Multihospital Outbreak of a Middle East Respiratory Syndrome Coronavirus Deletion Variant, Jordan: A Molecular, Serologic, and Epidemiologic Investigation
Identifieur interne : 000879 ( Main/Exploration ); précédent : 000878; suivant : 000880Multihospital Outbreak of a Middle East Respiratory Syndrome Coronavirus Deletion Variant, Jordan: A Molecular, Serologic, and Epidemiologic Investigation
Auteurs : Daniel C. Payne [Géorgie (pays)] ; Holly M. Biggs [Géorgie (pays)] ; Mohammad Mousa Al-Abdallat [Jordanie] ; Sultan Alqasrawi [Jordanie] ; Xiaoyan Lu [Géorgie (pays)] ; Glen R. Abedi [Géorgie (pays)] ; Aktham Haddadin [Jordanie] ; Ibrahim Iblan [Jordanie] ; Tarek Alsanouri [Jordanie] ; Mohannad Al Nsour [Jordanie] ; Sami Sheikh Ali [Jordanie] ; Brian Rha [Géorgie (pays)] ; Suvang U. Trivedi [Géorgie (pays)] ; Mohammed Ata Ur Rasheed [Géorgie (pays)] ; Azaibi Tamin [Géorgie (pays)] ; Mart M. Lamers [Pays-Bas] ; Bart L. Haagmans [Pays-Bas] ; Dean D. Erdman [Géorgie (pays)] ; Natalie J. Thornburg [Géorgie (pays)] ; Susan I. Gerber [Géorgie (pays)]Source :
- Open Forum Infectious Diseases [ 2328-8957 ] ; 2018.
Abstract
An outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in Jordan in 2015 involved a variant virus that acquired distinctive deletions in the accessory open reading frames. We conducted a molecular and seroepidemiologic investigation to describe the deletion variant’s transmission patterns and epidemiology.
We reviewed epidemiologic and medical chart data and analyzed viral genome sequences from respiratory specimens of MERS-CoV cases. In early 2016, sera and standardized interviews were obtained from MERS-CoV cases and their contacts. Sera were evaluated by nucleocapsid and spike protein enzyme immunoassays and microneutralization.
Among 16 cases, 11 (69%) had health care exposure and 5 (31%) were relatives of a known case; 13 (81%) were symptomatic, and 7 (44%) died. Genome sequencing of MERS-CoV from 13 cases revealed 3 transmissible deletions associated with clinical illness during the outbreak. Deletion variant sequences were epidemiologically clustered and linked to a common transmission chain. Interviews and sera were collected from 2 surviving cases, 23 household contacts, and 278 health care contacts; 1 (50%) case, 2 (9%) household contacts, and 3 (1%) health care contacts tested seropositive.
The MERS-CoV deletion variants retained human-to-human transmissibility and caused clinical illness in infected persons despite accumulated mutations. Serology suggested limited transmission beyond that detected during the initial outbreak investigation.
Url:
DOI: 10.1093/ofid/ofy095
PubMed: 30294616
PubMed Central: 5965092
Affiliations:
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Lamers</name><affiliation wicri:level="3"><nlm:aff id="AF0006">Viroscience Department, Erasmus University Medical Center, Rotterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Viroscience Department, Erasmus University Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Haagmans, Bart L" sort="Haagmans, Bart L" uniqKey="Haagmans B" first="Bart L" last="Haagmans">Bart L. 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Thornburg</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I" last="Gerber">Susan I. 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Payne</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Biggs, Holly M" sort="Biggs, Holly M" uniqKey="Biggs H" first="Holly M" last="Biggs">Holly M. Biggs</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Al Abdallat, Mohammad Mousa" sort="Al Abdallat, Mohammad Mousa" uniqKey="Al Abdallat M" first="Mohammad Mousa" last="Al-Abdallat">Mohammad Mousa Al-Abdallat</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Communicable Diseases Directorate, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Communicable Diseases Directorate, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Alqasrawi, Sultan" sort="Alqasrawi, Sultan" uniqKey="Alqasrawi S" first="Sultan" last="Alqasrawi">Sultan Alqasrawi</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Communicable Diseases Directorate, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Communicable Diseases Directorate, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Lu, Xiaoyan" sort="Lu, Xiaoyan" uniqKey="Lu X" first="Xiaoyan" last="Lu">Xiaoyan Lu</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Abedi, Glen R" sort="Abedi, Glen R" uniqKey="Abedi G" first="Glen R" last="Abedi">Glen R. Abedi</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Haddadin, Aktham" sort="Haddadin, Aktham" uniqKey="Haddadin