah Assiri [Arabie saoudite] ; Abdul Aziz Bin Saeed [Arabie saoudite] ; Peter Karim Ben Embarek [Suisse] ; Hassan El Bushra [Arabie saoudite] ; Moran Ki [Corée du Sud] ; Mamunur Rahman Malik [Égypte] ; Arnaud Fontanet [France] ; Simon Cauchemez [France] ; Maria D. Van Kerkhove [France, Suisse]Source :
- Scientific Reports [ 2045-2322 ] ; 2019.
Abstract
Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6–8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3–5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01–0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.
Url:
DOI: 10.1038/s41598-019-43586-9
PubMed: 31089148
PubMed Central: 6517387
Affiliations:
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Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Geneva</wicri:regionArea></affiliation></author><author><name sortKey="El Bushra, Hassan" sort="El Bushra, Hassan" uniqKey="El Bushra H" first="Hassan" last="El Bushra">Hassan El Bushra</name><affiliation wicri:level="1"><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="GRID">grid.415696.9</institution-id><institution>Formerly Ministry of Health,</institution></institution-wrap>Riyadh, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Riyadh</wicri:regionArea></affiliation></author><author><name sortKey="Ki, Moran" sort="Ki, Moran" uniqKey="Ki M" first="Moran" last="Ki">Moran Ki</name><affiliation wicri:level="1"><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0628 9810</institution-id><institution-id institution-id-type="GRID">grid.410914.9</institution-id><institution>Department of Cancer Control and 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sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name><affiliation wicri:level="1"><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2353 6535</institution-id><institution-id institution-id-type="GRID">grid.428999.7</institution-id><institution>Emerging Diseases Epidemiology Unit,</institution><institution>Institut Pasteur,</institution></institution-wrap>75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>75015 Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2353 6535</institution-id><institution-id institution-id-type="GRID">grid.428999.7</institution-id><institution>Centre for Global Health,</institution><institution>Institut Pasteur,</institution></institution-wrap>75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>75015 Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2185 090X</institution-id><institution-id institution-id-type="GRID">grid.36823.3c</institution-id><institution>Conservatoire National des Arts et Métiers,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Cauchemez, Simon" sort="Cauchemez, Simon" uniqKey="Cauchemez S" first="Simon" last="Cauchemez">Simon Cauchemez</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Mathematical Modelling of Infectious Diseases, Institut Pasteur, UMR2000, CNRS, 75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Mathematical Modelling of Infectious Diseases, Institut Pasteur, UMR2000, CNRS, 75015 Paris</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Van Kerkhove, Maria D" sort="Van Kerkhove, Maria D" uniqKey="Van Kerkhove M" first="Maria D." last="Van Kerkhove">Maria D. Van Kerkhove</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2353 6535</institution-id><institution-id institution-id-type="GRID">grid.428999.7</institution-id><institution>Formerly Outbreak Investigation Task Force,</institution><institution>Centre for Global Health, Institut Pasteur,</institution></institution-wrap>75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>75015 Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff13"><institution-wrap><institution-id institution-id-type="ISNI">0000000121633745</institution-id><institution-id institution-id-type="GRID">grid.3575.4</institution-id><institution>Infectious Hazards Management, Health Emergencies Programme,</institution><institution>World Health Organization,</institution></institution-wrap>Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Geneva</wicri:regionArea></affiliation></author></analytic><series><title level="j">Scientific Reports</title><idno type="eISSN">2045-2322</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="Par1">Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015–2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6–8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3–5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01–0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.