Transmission of MERS-Coronavirus in Household Contacts
Identifieur interne : 001E33 ( Main/Exploration ); précédent : 001E32; suivant : 001E34Transmission of MERS-Coronavirus in Household Contacts
Auteurs : Christian Drosten [Allemagne] ; Benjamin Meyer [Allemagne] ; Marcel A. Müller [Allemagne, Arabie saoudite] ; Victor M. Corman [Allemagne] ; Malak Al-Masri ; Raheela Hossain [Arabie saoudite] ; Hosam Madani [Arabie saoudite] ; Andrea Sieberg [Allemagne] ; Berend Jan Bosch [Pays-Bas] ; Erik Lattwein [Allemagne] ; Raafat F. Alhakeem [Arabie saoudite] ; Abdullah M. Assiri [Arabie saoudite] ; Waleed Hajomar [Arabie saoudite] ; Ali M. Albarrak [Arabie saoudite] ; Jaffar A. Al-Tawfiq [Arabie saoudite, États-Unis] ; Alimuddin I. Zumla [Arabie saoudite, Royaume-Uni] ; Ziad A. Memish [Arabie saoudite]Source :
- The New England journal of medicine [ 0028-4793 ] ; 2014.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Médecine.
English descriptors
Abstract
BACKGROUND Strategies to contain the Middle East respiratory syndrome coronavirus (MERS-CoV) depend on knowledge of the rate of human-to-human transmission, including subclinical infections. A lack of serologic tools has hindered targeted studies of transmission. METHODS We studied 26 index patients with MERS-CoV infection and their 280 household contacts. The median time from the onset of symptoms in index patients to the latest blood sampling in contact patients was 17.5 days (range, 5 to 216; mean, 34.4). Probable cases of secondary transmission were identified on the basis of reactivity in two reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays with independent RNA extraction from throat swabs or reactivity on enzyme-linked immunosorbent assay against MERS-CoV S1 antigen, supported by reactivity on recombinant S-protein immunofluorescence and demonstration of neutralization of more than 50% of the infectious virus seed dose on plaque-reduction neutralization testing. RESULTS Among the 280 household contacts of the 26 index patients, there were 12 probable cases of secondary transmission (4%; 95% confidence interval, 2 to 7). Of these cases, 7 were identified by means of RT-PCR, all in samples obtained within 14 days after the onset of symptoms in index patients, and 5 were identified by means of serologic analysis, all in samples obtained 13 days or more after symptom onset in index patients. Probable cases of secondary transmission occurred in 6 of 26 clusters (23%). Serologic results in contacts who were sampled 13 days or more after exposure were similar to overall study results for combined RT-PCR and serologic testing. CONCLUSIONS The rate of secondary transmission among household contacts of patients with MERS-CoV infection has been approximately 5%. Our data provide insight into the rate of subclinical transmission of MERS-CoV in the home.
Affiliations:
- Allemagne, Arabie saoudite, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, District de Cologne, Grand Londres, Rhénanie-du-Nord-Westphalie, Utrecht (province)
- Bonn, Londres, Utrecht
- University College de Londres, Université d'Utrecht
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Zumla</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Global Center for Mass Gatherings Medicine, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="11"><s1>Division of Infection and Immunity, University College London (UCL), and National Institute for Health Research Biomedical Research Centre, UCL Hospitals</s1><s2>London</s2><s3>GBR</s3><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. 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Müller</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Institute of Virology, University of Bonn Medical Center</s1><s2>Bonn</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Global Center for Mass Gatherings Medicine, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Corman, Victor M" sort="Corman, Victor M" uniqKey="Corman V" first="Victor M." last="Corman">Victor M. Corman</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Institute of Virology, University of Bonn Medical Center</s1><s2>Bonn</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation></author><author><name sortKey="Al Masri, Malak" sort="Al Masri, Malak" uniqKey="Al Masri M" first="Malak" last="Al-Masri">Malak Al-Masri</name></author><author><name sortKey="Hossain, Raheela" sort="Hossain, Raheela" uniqKey="Hossain R" first="Raheela" last="Hossain">Raheela Hossain</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Regional Laboratory, Ministry of Health</s1><s2>Jeddah</s2><s3>SAU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Madani, Hosam" sort="Madani, Hosam" uniqKey="Madani