Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases
Identifieur interne : 000478 ( Pmc/Checkpoint ); précédent : 000477; suivant : 000479Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases
Auteurs : Romy Conzade [Allemagne] ; Rebecca Grant [France] ; Mamunur Rahman Malik ; Amgad Elkholy ; Mohamed Elhakim ; Dalia Samhouri ; Peter K. Ben Embarek ; Maria D. Van KerkhoveSource :
- Viruses [ 1999-4915 ] ; 2018.
Abstract
Dromedary camels (
Url:
DOI: 10.3390/v10080425
PubMed: 30104551
PubMed Central: 6115845
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases</title><author><name sortKey="Conzade, Romy" sort="Conzade, Romy" uniqKey="Conzade R" first="Romy" last="Conzade">Romy Conzade</name><affiliation><nlm:aff id="af1-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-viruses-10-00425">Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764 Neuherberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764 Neuherberg</wicri:regionArea><wicri:noRegion>85764 Neuherberg</wicri:noRegion><wicri:noRegion>85764 Neuherberg</wicri:noRegion><wicri:noRegion>85764 Neuherberg</wicri:noRegion></affiliation></author><author><name sortKey="Grant, Rebecca" sort="Grant, Rebecca" uniqKey="Grant R" first="Rebecca" last="Grant">Rebecca Grant</name><affiliation><nlm:aff id="af1-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</nlm:aff></affiliation><affiliation wicri:level="3"><nlm:aff id="af3-viruses-10-00425">Institut Pasteur, Centre for Global Health Research and Education, 75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Institut Pasteur, Centre for Global Health Research and Education, 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="Malik, Mamunur Rahman" sort="Malik, Mamunur Rahman" uniqKey="Malik M" first="Mamunur Rahman" last="Malik">Mamunur Rahman Malik</name><affiliation><nlm:aff id="af4-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</nlm:aff></affiliation></author><author><name sortKey="Elkholy, Amgad" sort="Elkholy, Amgad" uniqKey="Elkholy A" first="Amgad" last="Elkholy">Amgad Elkholy</name><affiliation><nlm:aff id="af4-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</nlm:aff></affiliation></author><author><name sortKey="Elhakim, Mohamed" sort="Elhakim, Mohamed" uniqKey="Elhakim M" first="Mohamed" last="Elhakim">Mohamed Elhakim</name><affiliation><nlm:aff id="af4-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</nlm:aff></affiliation></author><author><name sortKey="Samhouri, Dalia" sort="Samhouri, Dalia" uniqKey="Samhouri D" first="Dalia" last="Samhouri">Dalia Samhouri</name><affiliation><nlm:aff id="af5-viruses-10-00425">Department of Country Preparedness and International Health Regulations, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>samhourid@who.int</email></nlm:aff></affiliation></author><author><name sortKey="Ben Embarek, Peter K" sort="Ben Embarek, Peter K" uniqKey="Ben Embarek P" first="Peter K." last="Ben Embarek">Peter K. Ben Embarek</name><affiliation><nlm:aff id="af6-viruses-10-00425">Department of Food Safety and Zoonoses, World Health Organization, 1211 Geneva, Switzerland;<email>benembarekp@who.int</email></nlm:aff></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><nlm:aff id="af1-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30104551</idno><idno type="pmc">6115845</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115845</idno><idno type="RBID">PMC:6115845</idno><idno type="doi">10.3390/v10080425</idno><date when="2018">2018</date><idno type="wicri:Area/Pmc/Corpus">001209</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001209</idno><idno type="wicri:Area/Pmc/Curation">001209</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001209</idno><idno type="wicri:Area/Pmc/Checkpoint">000478</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000478</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases</title><author><name sortKey="Conzade, Romy" sort="Conzade, Romy" uniqKey="Conzade R" first="Romy" last="Conzade">Romy Conzade</name><affiliation><nlm:aff id="af1-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-viruses-10-00425">Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764 Neuherberg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764 Neuherberg</wicri:regionArea><wicri:noRegion>85764 Neuherberg</wicri:noRegion><wicri:noRegion>85764 Neuherberg</wicri:noRegion><wicri:noRegion>85764 Neuherberg</wicri:noRegion></affiliation></author><author><name sortKey="Grant, Rebecca" sort="Grant, Rebecca" uniqKey="Grant R" first="Rebecca" last="Grant">Rebecca Grant</name><affiliation><nlm:aff id="af1-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</nlm:aff></affiliation><affiliation wicri:level="3"><nlm:aff id="af3-viruses-10-00425">Institut Pasteur, Centre for Global Health Research and Education, 75015 Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Institut Pasteur, Centre for Global Health Research and Education, 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="Malik, Mamunur Rahman" sort="Malik, Mamunur Rahman" uniqKey="Malik M" first="Mamunur