Unraveling the drivers of MERS-CoV transmission.
Identifieur interne : 000F71 ( Main/Exploration ); précédent : 000F70; suivant : 000F72Unraveling the drivers of MERS-CoV transmission.
Auteurs : Simon Cauchemez [France] ; Pierre Nouvellet [Royaume-Uni] ; Anne Cori [Royaume-Uni] ; Thibaut Jombart [Royaume-Uni] ; Tini Garske [Royaume-Uni] ; Hannah Clapham [États-Unis] ; Sean Moore [États-Unis] ; Harriet Linden Mills [Royaume-Uni] ; Henrik Salje [États-Unis] ; Caitlin Collins [Royaume-Uni] ; Isabel Rodriquez-Barraquer [États-Unis] ; Steven Riley [Royaume-Uni] ; Shaun Truelove [États-Unis] ; Homoud Algarni ; Rafat Alhakeem ; Khalid Alharbi ; Abdulhafiz Turkistani ; Ricardo J. Aguas [Royaume-Uni] ; Derek A T. Cummings [États-Unis] ; Maria D. Van Kerkhove [France] ; Christl A. Donnelly [Royaume-Uni] ; Justin Lessler [États-Unis] ; Christophe Fraser [Royaume-Uni] ; Ali Al-Barrak [Royaume-Uni] ; Neil M. Ferguson [Royaume-Uni]Source :
- Proceedings of the National Academy of Sciences of the United States of America [ 1091-6490 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- transmission : Animaux, Humains, Infections à coronavirus, Réservoirs d'agents pathogènes, Zoonoses.
English descriptors
- KwdEn :
- MESH :
- transmission : Coronavirus Infections, Zoonoses.
- Animals, Disease Reservoirs, Humans.
Abstract
With more than 1,700 laboratory-confirmed infections, Middle East respiratory syndrome coronavirus (MERS-CoV) remains a significant threat for public health. However, the lack of detailed data on modes of transmission from the animal reservoir and between humans means that the drivers of MERS-CoV epidemics remain poorly characterized. Here, we develop a statistical framework to provide a comprehensive analysis of the transmission patterns underlying the 681 MERS-CoV cases detected in the Kingdom of Saudi Arabia (KSA) between January 2013 and July 2014. We assess how infections from the animal reservoir, the different levels of mixing, and heterogeneities in transmission have contributed to the buildup of MERS-CoV epidemics in KSA. We estimate that 12% [95% credible interval (CI): 9%, 15%] of cases were infected from the reservoir, the rest via human-to-human transmission in clusters (60%; CI: 57%, 63%), within (23%; CI: 20%, 27%), or between (5%; CI: 2%, 8%) regions. The reproduction number at the start of a cluster was 0.45 (CI: 0.33, 0.58) on average, but with large SD (0.53; CI: 0.35, 0.78). It was >1 in 12% (CI: 6%, 18%) of clusters but fell by approximately one-half (47% CI: 34%, 63%) its original value after 10 cases on average. The ongoing exposure of humans to MERS-CoV from the reservoir is of major concern, given the continued risk of substantial outbreaks in health care systems. The approach we present allows the study of infectious disease transmission when data linking cases to each other remain limited and uncertain.