H" first="Hosam" last="Madani">Hosam Madani</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Regional Laboratory, Ministry of Health</s1><s2>Jeddah</s2><s3>SAU</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Jeddah</wicri:noRegion></affiliation></author><author><name sortKey="Sieberg, Andrea" sort="Sieberg, Andrea" uniqKey="Sieberg A" first="Andrea" last="Sieberg">Andrea Sieberg</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Institute of Virology, University of Bonn Medical Center</s1><s2>Bonn</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation></author><author><name sortKey="Jan Bosch, Berend" sort="Jan Bosch, Berend" uniqKey="Jan Bosch B" first="Berend" last="Jan Bosch">Berend Jan Bosch</name><affiliation wicri:level="4"><inist:fA14 i1="10"><s1>Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>9 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName><orgName type="university">Université d'Utrecht</orgName></affiliation></author><author><name sortKey="Lattwein, Erik" sort="Lattwein, Erik" uniqKey="Lattwein E" first="Erik" last="Lattwein">Erik Lattwein</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Euroimmun</s1><s2>Lubeck</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Lubeck</wicri:noRegion><wicri:noRegion>Euroimmun</wicri:noRegion><wicri:noRegion>Euroimmun</wicri:noRegion></affiliation></author><author><name sortKey="Alhakeem, Raafat F" sort="Alhakeem, Raafat F" uniqKey="Alhakeem R" first="Raafat F." last="Alhakeem">Raafat F. Alhakeem</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Global Center for Mass Gatherings Medicine, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Global Center for Mass Gatherings Medicine, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Hajomar, Waleed" sort="Hajomar, Waleed" uniqKey="Hajomar W" first="Waleed" last="Hajomar">Waleed Hajomar</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Regional Laboratory, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>13 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Albarrak, Ali M" sort="Albarrak, Ali M" uniqKey="Albarrak A" first="Ali M." last="Albarrak">Ali M. Albarrak</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Prince Sultan Military Medical City</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>14 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Prince Sultan Military Medical City</wicri:noRegion></affiliation></author><author><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Johns Hopkins Aramco Healthcare</s1><s2>Dhahran</s2><s3>SAU</s3><sZ>15 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Johns Hopkins Aramco Healthcare</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Indiana University School of Medicine</s1><s2>Indianapolis</s2><s3>USA</s3><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Indiana University School of Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Zumla, Alimuddin I" sort="Zumla, Alimuddin I" uniqKey="Zumla A" first="Alimuddin I." last="Zumla">Alimuddin I. Zumla</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Global Center for Mass Gatherings Medicine, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="11"><s1>Division of Infection and Immunity, University College London (UCL), and National Institute for Health Research Biomedical Research Centre, UCL Hospitals</s1><s2>London</s2><s3>GBR</s3><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Global Center for Mass Gatherings Medicine, Ministry of Health</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>3 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Riyadh</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Alfaisal University</s1><s2>Riyadh</s2><s3>SAU</s3><sZ>17 aut.</sZ></inist:fA14><country>Arabie saoudite</country><wicri:noRegion>Alfaisal University</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Coronavirus</term><term>Medicine</term><term>Middle East respiratory syndrome</term><term>Transmission</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Transmission</term><term>Médecine</term><term>Coronavirus</term><term>Syndrome respiratoire du Moyen-Orient</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 Strategies to contain the Middle East respiratory syndrome coronavirus (MERS-CoV) depend on knowledge of the rate of human-to-human transmission, including subclinical infections. A lack of serologic tools has hindered targeted studies of transmission. METHODS We studied 26 index patients with MERS-CoV infection and their 280 household contacts. The median time from the onset of symptoms in index patients to the latest blood sampling in contact patients