A Review of Asymptomatic and Subclinical Middle East Respiratory Syndrome Coronavirus Infections
Identifieur interne : 000430 ( Pmc/Checkpoint ); précédent : 000429; suivant : 000431A Review of Asymptomatic and Subclinical Middle East Respiratory Syndrome Coronavirus Infections
Auteurs : Rebecca Grant [Suisse, France] ; Mamunur Rahman Malik [Égypte] ; Amgad Elkholy [Égypte] ; Maria D. Van Kerkhove [Suisse]Source :
- Epidemiologic Reviews [ 0193-936X ] ; 2019.
Abstract
The epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) since 2012 has been largely characterized by recurrent zoonotic spillover from dromedary camels followed by limited human-to-human transmission, predominantly in health-care settings. The full extent of infection of MERS-CoV is not clear, nor is the extent and/or role of asymptomatic infections in transmission. We conducted a review of molecular and serological investigations through PubMed and EMBASE from September 2012 to November 15, 2018, to measure subclinical or asymptomatic MERS-CoV infection within and outside of health-care settings. We performed retrospective analysis of laboratory-confirmed MERS-CoV infections reported to the World Health Organization to November 27, 2018, to summarize what is known about asymptomatic infections identified through national surveillance systems. We identified 23 studies reporting evidence of MERS-CoV infection outside of health-care settings, mainly of camel workers, with seroprevalence ranges of 0%–67% depending on the study location. We identified 20 studies in health-care settings of health-care worker (HCW) and family contacts, of which 11 documented molecular evidence of MERS-CoV infection among asymptomatic contacts. Since 2012, 298 laboratory-confirmed cases were reported as asymptomatic to the World Health Organization, 164 of whom were HCWs. The potential to transmit MERS-CoV to others has been demonstrated in viral-shedding studies of asymptomatic MERS infections. Our results highlight the possibility for onward transmission of MERS-CoV from asymptomatic individuals. Screening of HCW contacts of patients with confirmed MERS-CoV is currently recommended, but systematic screening of non-HCW contacts outside of health-care facilities should be encouraged.
Url:
DOI: 10.1093/epirev/mxz009
PubMed: 31781765
PubMed Central: 7108493
Affiliations:
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<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>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>The epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) since 2012 has been largely characterized by recurrent zoonotic spillover from dromedary camels followed by limited human-to-human transmission, predominantly in health-care settings. The full extent of infection of MERS-CoV is not clear, nor is the extent and/or role of asymptomatic infections in transmission. We conducted a review of molecular and serological investigations through PubMed and EMBASE from September 2012 to November 15, 2018, to measure subclinical or asymptomatic MERS-CoV infection within and outside of health-care settings. We performed retrospective analysis of laboratory-confirmed MERS-CoV infections reported to the World Health Organization to November 27, 2018, to summarize what is known about asymptomatic infections identified through national surveillance systems. We identified 23 studies reporting evidence of MERS-CoV infection outside of health-care settings, mainly of camel workers, with seroprevalence ranges of 0%–67% depending on the study location. We identified 20 studies in health-care settings of health-care worker (HCW) and family contacts, of which 11 documented molecular evidence of MERS-CoV infection among asymptomatic contacts. Since 2012, 298 laboratory-confirmed cases were reported as asymptomatic to the World Health Organization, 164 of whom were HCWs. The potential to transmit MERS-CoV to others has been demonstrated in viral-shedding studies of asymptomatic MERS infections. Our results highlight the possibility for onward transmission of MERS-CoV from asymptomatic individuals. Screening of HCW contacts of patients with confirmed MERS-CoV is currently recommended, but systematic screening of non-HCW contacts outside of health-care facilities should be encouraged.</p>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Epidemiol Rev</journal-id>
<journal-id journal-id-type="iso-abbrev">Epidemiol Rev</journal-id>
<journal-id journal-id-type="publisher-id">epirev</journal-id>
<journal-title-group><journal-title>Epidemiologic Reviews</journal-title>
</journal-title-group>
<issn pub-type="ppub">0193-936X</issn>
<issn pub-type="epub">1478-6729</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">31781765</article-id>
<article-id pub-id-type="pmc">7108493</article-id>
<article-id pub-id-type="doi">10.1093/epirev/mxz009</article-id>
<article-id pub-id-type="publisher-id">mxz009</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>A Review of Asymptomatic and Subclinical Middle East Respiratory Syndrome Coronavirus Infections</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Grant</surname>