DOI: 10.1073/pnas.1519235113
PubMed: 27457935
Affiliations:
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Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Truelove, Shaun" sort="Truelove, Shaun" uniqKey="Truelove S" first="Shaun" last="Truelove">Shaun Truelove</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Algarni, Homoud" sort="Algarni, Homoud" uniqKey="Algarni H" 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Abdulhafiz" uniqKey="Turkistani A" first="Abdulhafiz" last="Turkistani">Abdulhafiz Turkistani</name><affiliation><nlm:affiliation>Ministry of Health, Riyadh 12234, Kingdom of Saudi Arabia;</nlm:affiliation><wicri:noCountry code="subField">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Aguas, Ricardo J" sort="Aguas, Ricardo J" uniqKey="Aguas R" first="Ricardo J" last="Aguas">Ricardo J. Aguas</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Cummings, Derek A T" sort="Cummings, Derek A T" uniqKey="Cummings D" first="Derek A T" last="Cummings">Derek A T. Cummings</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205; Department of Biology, University of Florida, Gainesville, FL 32610; Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205; Department of Biology, University of Florida, Gainesville, FL 32610; Emerging Pathogens Institute, University of Florida, Gainesville</wicri:cityArea></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="3"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom; Outbreak Investigation Task Force, Center for Global Health, Institut Pasteur, 75015 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom; Outbreak Investigation Task Force, Center for Global Health, Institut Pasteur, 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="Donnelly, Christl A" sort="Donnelly, Christl A" uniqKey="Donnelly C" first="Christl A" last="Donnelly">Christl A. 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Associée 3012, 75015 Paris, France; Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, 75015 Paris, France;</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, 75015 Paris, France; Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, 75015 Paris, France; Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, 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="Nouvellet, Pierre" sort="Nouvellet, Pierre" uniqKey="Nouvellet P" first="Pierre" last="Nouvellet">Pierre Nouvellet</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Cori, Anne" sort="Cori, Anne" uniqKey="Cori A" first="Anne" last="Cori">Anne Cori</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Jombart, Thibaut" sort="Jombart, Thibaut" uniqKey="Jombart T" first="Thibaut" last="Jombart">Thibaut Jombart</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Garske, Tini" sort="Garske, Tini" uniqKey="Garske T" first="Tini" last="Garske">Tini Garske</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Clapham, Hannah" sort="Clapham, Hannah" uniqKey="Clapham H" first="Hannah" last="Clapham">Hannah Clapham</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Moore, Sean" sort="Moore, Sean" uniqKey="Moore S" first="Sean" last="Moore">Sean Moore</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Mills, Harriet Linden" sort="Mills, Harriet Linden" uniqKey="Mills H" first="Harriet Linden" last="Mills">Harriet Linden Mills</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Salje, Henrik" sort="Salje, Henrik" uniqKey="Salje H" first="Henrik" last="Salje">Henrik Salje</name><affiliation wicri:level="2"><nlm:affiliation>Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, 75015 Paris, France; Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, 75015 Paris, France; Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, 75015 Paris, France; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, 75015 Paris, France; Centre National de la Recherche Scientifique, Unité de Recherche Associée 3012, 75015 Paris, France; Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, 75015 Paris, France; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Collins, Caitlin" sort="Collins, Caitlin" uniqKey="Collins C" first="Caitlin" last="Collins">Caitlin Collins</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Rodriquez Barraquer, Isabel" sort="Rodriquez Barraquer, Isabel" uniqKey="Rodriquez Barraquer I" first="Isabel" last="Rodriquez-Barraquer">Isabel Rodriquez-Barraquer</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Riley, Steven" sort="Riley, Steven" uniqKey="Riley S" first="Steven" last="Riley">Steven Riley</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Truelove, Shaun" sort="Truelove, Shaun" uniqKey="Truelove S" first="Shaun" last="Truelove">Shaun Truelove</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Algarni, Homoud" sort="Algarni, Homoud" uniqKey="Algarni H" first="Homoud" last="Algarni">Homoud Algarni</name><affiliation><nlm:affiliation>Ministry of Health, Riyadh 12234, Kingdom of Saudi Arabia;</nlm:affiliation><wicri:noCountry