</p></div></front><back><div1 type="bibliography"><listBibl><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="Hijawi, B" uniqKey="Hijawi B">B Hijawi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Cauchemez, S" uniqKey="Cauchemez S">S 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Nazer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bushra, Elhe" uniqKey="Bushra E">ElHE Bushra</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Baffoe Bonnie, H" uniqKey="Baffoe Bonnie H">H Baffoe-Bonnie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ki, M" uniqKey="Ki M">M 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uniqKey="Yu H">H Yu</name></author><author><name sortKey="Yu, X J" uniqKey="Yu X">X-J Yu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Van Kerkhove, Md" uniqKey="Van Kerkhove M">MD Van Kerkhove</name></author><author><name sortKey="Peiris, Mjs" uniqKey="Peiris M">MJS Peiris</name></author><author><name sortKey="Malik, Mr" uniqKey="Malik M">MR Malik</name></author><author><name sortKey="Ben Embarek, P" uniqKey="Ben Embarek P">P Ben Embarek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Balkhy, Hh" uniqKey="Balkhy H">HH Balkhy</name></author><author><name sortKey="Perl, Tm" uniqKey="Perl T">TM Perl</name></author><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, S" uniqKey="Liu S">S Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bushra, Ehe" uniqKey="Bushra E">EHE Bushra</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wallinga, J" uniqKey="Wallinga J">J Wallinga</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Obadia, T" uniqKey="Obadia T">T Obadia</name></author><author><name sortKey="Haneef, R" uniqKey="Haneef R">R Haneef</name></author><author><name sortKey="Boelle, P Y" uniqKey="Boelle P">P-Y Boëlle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cauchemez, S" uniqKey="Cauchemez S">S Cauchemez</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Choi, S" uniqKey="Choi S">S Choi</name></author><author><name sortKey="Jung, E" uniqKey="Jung E">E Jung</name></author><author><name sortKey="Choi, By" uniqKey="Choi B">BY Choi</name></author><author><name sortKey="Hur, Yj" uniqKey="Hur Y">YJ Hur</name></author><author><name sortKey="Ki, M" uniqKey="Ki M">M Ki</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Y" uniqKey="Kim Y">Y Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chowell, G" uniqKey="Chowell G">G Chowell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Sw" uniqKey="Kim S">SW Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arabi, Ym" uniqKey="Arabi Y">YM Arabi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rivers, Cm" uniqKey="Rivers C">CM Rivers</name></author><author><name sortKey="Majumder, Ms" uniqKey="Majumder M">MS Majumder</name></author><author><name sortKey="Lofgren, Et" uniqKey="Lofgren E">ET Lofgren</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Arabie saoudite</li><li>Corée du Sud</li><li>France</li><li>Suisse</li><li>Égypte</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Bernard Stoecklin, Sibylle" sort="Bernard Stoecklin, Sibylle" uniqKey="Bernard Stoecklin S" first="Sibylle" last="Bernard-Stoecklin">Sibylle Bernard-Stoecklin</name></noRegion><name sortKey="Bernard Stoecklin, Sibylle" sort="Bernard Stoecklin, Sibylle" uniqKey="Bernard Stoecklin S" first="Sibylle" last="Bernard-Stoecklin">Sibylle Bernard-Stoecklin</name><name sortKey="Cauchemez, Simon" sort="Cauchemez, Simon" uniqKey="Cauchemez S" first="Simon" last="Cauchemez">Simon Cauchemez</name><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name><name sortKey="Fontanet, Arnaud" sort="Fontanet, Arnaud" uniqKey="Fontanet A" first="Arnaud" last="Fontanet">Arnaud Fontanet</name><name sortKey="Nikolay, Birgit" sort="Nikolay, Birgit" uniqKey="Nikolay B" first="Birgit" last="Nikolay">Birgit Nikolay</name><name sortKey="Van Kerkhove, Maria D" sort="Van Kerkhove, Maria D" uniqKey="Van Kerkhove M" first="Maria D." last="Van Kerkhove">Maria D. Van Kerkhove</name></country><country name="Arabie saoudite"><noRegion><name sortKey="Assiri, Abdullah" sort="Assiri, Abdullah" uniqKey="Assiri A" first="Abdullah" last="Assiri">Abdullah Assiri</name></noRegion><name sortKey="Bin Saeed, Abdul Aziz" sort="Bin Saeed, Abdul Aziz" uniqKey="Bin Saeed A" first="Abdul Aziz" last="Bin Saeed">Abdul Aziz Bin Saeed</name><name sortKey="Bin Saeed, Abdul Aziz" sort="Bin Saeed, Abdul Aziz" uniqKey="Bin Saeed A" first="Abdul Aziz" last="Bin Saeed">Abdul Aziz Bin Saeed</name><name sortKey="El Bushra, Hassan" sort="El Bushra, Hassan" uniqKey="El Bushra H" first="Hassan" last="El Bushra">Hassan El Bushra</name></country><country name="Suisse"><noRegion><name sortKey="Ben Embarek, Peter Karim" sort="Ben Embarek, Peter Karim" uniqKey="Ben Embarek P" first="Peter Karim" last="Ben Embarek">Peter Karim Ben Embarek</name></noRegion><name sortKey="Van Kerkhove, Maria D" sort="Van Kerkhove, Maria D" uniqKey="Van Kerkhove M" first="Maria D." last="Van Kerkhove">Maria D. Van Kerkhove</name></country><country name="Corée du Sud"><noRegion><name sortKey="Ki, Moran" sort="Ki, Moran" uniqKey="Ki M" first="Moran" last="Ki">Moran Ki</name></noRegion></country><country name="Égypte"><noRegion><name sortKey="Malik, Mamunur Rahman" sort="Malik, Mamunur Rahman" uniqKey="Malik M" first="Mamunur Rahman" last="Malik">Mamunur Rahman Malik</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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