Rahman" last="Malik">Mamunur Rahman Malik</name><affiliation><nlm:aff id="af4-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</nlm:aff></affiliation></author><author><name sortKey="Elkholy, Amgad" sort="Elkholy, Amgad" uniqKey="Elkholy A" first="Amgad" last="Elkholy">Amgad Elkholy</name><affiliation><nlm:aff id="af4-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</nlm:aff></affiliation></author><author><name sortKey="Elhakim, Mohamed" sort="Elhakim, Mohamed" uniqKey="Elhakim M" first="Mohamed" last="Elhakim">Mohamed Elhakim</name><affiliation><nlm:aff id="af4-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</nlm:aff></affiliation></author><author><name sortKey="Samhouri, Dalia" sort="Samhouri, Dalia" uniqKey="Samhouri D" first="Dalia" last="Samhouri">Dalia Samhouri</name><affiliation><nlm:aff id="af5-viruses-10-00425">Department of Country Preparedness and International Health Regulations, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>samhourid@who.int</email></nlm:aff></affiliation></author><author><name sortKey="Ben Embarek, Peter K" sort="Ben Embarek, Peter K" uniqKey="Ben Embarek P" first="Peter K." last="Ben Embarek">Peter K. Ben Embarek</name><affiliation><nlm:aff id="af6-viruses-10-00425">Department of Food Safety and Zoonoses, World Health Organization, 1211 Geneva, Switzerland;<email>benembarekp@who.int</email></nlm:aff></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><nlm:aff id="af1-viruses-10-00425">Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</nlm:aff></affiliation></author></analytic><series><title level="j">Viruses</title><idno type="eISSN">1999-4915</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Dromedary camels (<italic>Camelus dromedarius</italic>) are now known to be the vertebrate animal reservoir that intermittently transmits the Middle East respiratory syndrome coronavirus (MERS-CoV) to humans. Yet, details as to the specific mechanism(s) of zoonotic transmission from dromedaries to humans remain unclear. The aim of this study was to describe direct and indirect contact with dromedaries among all cases, and then separately for primary, non-primary, and unclassified cases of laboratory-confirmed MERS-CoV reported to the World Health Organization (WHO) between 1 January 2015 and 13 April 2018. We present any reported dromedary contact: direct, indirect, and type of indirect contact. Of all 1125 laboratory-confirmed MERS-CoV cases reported to WHO during the time period, there were 348 (30.9%) primary cases, 455 (40.4%) non-primary cases, and 322 (28.6%) unclassified cases. Among primary cases, 191 (54.9%) reported contact with dromedaries: 164 (47.1%) reported direct contact, 155 (44.5%) reported indirect contact. Five (1.1%) non-primary cases also reported contact with dromedaries. Overall, unpasteurized milk was the most frequent type of dromedary product consumed. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Viruses</journal-id><journal-id journal-id-type="iso-abbrev">Viruses</journal-id><journal-id journal-id-type="publisher-id">viruses</journal-id><journal-title-group><journal-title>Viruses</journal-title></journal-title-group><issn pub-type="epub">1999-4915</issn><publisher><publisher-name>MDPI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30104551</article-id><article-id pub-id-type="pmc">6115845</article-id><article-id pub-id-type="doi">10.3390/v10080425</article-id><article-id pub-id-type="publisher-id">viruses-10-00425</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Conzade</surname><given-names>Romy</given-names></name><xref ref-type="aff" rid="af1-viruses-10-00425">1</xref><xref ref-type="aff" rid="af2-viruses-10-00425">2</xref><xref ref-type="author-notes" rid="fn1-viruses-10-00425">†</xref></contrib><contrib contrib-type="author"><name><surname>Grant</surname><given-names>Rebecca</given-names></name><xref ref-type="aff" rid="af1-viruses-10-00425">1</xref><xref ref-type="aff" rid="af3-viruses-10-00425">3</xref><xref ref-type="author-notes" rid="fn1-viruses-10-00425">†</xref></contrib><contrib contrib-type="author"><name><surname>Malik</surname><given-names>Mamunur Rahman</given-names></name><xref ref-type="aff" rid="af4-viruses-10-00425">4</xref></contrib><contrib contrib-type="author"><name><surname>Elkholy</surname><given-names>Amgad</given-names></name><xref ref-type="aff" rid="af4-viruses-10-00425">4</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0001-5785-1592</contrib-id><name><surname>Elhakim</surname><given-names>Mohamed</given-names></name><xref ref-type="aff" rid="af4-viruses-10-00425">4</xref></contrib><contrib contrib-type="author"><name><surname>Samhouri</surname><given-names>Dalia</given-names></name><xref ref-type="aff" rid="af5-viruses-10-00425">5</xref></contrib><contrib contrib-type="author"><name><surname>Ben Embarek</surname><given-names>Peter K.</given-names></name><xref ref-type="aff" rid="af6-viruses-10-00425">6</xref></contrib><contrib contrib-type="author"><name><surname>Van Kerkhove</surname><given-names>Maria D.