code="subField">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Alhakeem, Rafat" sort="Alhakeem, Rafat" uniqKey="Alhakeem R" first="Rafat" last="Alhakeem">Rafat Alhakeem</name><affiliation><nlm:affiliation>Ministry of Health, Riyadh 12234, Kingdom of Saudi Arabia;</nlm:affiliation><wicri:noCountry code="subField">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Alharbi, Khalid" sort="Alharbi, Khalid" uniqKey="Alharbi K" first="Khalid" last="Alharbi">Khalid Alharbi</name><affiliation><nlm:affiliation>Ministry of Health, Riyadh 12234, Kingdom of Saudi Arabia;</nlm:affiliation><wicri:noCountry code="subField">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Turkistani, Abdulhafiz" sort="Turkistani, Abdulhafiz" uniqKey="Turkistani A" first="Abdulhafiz" last="Turkistani">Abdulhafiz Turkistani</name><affiliation><nlm:affiliation>Ministry of Health, Riyadh 12234, Kingdom of Saudi Arabia;</nlm:affiliation><wicri:noCountry code="subField">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Aguas, Ricardo J" sort="Aguas, Ricardo J" uniqKey="Aguas R" first="Ricardo J" last="Aguas">Ricardo J. Aguas</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Cummings, Derek A T" sort="Cummings, Derek A T" uniqKey="Cummings D" first="Derek A T" last="Cummings">Derek A T. Cummings</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205; Department of Biology, University of Florida, Gainesville, FL 32610; Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205; Department of Biology, University of Florida, Gainesville, FL 32610; Emerging Pathogens Institute, University of Florida, Gainesville</wicri:cityArea></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="3"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom; Outbreak Investigation Task Force, Center for Global Health, Institut Pasteur, 75015 Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom; Outbreak Investigation Task Force, Center for Global Health, Institut Pasteur, 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="Donnelly, Christl A" sort="Donnelly, Christl A" uniqKey="Donnelly C" first="Christl A" last="Donnelly">Christl A. Donnelly</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Lessler, Justin" sort="Lessler, Justin" uniqKey="Lessler J" first="Justin" last="Lessler">Justin Lessler</name><affiliation wicri:level="2"><nlm:affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205;</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Fraser, Christophe" sort="Fraser, Christophe" uniqKey="Fraser C" first="Christophe" last="Fraser">Christophe Fraser</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom;</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author><author><name sortKey="Al Barrak, Ali" sort="Al Barrak, Ali" uniqKey="Al Barrak A" first="Ali" last="Al-Barrak">Ali Al-Barrak</name><affiliation wicri:level="1"><nlm:affiliation>Ministry of Health, Riyadh 12234, Kingdom of Saudi Arabia; neil.ferguson@imperial.ac.uk ambarrak@moh.gov.sa.</nlm:affiliation><country wicri:rule="url">Royaume-Uni</country><wicri:regionArea>Ministry of Health, Riyadh 12234</wicri:regionArea><wicri:noRegion>Riyadh 12234</wicri:noRegion></affiliation></author><author><name sortKey="Ferguson, Neil M" sort="Ferguson, Neil M" uniqKey="Ferguson N" first="Neil M" last="Ferguson">Neil M. Ferguson</name><affiliation wicri:level="1"><nlm:affiliation>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG, United Kingdom; neil.ferguson@imperial.ac.uk ambarrak@moh.gov.sa.</nlm:affiliation><country wicri:rule="url">Royaume-Uni</country><wicri:regionArea>Medical Research Council Centre for Outbreak Analysis and Modelling, Imperial College London, Faculty of Medicine, London W2 1PG</wicri:regionArea><wicri:noRegion>London W2 1PG</wicri:noRegion></affiliation></author></analytic><series><title level="j">Proceedings of the National Academy of Sciences of the United States of America</title><idno type="eISSN">1091-6490</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals</term><term>Coronavirus Infections (transmission)</term><term>Disease Reservoirs</term><term>Humans</term><term>Zoonoses (transmission)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Animaux</term><term>Humains</term><term>Infections à coronavirus (transmission)</term><term>Réservoirs d'agents pathogènes</term><term>Zoonoses (transmission)</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Coronavirus Infections</term><term>Zoonoses</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Disease Reservoirs</term><term>Humans</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="fr"><term>Animaux</term><term>Humains</term><term>Infections à coronavirus</term><term>Réservoirs d'agents pathogènes</term><term>Zoonoses</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">With more than 1,700 laboratory-confirmed infections, Middle East respiratory syndrome coronavirus (MERS-CoV) remains a significant threat for public health. However, the lack of detailed data on modes of transmission from