<given-names>Rebecca</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Malik</surname>
<given-names>Mamunur Rahman</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Elkholy</surname>
<given-names>Amgad</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Van Kerkhove</surname>
<given-names>Maria D</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
<xref rid="cor1" ref-type="corresp"></xref>
<pmc-comment>vankerkhovem@who.int </pmc-comment>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
Department of Infectious Hazard Management, WHO Health Emergencies Programme,<institution>World Health Organization</institution>
, Geneva,<country country="CH">Switzerland</country>
</aff>
<aff id="aff2"><label>2</label>
Infectious Hazard Management Unit, Department of Health Emergencies,<institution>World Health Organization Regional Office for the Eastern Mediterranean</institution>
, Cairo,<country country="EG">Egypt</country>
</aff>
<aff id="aff3"><label>3</label>
Centre for Global Health,<institution>Institut Pasteur</institution>
, Paris,<country country="FR">France</country>
</aff>
<author-notes><corresp id="cor1">Correspondence to Maria D Van Kerkhove, PhD, Department of Infectious Hazards Management, Health Emergencies Program, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland (e-mail: <email>vankerkhovem@who.int</email>
)</corresp>
</author-notes>
<pub-date pub-type="epub" iso-8601-date="2019-11-29"><day>29</day>
<month>11</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>29</day>
<month>11</month>
<year>2019</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the . </pmc-comment>
<elocation-id>mxz009</elocation-id>
<history><date date-type="received"><day>6</day>
<month>12</month>
<year>2018</year>
</date>
<date date-type="rev-recd"><day>2</day>
<month>4</month>
<year>2019</year>
</date>
<date date-type="accepted"><day>9</day>
<month>9</month>
<year>2019</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.</copyright-statement>
<copyright-year>2019</copyright-year>
<license license-type="cc-by-nc" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com</license-p>
</license>
</permissions>
<self-uri xlink:href="mxz009.pdf"></self-uri>
<abstract><title>Abstract</title>
<p>The epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) since 2012 has been largely characterized by recurrent zoonotic spillover from dromedary camels followed by limited human-to-human transmission, predominantly in health-care settings. The full extent of infection of MERS-CoV is not clear, nor is the extent and/or role of asymptomatic infections in transmission. We conducted a review of molecular and serological investigations through PubMed and EMBASE from September 2012 to November 15, 2018, to measure subclinical or asymptomatic MERS-CoV infection within and outside of health-care settings. We performed retrospective analysis of laboratory-confirmed MERS-CoV infections reported to the World Health Organization to November 27, 2018, to summarize what is known about asymptomatic infections identified through national surveillance systems. We identified 23 studies reporting evidence of MERS-CoV infection outside of health-care settings, mainly of camel workers, with seroprevalence ranges of 0%–67% depending on the study location. We identified 20 studies in health-care settings of health-care worker (HCW) and family contacts, of which 11 documented molecular evidence of MERS-CoV infection among asymptomatic contacts. Since 2012, 298 laboratory-confirmed cases were reported as asymptomatic to the World Health Organization, 164 of whom were HCWs. The potential to transmit MERS-CoV to others has been demonstrated in viral-shedding studies of asymptomatic MERS infections. Our results highlight the possibility for onward transmission of MERS-CoV from asymptomatic individuals. Screening of HCW contacts of patients with confirmed MERS-CoV is currently recommended, but systematic screening of non-HCW contacts outside of health-care facilities should be encouraged.</p>
</abstract>
<kwd-group><kwd>health-care workers</kwd>
<kwd>infection control</kwd>
<kwd>MERS-CoV</kwd>
<kwd>seroprevalence</kwd>
<kwd>subclinical infections</kwd>
</kwd-group>
<counts><page-count count="13"></page-count>
</counts>
<custom-meta-group><custom-meta><meta-name>edited-state</meta-name>
<meta-value>corrected-proof</meta-value>
</custom-meta>
<custom-meta><meta-name>article-lifecycle</meta-name>
<meta-value>PAP</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>France</li>
<li>Suisse</li>
<li>Égypte</li>
</country>
</list>
<tree><country name="Suisse"><noRegion><name sortKey="Grant, Rebecca" sort="Grant, Rebecca" uniqKey="Grant R" first="Rebecca" last="Grant">Rebecca Grant</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="France"><noRegion><name sortKey="Grant, Rebecca" sort="Grant, Rebecca" uniqKey="Grant R" first="Rebecca" last="Grant">Rebecca Grant</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>
<name sortKey="Elkholy, Amgad" sort="Elkholy, Amgad" uniqKey="Elkholy A" first="Amgad" last="Elkholy">Amgad Elkholy</name>
</country>
</tree>
</affiliations>
</record>
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