</given-names></name><xref ref-type="aff" rid="af1-viruses-10-00425">1</xref><xref rid="c1-viruses-10-00425" ref-type="corresp">*</xref></contrib></contrib-group><aff id="af1-viruses-10-00425"><label>1</label>Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland;<email>romy.conzade@helmholtz-muenchen.de</email> (R.C.);<email>grantr@who.int</email> (R.G.)</aff><aff id="af2-viruses-10-00425"><label>2</label>Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, 85764 Neuherberg, Germany</aff><aff id="af3-viruses-10-00425"><label>3</label>Institut Pasteur, Centre for Global Health Research and Education, 75015 Paris, France</aff><aff id="af4-viruses-10-00425"><label>4</label>Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>malikm@who.int</email> (M.R.M.);<email>elkholya@who.int</email> (A.E.);<email>elhakimm@who.int</email> (M.E.)</aff><aff id="af5-viruses-10-00425"><label>5</label>Department of Country Preparedness and International Health Regulations, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt;<email>samhourid@who.int</email></aff><aff id="af6-viruses-10-00425"><label>6</label>Department of Food Safety and Zoonoses, World Health Organization, 1211 Geneva, Switzerland;<email>benembarekp@who.int</email></aff><author-notes><corresp id="c1-viruses-10-00425"><label>*</label>Correspondence: <email>vankerkhovem@who.int</email>; Tel.: +41-22-79-11817</corresp><fn id="fn1-viruses-10-00425"><label>†</label><p>These authors contributed equally to this work.</p></fn></author-notes><pub-date pub-type="epub"><day>13</day><month>8</month><year>2018</year></pub-date><pub-date pub-type="collection"><month>8</month><year>2018</year></pub-date><volume>10</volume><issue>8</issue><elocation-id>425</elocation-id><history><date date-type="received"><day>18</day><month>7</month><year>2018</year></date><date date-type="accepted"><day>09</day><month>8</month><year>2018</year></date></history><permissions><copyright-statement>© 2018 by the authors.</copyright-statement><copyright-year>2018</copyright-year><license license-type="open-access"><license-p>Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>).</license-p></license></permissions><abstract><p>Dromedary camels (<italic>Camelus dromedarius</italic>) are now known to be the vertebrate animal reservoir that intermittently transmits the Middle East respiratory syndrome coronavirus (MERS-CoV) to humans. Yet, details as to the specific mechanism(s) of zoonotic transmission from dromedaries to humans remain unclear. The aim of this study was to describe direct and indirect contact with dromedaries among all cases, and then separately for primary, non-primary, and unclassified cases of laboratory-confirmed MERS-CoV reported to the World Health Organization (WHO) between 1 January 2015 and 13 April 2018. We present any reported dromedary contact: direct, indirect, and type of indirect contact. Of all 1125 laboratory-confirmed MERS-CoV cases reported to WHO during the time period, there were 348 (30.9%) primary cases, 455 (40.4%) non-primary cases, and 322 (28.6%) unclassified cases. Among primary cases, 191 (54.9%) reported contact with dromedaries: 164 (47.1%) reported direct contact, 155 (44.5%) reported indirect contact. Five (1.1%) non-primary cases also reported contact with dromedaries. Overall, unpasteurized milk was the most frequent type of dromedary product consumed. Among cases for whom exposure was systematically collected and reported to WHO, contact with dromedaries or dromedary products has played an important role in zoonotic transmission.</p></abstract><kwd-group><kwd>MERS-CoV</kwd><kwd>dromedary camels</kwd><kwd>zoonotic transmission</kwd></kwd-group></article-meta></front><floats-group><table-wrap id="viruses-10-00425-t001" orientation="portrait" position="float"><object-id pub-id-type="pii">viruses-10-00425-t001_Table 1</object-id><label>Table 1</label><caption><p>Description of laboratory-confirmed MERS-CoV cases reported to World Health Organization (WHO) between 1 January 2015 and 13 April 2018 (<italic>n</italic> = 1125). Results are presented as frequencies (%), unless otherwise stated.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="2" align="left" valign="middle" style="border-top:solid thin;border-bottom:solid thin">Characteristics</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">All Cases<break></break>(<italic>n</italic> = 1125)</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">Primary Cases<break></break>(<italic>n</italic> = 348) </th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">Non-Primary Cases<break></break>(<italic>n</italic> = 455)</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">Unclassified Cases<break></break>(<italic>n</italic> = 322)</th></tr><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th></tr></thead><tbody><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Age</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Mean (years)</td><td colspan="2" align="center" valign="middle" rowspan="1">54.9</td><td