the animal reservoir and between humans means that the drivers of MERS-CoV epidemics remain poorly characterized. Here, we develop a statistical framework to provide a comprehensive analysis of the transmission patterns underlying the 681 MERS-CoV cases detected in the Kingdom of Saudi Arabia (KSA) between January 2013 and July 2014. We assess how infections from the animal reservoir, the different levels of mixing, and heterogeneities in transmission have contributed to the buildup of MERS-CoV epidemics in KSA. We estimate that 12% [95% credible interval (CI): 9%, 15%] of cases were infected from the reservoir, the rest via human-to-human transmission in clusters (60%; CI: 57%, 63%), within (23%; CI: 20%, 27%), or between (5%; CI: 2%, 8%) regions. The reproduction number at the start of a cluster was 0.45 (CI: 0.33, 0.58) on average, but with large SD (0.53; CI: 0.35, 0.78). It was >1 in 12% (CI: 6%, 18%) of clusters but fell by approximately one-half (47% CI: 34%, 63%) its original value after 10 cases on average. The ongoing exposure of humans to MERS-CoV from the reservoir is of major concern, given the continued risk of substantial outbreaks in health care systems. The approach we present allows the study of infectious disease transmission when data linking cases to each other remain limited and uncertain.</div></front></TEI><affiliations><list><country><li>France</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Floride</li><li>Maryland</li><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><noCountry><name sortKey="Algarni, Homoud" sort="Algarni, Homoud" uniqKey="Algarni H" first="Homoud" last="Algarni">Homoud Algarni</name><name sortKey="Alhakeem, Rafat" sort="Alhakeem, Rafat" uniqKey="Alhakeem R" first="Rafat" last="Alhakeem">Rafat Alhakeem</name><name sortKey="Alharbi, Khalid" sort="Alharbi, Khalid" uniqKey="Alharbi K" first="Khalid" last="Alharbi">Khalid Alharbi</name><name sortKey="Turkistani, Abdulhafiz" sort="Turkistani, Abdulhafiz" uniqKey="Turkistani A" first="Abdulhafiz" last="Turkistani">Abdulhafiz Turkistani</name></noCountry><country name="France"><region name="Île-de-France"><name sortKey="Cauchemez, Simon" sort="Cauchemez, Simon" uniqKey="Cauchemez S" first="Simon" last="Cauchemez">Simon Cauchemez</name></region><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="Royaume-Uni"><noRegion><name sortKey="Nouvellet, Pierre" sort="Nouvellet, Pierre" uniqKey="Nouvellet P" first="Pierre" last="Nouvellet">Pierre Nouvellet</name></noRegion><name sortKey="Aguas, Ricardo J" sort="Aguas, Ricardo J" uniqKey="Aguas R" first="Ricardo J" last="Aguas">Ricardo J. Aguas</name><name sortKey="Al Barrak, Ali" sort="Al Barrak, Ali" uniqKey="Al Barrak A" first="Ali" last="Al-Barrak">Ali Al-Barrak</name><name sortKey="Collins, Caitlin" sort="Collins, Caitlin" uniqKey="Collins C" first="Caitlin" last="Collins">Caitlin Collins</name><name sortKey="Cori, Anne" sort="Cori, Anne" uniqKey="Cori A" first="Anne" last="Cori">Anne Cori</name><name sortKey="Donnelly, Christl A" sort="Donnelly, Christl A" uniqKey="Donnelly C" first="Christl A" last="Donnelly">Christl A. Donnelly</name><name sortKey="Ferguson, Neil M" sort="Ferguson, Neil M" uniqKey="Ferguson N" first="Neil M" last="Ferguson">Neil M. Ferguson</name><name sortKey="Fraser, Christophe" sort="Fraser, Christophe" uniqKey="Fraser C" first="Christophe" last="Fraser">Christophe Fraser</name><name sortKey="Garske, Tini" sort="Garske, Tini" uniqKey="Garske T" first="Tini" last="Garske">Tini Garske</name><name sortKey="Jombart, Thibaut" sort="Jombart, Thibaut" uniqKey="Jombart T" first="Thibaut" last="Jombart">Thibaut Jombart</name><name sortKey="Mills, Harriet Linden" sort="Mills, Harriet Linden" uniqKey="Mills H" first="Harriet Linden" last="Mills">Harriet Linden Mills</name><name sortKey="Riley, Steven" sort="Riley, Steven" uniqKey="Riley S" first="Steven" last="Riley">Steven Riley</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Clapham, Hannah" sort="Clapham, Hannah" uniqKey="Clapham H" first="Hannah" last="Clapham">Hannah Clapham</name></region><name sortKey="Cummings, Derek A T" sort="Cummings, Derek A T" uniqKey="Cummings D" first="Derek A T" last="Cummings">Derek A T. Cummings</name><name sortKey="Lessler, Justin" sort="Lessler, Justin" uniqKey="Lessler J" first="Justin" last="Lessler">Justin Lessler</name><name sortKey="Moore, Sean" sort="Moore, Sean" uniqKey="Moore S" first="Sean" last="Moore">Sean Moore</name><name sortKey="Rodriquez Barraquer, Isabel" sort="Rodriquez Barraquer, Isabel" uniqKey="Rodriquez Barraquer I" first="Isabel" last="Rodriquez-Barraquer">Isabel Rodriquez-Barraquer</name><name sortKey="Salje, Henrik" sort="Salje, Henrik" uniqKey="Salje H" first="Henrik" last="Salje">Henrik Salje</name><name sortKey="Truelove, Shaun" sort="Truelove, Shaun" uniqKey="Truelove S" first="Shaun" last="Truelove">Shaun Truelove</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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