A" first="Aktham" last="Haddadin">Aktham Haddadin</name><affiliation wicri:level="1"><nlm:aff id="AF0003">Laboratory Directorate, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Laboratory Directorate, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Iblan, Ibrahim" sort="Iblan, Ibrahim" uniqKey="Iblan I" first="Ibrahim" last="Iblan">Ibrahim Iblan</name><affiliation wicri:level="1"><nlm:aff id="AF0004">Field Epidemiology Training Program, Jordan Ministry of Health, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Field Epidemiology Training Program, Jordan Ministry of Health, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Alsanouri, Tarek" sort="Alsanouri, Tarek" uniqKey="Alsanouri T" first="Tarek" last="Alsanouri">Tarek Alsanouri</name><affiliation wicri:level="1"><nlm:aff id="AF0005">Eastern Mediterranean Public Health Network, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Eastern Mediterranean Public Health Network, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Al Nsour, Mohannad" sort="Al Nsour, Mohannad" uniqKey="Al Nsour M" first="Mohannad" last="Al Nsour">Mohannad Al Nsour</name><affiliation wicri:level="1"><nlm:aff id="AF0005">Eastern Mediterranean Public Health Network, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Eastern Mediterranean Public Health Network, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Sheikh Ali, Sami" sort="Sheikh Ali, Sami" uniqKey="Sheikh Ali S" first="Sami" last="Sheikh Ali">Sami Sheikh Ali</name><affiliation wicri:level="1"><nlm:aff id="AF0002">Communicable Diseases Directorate, Amman, Jordan</nlm:aff><country xml:lang="fr">Jordanie</country><wicri:regionArea>Communicable Diseases Directorate, Amman</wicri:regionArea><wicri:noRegion>Amman</wicri:noRegion></affiliation></author><author><name sortKey="Rha, Brian" sort="Rha, Brian" uniqKey="Rha B" first="Brian" last="Rha">Brian Rha</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Trivedi, Suvang U" sort="Trivedi, Suvang U" uniqKey="Trivedi S" first="Suvang U" last="Trivedi">Suvang U. Trivedi</name><affiliation wicri:level="1"><nlm:aff id="AF0007">IHRC, Inc, contracting agency for the Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>IHRC, Inc, contracting agency for the Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Rasheed, Mohammed Ata Ur" sort="Rasheed, Mohammed Ata Ur" uniqKey="Rasheed M" first="Mohammed Ata Ur" last="Rasheed">Mohammed Ata Ur Rasheed</name><affiliation wicri:level="1"><nlm:aff id="AF0007">IHRC, Inc, contracting agency for the Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>IHRC, Inc, contracting agency for the Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Tamin, Azaibi" sort="Tamin, Azaibi" uniqKey="Tamin A" first="Azaibi" last="Tamin">Azaibi Tamin</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Lamers, Mart M" sort="Lamers, Mart M" uniqKey="Lamers M" first="Mart M" last="Lamers">Mart M. Lamers</name><affiliation wicri:level="3"><nlm:aff id="AF0006">Viroscience Department, Erasmus University Medical Center, Rotterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Viroscience Department, Erasmus University Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Haagmans, Bart L" sort="Haagmans, Bart L" uniqKey="Haagmans B" first="Bart L" last="Haagmans">Bart L. Haagmans</name><affiliation wicri:level="3"><nlm:aff id="AF0006">Viroscience Department, Erasmus University Medical Center, Rotterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Viroscience Department, Erasmus University Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Erdman, Dean D" sort="Erdman, Dean D" uniqKey="Erdman D" first="Dean D" last="Erdman">Dean D. Erdman</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Thornburg, Natalie J" sort="Thornburg, Natalie J" uniqKey="Thornburg N" first="Natalie J" last="Thornburg">Natalie J. Thornburg</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I" last="Gerber">Susan I. Gerber</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia</nlm:aff><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author></analytic><series><title level="j">Open Forum Infectious Diseases</title><idno type="eISSN">2328-8957</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec id="s1"><title>Background</title><p>An outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in Jordan in 2015 involved a variant virus that acquired distinctive deletions in the accessory open reading frames. We conducted a molecular and seroepidemiologic investigation to describe the deletion variant’s transmission patterns and epidemiology.