colspan="2" align="center" valign="middle" rowspan="1">57.7</td><td colspan="2" align="center" valign="middle" rowspan="1">53.4</td><td colspan="2" align="center" valign="middle" rowspan="1">54.1</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">SD (years)</td><td colspan="2" align="center" valign="middle" rowspan="1">17.3</td><td colspan="2" align="center" valign="middle" rowspan="1">15.8</td><td colspan="2" align="center" valign="middle" rowspan="1">17.9</td><td colspan="2" align="center" valign="middle" rowspan="1">17.6</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Sex</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Male</td><td align="center" valign="middle" rowspan="1" colspan="1">808</td><td align="center" valign="middle" rowspan="1" colspan="1">71.8</td><td align="center" valign="middle" rowspan="1" colspan="1">301</td><td align="center" valign="middle" rowspan="1" colspan="1">86.5</td><td align="center" valign="middle" rowspan="1" colspan="1">284</td><td align="center" valign="middle" rowspan="1" colspan="1">62.4</td><td align="center" valign="middle" rowspan="1" colspan="1">223</td><td align="center" valign="middle" rowspan="1" colspan="1">69.3</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Female</td><td align="center" valign="middle" rowspan="1" colspan="1">313</td><td align="center" valign="middle" rowspan="1" colspan="1">27.8</td><td align="center" valign="middle" rowspan="1" colspan="1">45</td><td align="center" valign="middle" rowspan="1" colspan="1">12.9</td><td align="center" valign="middle" rowspan="1" colspan="1">171</td><td align="center" valign="middle" rowspan="1" colspan="1">37.6</td><td align="center" valign="middle" rowspan="1" colspan="1">97</td><td align="center" valign="middle" rowspan="1" colspan="1">30.1</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" rowspan="1" colspan="1">4</td><td align="center" valign="middle" rowspan="1" colspan="1">0.4</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.6</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.6</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Country of MERS-CoV exposure</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><italic>Within the Middle East</italic></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Islamic Republic of Iran</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">0.1</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">0.2</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Jordan</td><td align="center" valign="middle" rowspan="1" colspan="1">13</td><td align="center" valign="middle" rowspan="1" colspan="1">1.2</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">4</td><td align="center" valign="middle" rowspan="1" colspan="1">0.9</td><td align="center" valign="middle" rowspan="1" colspan="1">9</td><td align="center" valign="middle" rowspan="1" colspan="1">2.8</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Kingdom of Saudi Arabia</td><td align="center" valign="middle" rowspan="1" colspan="1">911</td><td align="center" valign="middle" rowspan="1" colspan="1">90.0</td><td align="center" valign="middle" rowspan="1" colspan="1">335</td><td align="center" valign="middle" rowspan="1" colspan="1">96.3</td><td align="center" valign="middle" rowspan="1" colspan="1">276</td><td align="center" valign="middle" rowspan="1" colspan="1">60.7</td><td align="center" valign="middle" rowspan="1" colspan="1">300</td><td align="center" valign="middle" rowspan="1" colspan="1">93.2</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Kuwait</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.2</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.6</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Oman</td><td align="center" valign="middle" rowspan="1" colspan="1">10</td><td align="center" valign="middle" rowspan="1" colspan="1">0.9</td><td align="center" valign="middle" rowspan="1" colspan="1">4</td><td align="center" valign="middle" rowspan="1" colspan="1">1.2</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">0.2</td><td align="center" valign="middle" rowspan="1" colspan="1">5</td><td align="center" valign="middle" rowspan="1" colspan="1">1.6</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Qatar</td><td align="center" valign="middle" rowspan="1" colspan="1">9</td><td align="center" valign="middle" rowspan="1" colspan="1">0.8</td><td align="center" valign="middle" rowspan="1" colspan="1">5</td><td align="center" valign="middle" rowspan="1" colspan="1">1.4</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">4</td><td align="center" valign="middle" rowspan="1" colspan="1">1.2</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">United Arab Emirates</td><td align="center" valign="middle" rowspan="1" colspan="1">6</td><td align="center" valign="middle" rowspan="1" colspan="1">0.5</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.6</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">4</td><td align="center" valign="middle" rowspan="1" colspan="1">1.2</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><italic>Outside