was 17.5 days (range, 5 to 216; mean, 34.4). Probable cases of secondary transmission were identified on the basis of reactivity in two reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays with independent RNA extraction from throat swabs or reactivity on enzyme-linked immunosorbent assay against MERS-CoV S1 antigen, supported by reactivity on recombinant S-protein immunofluorescence and demonstration of neutralization of more than 50% of the infectious virus seed dose on plaque-reduction neutralization testing. RESULTS Among the 280 household contacts of the 26 index patients, there were 12 probable cases of secondary transmission (4%; 95% confidence interval, 2 to 7). Of these cases, 7 were identified by means of RT-PCR, all in samples obtained within 14 days after the onset of symptoms in index patients, and 5 were identified by means of serologic analysis, all in samples obtained 13 days or more after symptom onset in index patients. Probable cases of secondary transmission occurred in 6 of 26 clusters (23%). Serologic results in contacts who were sampled 13 days or more after exposure were similar to overall study results for combined RT-PCR and serologic testing. CONCLUSIONS The rate of secondary transmission among household contacts of patients with MERS-CoV infection has been approximately 5%. Our data provide insight into the rate of subclinical transmission of MERS-CoV in the home.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Arabie saoudite</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>District de Cologne</li><li>Grand Londres</li><li>Rhénanie-du-Nord-Westphalie</li><li>Utrecht (province)</li></region><settlement><li>Bonn</li><li>Londres</li><li>Utrecht</li></settlement><orgName><li>University College de Londres</li><li>Université d'Utrecht</li></orgName></list><tree><noCountry><name sortKey="Al Masri, Malak" sort="Al Masri, Malak" uniqKey="Al Masri M" first="Malak" last="Al-Masri">Malak Al-Masri</name></noCountry><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Drosten, Christian" sort="Drosten, Christian" uniqKey="Drosten C" first="Christian" last="Drosten">Christian Drosten</name></region><name sortKey="Corman, Victor M" sort="Corman, Victor M" uniqKey="Corman V" first="Victor M." last="Corman">Victor M. Corman</name><name sortKey="Lattwein, Erik" sort="Lattwein, Erik" uniqKey="Lattwein E" first="Erik" last="Lattwein">Erik Lattwein</name><name sortKey="Meyer, Benjamin" sort="Meyer, Benjamin" uniqKey="Meyer B" first="Benjamin" last="Meyer">Benjamin Meyer</name><name sortKey="Muller, Marcel A" sort="Muller, Marcel A" uniqKey="Muller M" first="Marcel A." last="Müller">Marcel A. Müller</name><name sortKey="Sieberg, Andrea" sort="Sieberg, Andrea" uniqKey="Sieberg A" first="Andrea" last="Sieberg">Andrea Sieberg</name></country><country name="Arabie saoudite"><noRegion><name sortKey="Muller, Marcel A" sort="Muller, Marcel A" uniqKey="Muller M" first="Marcel A." last="Müller">Marcel A. Müller</name></noRegion><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name><name sortKey="Albarrak, Ali M" sort="Albarrak, Ali M" uniqKey="Albarrak A" first="Ali M." last="Albarrak">Ali M. Albarrak</name><name sortKey="Alhakeem, Raafat F" sort="Alhakeem, Raafat F" uniqKey="Alhakeem R" first="Raafat F." last="Alhakeem">Raafat F. Alhakeem</name><name sortKey="Assiri, Abdullah M" sort="Assiri, Abdullah M" uniqKey="Assiri A" first="Abdullah M." last="Assiri">Abdullah M. Assiri</name><name sortKey="Hajomar, Waleed" sort="Hajomar, Waleed" uniqKey="Hajomar W" first="Waleed" last="Hajomar">Waleed Hajomar</name><name sortKey="Hossain, Raheela" sort="Hossain, Raheela" uniqKey="Hossain R" first="Raheela" last="Hossain">Raheela Hossain</name><name sortKey="Madani, Hosam" sort="Madani, Hosam" uniqKey="Madani H" first="Hosam" last="Madani">Hosam Madani</name><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><name sortKey="Zumla, Alimuddin I" sort="Zumla, Alimuddin I" uniqKey="Zumla A" first="Alimuddin I." last="Zumla">Alimuddin I. Zumla</name></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Jan Bosch, Berend" sort="Jan Bosch, Berend" uniqKey="Jan Bosch B" first="Berend" last="Jan Bosch">Berend Jan Bosch</name></region></country><country name="États-Unis"><noRegion><name sortKey="Al Tawfiq, Jaffar A" sort="Al Tawfiq, Jaffar A" uniqKey="Al Tawfiq J" first="Jaffar A." last="Al-Tawfiq">Jaffar A. Al-Tawfiq</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Zumla, Alimuddin I" sort="Zumla, Alimuddin I" uniqKey="Zumla A" first="Alimuddin I." last="Zumla">Alimuddin I. Zumla</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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