</p></sec><sec id="s2"><title>Methods</title><p>We reviewed epidemiologic and medical chart data and analyzed viral genome sequences from respiratory specimens of MERS-CoV cases. In early 2016, sera and standardized interviews were obtained from MERS-CoV cases and their contacts. Sera were evaluated by nucleocapsid and spike protein enzyme immunoassays and microneutralization.</p></sec><sec id="s3"><title>Results</title><p>Among 16 cases, 11 (69%) had health care exposure and 5 (31%) were relatives of a known case; 13 (81%) were symptomatic, and 7 (44%) died. Genome sequencing of MERS-CoV from 13 cases revealed 3 transmissible deletions associated with clinical illness during the outbreak. Deletion variant sequences were epidemiologically clustered and linked to a common transmission chain. Interviews and sera were collected from 2 surviving cases, 23 household contacts, and 278 health care contacts; 1 (50%) case, 2 (9%) household contacts, and 3 (1%) health care contacts tested seropositive.</p></sec><sec id="s4"><title>Conclusions</title><p>The MERS-CoV deletion variants retained human-to-human transmissibility and caused clinical illness in infected persons despite accumulated mutations. 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Heo</name></author><author><name sortKey="Song, Ms" uniqKey="Song M">MS Song</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Sh" uniqKey="Kim S">SH Kim</name></author><author><name sortKey="Chang, Sy" uniqKey="Chang S">SY Chang</name></author><author><name sortKey="Sung, M" uniqKey="Sung M">M Sung</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Géorgie (pays)</li><li>Jordanie</li><li>Pays-Bas</li></country><region><li>Hollande-Méridionale</li></region><settlement><li>Rotterdam</li></settlement></list><tree><country name="Géorgie (pays)"><noRegion><name sortKey="Payne, Daniel C" sort="Payne, Daniel C" uniqKey="Payne D" first="Daniel C" last="Payne">Daniel C. Payne</name></noRegion><name sortKey="Abedi, Glen R" sort="Abedi, Glen R" uniqKey="Abedi G" first="Glen R" last="Abedi">Glen R. Abedi</name><name sortKey="Biggs, Holly M" sort="Biggs, Holly M" uniqKey="Biggs H" first="Holly M" last="Biggs">Holly M. Biggs</name><name sortKey="Erdman, Dean D" sort="Erdman, Dean D" uniqKey="Erdman D" first="Dean D" last="Erdman">Dean D. Erdman</name><name sortKey="Gerber, Susan I" sort="Gerber, Susan I" uniqKey="Gerber S" first="Susan I" last="Gerber">Susan I. Gerber</name><name sortKey="Lu, Xiaoyan" sort="Lu, Xiaoyan" uniqKey="Lu X" first="Xiaoyan" last="Lu">Xiaoyan Lu</name><name sortKey="Rasheed, Mohammed Ata Ur" sort="Rasheed, Mohammed Ata Ur" uniqKey="Rasheed M" first="Mohammed Ata Ur" last="Rasheed">Mohammed Ata Ur Rasheed</name><name sortKey="Rha, Brian" sort="Rha, Brian" uniqKey="Rha B" first="Brian" last="Rha">Brian Rha</name><name sortKey="Tamin, Azaibi" sort="Tamin, Azaibi" uniqKey="Tamin A" first="Azaibi" last="Tamin">Azaibi Tamin</name><name sortKey="Thornburg, Natalie J" sort="Thornburg, Natalie J" uniqKey="Thornburg N" first="Natalie J" last="Thornburg">Natalie J. Thornburg</name><name sortKey="Trivedi, Suvang U" sort="Trivedi, Suvang U" uniqKey="Trivedi S" first="Suvang U" last="Trivedi">Suvang U. Trivedi</name></country><country name="Jordanie"><noRegion><name sortKey="Al Abdallat, Mohammad Mousa" sort="Al Abdallat, Mohammad Mousa" uniqKey="Al Abdallat M" first="Mohammad Mousa" last="Al-Abdallat">Mohammad Mousa Al-Abdallat</name></noRegion><name sortKey="Al Nsour, Mohannad" sort="Al Nsour, Mohannad" uniqKey="Al Nsour M" first="Mohannad" last="Al Nsour">Mohannad Al Nsour</name><name sortKey="Alqasrawi, Sultan" sort="Alqasrawi, Sultan" uniqKey="Alqasrawi S" first="Sultan" last="Alqasrawi">Sultan Alqasrawi</name><name sortKey="Alsanouri, Tarek" sort="Alsanouri, Tarek" uniqKey="Alsanouri T" first="Tarek" last="Alsanouri">Tarek Alsanouri</name><name sortKey="Haddadin, Aktham" sort="Haddadin, Aktham" uniqKey="Haddadin A" first="Aktham" last="Haddadin">Aktham Haddadin</name><name sortKey="Iblan, Ibrahim" sort="Iblan, Ibrahim" uniqKey="Iblan I" first="Ibrahim" last="Iblan">Ibrahim Iblan</name><name sortKey="Sheikh Ali, Sami" sort="Sheikh Ali, Sami" uniqKey="Sheikh Ali S" first="Sami" last="Sheikh Ali">Sami Sheikh Ali</name></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Lamers, Mart M" sort="Lamers, Mart M" uniqKey="Lamers M" first="Mart M" last="Lamers">Mart M. Lamers</name></region><name sortKey="Haagmans, Bart L" sort="Haagmans, Bart L" uniqKey="Haagmans B" first="Bart L" last="Haagmans">Bart L. Haagmans</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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