the Middle East</italic></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Republic of Korea</td><td align="center" valign="middle" rowspan="1" colspan="1">172</td><td align="center" valign="middle" rowspan="1" colspan="1">15.3</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">172</td><td align="center" valign="middle" rowspan="1" colspan="1">37.8</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">0.1</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">1</td><td align="center" valign="middle" rowspan="1" colspan="1">0.2</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Severity</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Asymptomatic/mild</td><td align="center" valign="middle" rowspan="1" colspan="1">99</td><td align="center" valign="middle" rowspan="1" colspan="1">8.8</td><td align="center" valign="middle" rowspan="1" colspan="1">7</td><td align="center" valign="middle" rowspan="1" colspan="1">2.0</td><td align="center" valign="middle" rowspan="1" colspan="1">64</td><td align="center" valign="middle" rowspan="1" colspan="1">14.1</td><td align="center" valign="middle" rowspan="1" colspan="1">28</td><td align="center" valign="middle" rowspan="1" colspan="1">8.7</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Pneumonia/non-ICU</td><td align="center" valign="middle" rowspan="1" colspan="1">241</td><td align="center" valign="middle" rowspan="1" colspan="1">21.4</td><td align="center" valign="middle" rowspan="1" colspan="1">102</td><td align="center" valign="middle" rowspan="1" colspan="1">29.3</td><td align="center" valign="middle" rowspan="1" colspan="1">54</td><td align="center" valign="middle" rowspan="1" colspan="1">11.9</td><td align="center" valign="middle" rowspan="1" colspan="1">85</td><td align="center" valign="middle" rowspan="1" colspan="1">26.4</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Severe/fatal</td><td align="center" valign="middle" rowspan="1" colspan="1">553</td><td align="center" valign="middle" rowspan="1" colspan="1">49.2</td><td align="center" valign="middle" rowspan="1" colspan="1">209</td><td align="center" valign="middle" rowspan="1" colspan="1">60.1</td><td align="center" valign="middle" rowspan="1" colspan="1">190</td><td align="center" valign="middle" rowspan="1" colspan="1">41.8</td><td align="center" valign="middle" rowspan="1" colspan="1">154</td><td align="center" valign="middle" rowspan="1" colspan="1">47.8</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" rowspan="1" colspan="1">232</td><td align="center" valign="middle" rowspan="1" colspan="1">20.6</td><td align="center" valign="middle" rowspan="1" colspan="1">30</td><td align="center" valign="middle" rowspan="1" colspan="1">8.6</td><td align="center" valign="middle" rowspan="1" colspan="1">147</td><td align="center" valign="middle" rowspan="1" colspan="1">32.3</td><td align="center" valign="middle" rowspan="1" colspan="1">55</td><td align="center" valign="middle" rowspan="1" colspan="1">17.1</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Outcome</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Survived</td><td align="center" valign="middle" rowspan="1" colspan="1">245</td><td align="center" valign="middle" rowspan="1" colspan="1">21.8</td><td align="center" valign="middle" rowspan="1" colspan="1">79</td><td align="center" valign="middle" rowspan="1" colspan="1">22.7</td><td align="center" valign="middle" rowspan="1" colspan="1">109</td><td align="center" valign="middle" rowspan="1" colspan="1">24.0</td><td align="center" valign="middle" rowspan="1" colspan="1">57</td><td align="center" valign="middle" rowspan="1" colspan="1">17.7</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Died</td><td align="center" valign="middle" rowspan="1" colspan="1">414</td><td align="center" valign="middle" rowspan="1" colspan="1">36.8</td><td align="center" valign="middle" rowspan="1" colspan="1">151</td><td align="center" valign="middle" rowspan="1" colspan="1">43.4</td><td align="center" valign="middle" rowspan="1" colspan="1">149</td><td align="center" valign="middle" rowspan="1" colspan="1">32.8</td><td align="center" valign="middle" rowspan="1" colspan="1">114</td><td align="center" valign="middle" rowspan="1" colspan="1">35.4</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">466</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">41.4</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">118</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">33.9</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">197</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">43.3</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">151</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">46.9</td></tr></tbody></table><table-wrap-foot><fn><p>MERS-CoV: Middle East respiratory syndrome coronavirus; non-ICU: non-intensive care unit; primary case = cases with laboratory confirmation of MERS-CoV infection with no direct epidemiological link to a (confirmed or probable) human MERS case; non-primary case = cases with laboratory confirmation of MERS-CoV infection and with a direct epidemiological link to a (confirmed or probable) human MERS case; unspecified case = cases with insufficient information reported to WHO, on potential exposures prior to infection, to be classified as a primary or non-primary case.</p></fn></table-wrap-foot></table-wrap><table-wrap id="viruses-10-00425-t002" orientation="portrait" position="float"><object-id pub-id-type="pii">viruses-10-00425-t002_Table 2</object-id><label>Table 2</label><caption><p>Direct and indirect contact with dromedaries among laboratory-confirmed MERS-CoV cases reported to WHO between 1 January 2015 and 13 April 2018, <italic>n</italic> = 1125. Results are presented as frequencies (%), unless otherwise stated.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="2" align="left" valign="middle" style="border-top:solid thin;border-bottom:solid thin">Contact</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">All Cases<break></break>(<italic>n</italic> = 1125)</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">Primary Cases<break></break>(<italic>n</italic> = 348) </th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">Non-Primary Cases<break></break>(<italic>n</italic> = 455)</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin" rowspan="1">Unclassified Cases<break></break>(<italic>n</italic> = 322)</th></tr><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">%</th></tr></thead><tbody><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Any contact with dromedaries</bold></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Yes</td><td align="center" valign="middle" rowspan="1" colspan="1">235</td><td align="center" valign="middle" rowspan="1" colspan="1">20.9</td><td align="center" valign="middle" rowspan="1" colspan="1">191</td><td align="center" valign="middle" rowspan="1" colspan="1">54.9</td><td align="center" valign="middle" rowspan="1" colspan="1">5</td><td align="center" valign="middle" rowspan="1" colspan="1">1.1</td><td align="center" valign="middle" rowspan="1" colspan="1">39</td><td align="center" valign="middle" rowspan="1" colspan="1">12.1</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">No</td><td align="center" valign="middle" rowspan="1" colspan="1">276</td><td align="center" valign="middle" rowspan="1" colspan="1">24.5</td><td align="center" valign="middle" rowspan="1" colspan="1">62</td><td align="center" valign="middle" rowspan="1" colspan="1">17.8</td><td align="center" valign="middle" rowspan="1" colspan="1">162</td><td align="center" valign="middle" rowspan="1" colspan="1">35.6</td><td align="center" valign="middle" rowspan="1" colspan="1">52</td><td align="center" valign="middle" rowspan="1" colspan="1">16.2</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" rowspan="1" colspan="1">614</td><td align="center" valign="middle" rowspan="1" colspan="1">54.6</td><td align="center" valign="middle" rowspan="1" colspan="1">95</td><td align="center" valign="middle" rowspan="1" colspan="1">27.3</td><td align="center" valign="middle" rowspan="1" colspan="1">288</td><td align="center" valign="middle" rowspan="1" colspan="1">63.3</td><td align="center" valign="middle" rowspan="1" colspan="1">231</td><td align="center" valign="middle" rowspan="1" colspan="1">71.7</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Direct contact with dromedaries *</bold></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Yes</td><td align="center" valign="middle" rowspan="1" colspan="1">201</td><td align="center" valign="middle" rowspan="1" colspan="1">17.9</td><td align="center" valign="middle" rowspan="1" colspan="1">164</td><td align="center" valign="middle" rowspan="1" colspan="1">47.1</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.7</td><td align="center" valign="middle" rowspan="1" colspan="1">34</td><td align="center" valign="middle" rowspan="1" colspan="1">10.6</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">No</td><td align="center" valign="middle" rowspan="1" colspan="1">285</td><td align="center" valign="middle" rowspan="1" colspan="1">25.3</td><td align="center" valign="middle" rowspan="1" colspan="1">68</td><td align="center" valign="middle" rowspan="1" colspan="1">19.5</td><td align="center" valign="middle" rowspan="1" colspan="1">162</td><td align="center" valign="middle" rowspan="1" colspan="1">35.6</td><td align="center" valign="middle" rowspan="1" colspan="1">55</td><td align="center" valign="middle" rowspan="1" colspan="1">17.1</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" rowspan="1" colspan="1">639</td><td align="center" valign="middle" rowspan="1" colspan="1">56.8</td><td align="center" valign="middle" rowspan="1" colspan="1">116</td><td align="center" valign="middle" rowspan="1" colspan="1">33.3</td><td align="center" valign="middle" rowspan="1" colspan="1">290</td><td align="center" valign="middle" rowspan="1" colspan="1">63.7</td><td align="center" valign="middle" rowspan="1" colspan="1">233</td><td align="center" valign="middle" rowspan="1" colspan="1">72.4</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Indirect contact with dromedaries *</bold></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Yes</td><td align="center" valign="middle" rowspan="1" colspan="1">186</td><td align="center" valign="middle" rowspan="1" colspan="1">16.5</td><td align="center" valign="middle" rowspan="1" colspan="1">155</td><td align="center" valign="middle" rowspan="1" colspan="1">44.5</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.7</td><td align="center" valign="middle" rowspan="1" colspan="1">28</td><td align="center" valign="middle" rowspan="1" colspan="1">8.7</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">No</td><td align="center" valign="middle" rowspan="1" colspan="1">280</td><td align="center" valign="middle" rowspan="1" colspan="1">24.9</td><td align="center" valign="middle" rowspan="1" colspan="1">73</td><td align="center" valign="middle" rowspan="1" colspan="1">21.0</td><td align="center" valign="middle" rowspan="1" colspan="1">152</td><td align="center" valign="middle" rowspan="1" colspan="1">33.4</td><td align="center" valign="middle" rowspan="1" colspan="1">55</td><td align="center" valign="middle" rowspan="1" colspan="1">17.1</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Not reported</td><td align="center" valign="middle" rowspan="1" colspan="1">659</td><td align="center" valign="middle" rowspan="1" colspan="1">58.6</td><td align="center" valign="middle" rowspan="1" colspan="1">120</td><td align="center" valign="middle" rowspan="1" colspan="1">34.5</td><td align="center" valign="middle" rowspan="1" colspan="1">300</td><td align="center" valign="middle" rowspan="1" colspan="1">65.9</td><td align="center" valign="middle" rowspan="1" colspan="1">239</td><td align="center" valign="middle" rowspan="1" colspan="1">74.2</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Type of dromedary product consumed</bold></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Unpasteurized milk</td><td align="center" valign="middle" rowspan="1" colspan="1">163</td><td align="center" valign="middle" rowspan="1" colspan="1">14.5</td><td align="center" valign="middle" rowspan="1" colspan="1">137</td><td align="center" valign="middle" rowspan="1" colspan="1">39.4</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.7</td><td align="center" valign="middle" rowspan="1" colspan="1">23</td><td align="center" valign="middle" rowspan="1" colspan="1">7.1</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Milk (unspecified)</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.3</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.9</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Meat</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.2</td><td align="center" valign="middle" rowspan="1" colspan="1">2</td><td align="center" valign="middle" rowspan="1" colspan="1">0.6</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td><td align="center" valign="middle" rowspan="1" colspan="1">0</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Unspecified</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">18</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1.6</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">13</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3.7</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1.6</td></tr></tbody></table><table-wrap-foot><fn><p>MERS-CoV: Middle East respiratory syndrome coronavirus. * Direct and indirect contact not mutually exclusive—cases may have had both direct and indirect contact with dromedaries.</p></fn></table-wrap-foot></table-wrap><table-wrap id="viruses-10-00425-t003" orientation="portrait" position="float"><object-id pub-id-type="pii">viruses-10-00425-t003_Table 3</object-id><label>Table 3</label><caption><p>Comparison of laboratory-confirmed primary (<italic>n</italic> = 348) and non-primary (<italic>n</italic> = 455) MERS-CoV cases reported to WHO between 1 January 2015 and 13 April 2018. Results are presented as frequencies (%), unless otherwise stated</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="2" align="left" valign="middle" style="border-top:solid thin;border-bottom:solid thin">Characteristics</th><th colspan="2" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1">Primary Cases<break></break>(<italic>n</italic> = 348) </th><th colspan="2" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1">Non-Primary Cases<break></break>(<italic>n</italic> = 455)</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1"></th></tr><tr><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><italic>n</italic></th><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">%</th><th align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><italic>p</italic> Value</th></tr></thead><tbody><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Age</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Mean (years)</td><td colspan="2" align="center" valign="middle" rowspan="1">57.7</td><td colspan="2" align="center" valign="middle" rowspan="1">53.4</td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Sex</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Male</td><td align="center" valign="middle" rowspan="1" colspan="1">301</td><td align="center" valign="middle" rowspan="1" colspan="1">86.5</td><td align="center" valign="middle" rowspan="1" colspan="1">284</td><td align="center" valign="middle" rowspan="1" colspan="1">62.4</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Female</td><td align="center" valign="middle" rowspan="1" colspan="1">45</td><td align="center" valign="middle" rowspan="1" colspan="1">12.9</td><td align="center" valign="middle" rowspan="1" colspan="1">171</td><td align="center" valign="middle" rowspan="1" colspan="1">37.6</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Outcome</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1">0.08</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Survived</td><td align="center" valign="middle" rowspan="1" colspan="1">79</td><td align="center" valign="middle" rowspan="1" colspan="1">22.7</td><td align="center" valign="middle" rowspan="1" colspan="1">109</td><td align="center" valign="middle" rowspan="1" colspan="1">24.0</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Died</td><td align="center" valign="middle" rowspan="1" colspan="1">151</td><td align="center" valign="middle" rowspan="1" colspan="1">43.4</td><td align="center" valign="middle" rowspan="1" colspan="1">149</td><td align="center" valign="middle" rowspan="1" colspan="1">32.8</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1"><bold>Exposures</bold></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1">Any contact with dromedaries</td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td colspan="2" align="center" valign="middle" rowspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Yes</td><td align="center" valign="middle" rowspan="1" colspan="1">191</td><td align="center" valign="middle" rowspan="1" colspan="1">54.9</td><td align="center" valign="middle" rowspan="1" colspan="1">5</td><td align="center" valign="middle" rowspan="1" colspan="1">1.1</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">No</td><td align="center" valign="middle" rowspan="1" colspan="1">62</td><td align="center" valign="middle" rowspan="1" colspan="1">17.8</td><td align="center" valign="middle" rowspan="1" colspan="1">162</td><td align="center" valign="middle" rowspan="1" colspan="1">35.6</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1">Direct contact with dromedaries *</td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Yes</td><td align="center" valign="middle" rowspan="1" colspan="1">164</td><td align="center" valign="middle" rowspan="1" colspan="1">47.1</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.7</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="left" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">No</td><td align="center" valign="middle" rowspan="1" colspan="1">68</td><td align="center" valign="middle" rowspan="1" colspan="1">19.5</td><td align="center" valign="middle" rowspan="1" colspan="1">162</td><td align="center" valign="middle" rowspan="1" colspan="1">35.6</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td colspan="2" align="left" valign="middle" rowspan="1">Indirect contact with dromedaries *</td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="center" valign="middle" rowspan="1" colspan="1"><0.001</td></tr><tr><td align="center" valign="middle" rowspan="1" colspan="1"></td><td align="left" valign="middle" rowspan="1" colspan="1">Yes </td><td align="center" valign="middle" rowspan="1" colspan="1">155</td><td align="center" valign="middle" rowspan="1" colspan="1">44.5</td><td align="center" valign="middle" rowspan="1" colspan="1">3</td><td align="center" valign="middle" rowspan="1" colspan="1">0.7</td><td align="center" valign="middle" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">No</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">73</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">21.0</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">152</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">33.4</td><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td></tr></tbody></table><table-wrap-foot><fn><p>MERS-CoV: Middle East respiratory syndrome coronavirus. Primary case = cases with laboratory confirmation of MERS-CoV infection with no direct epidemiological link to a (confirmed or probable) human MERS case; non-primary case = cases with laboratory confirmation of MERS-CoV infection and with a direct epidemiological link to a (confirmed or probable) human MERS case; * Direct and indirect contact not mutually exclusive—cases may have had both direct and indirect contact with dromedaries.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Allemagne</li><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><noCountry><name sortKey="Ben Embarek, Peter K" sort="Ben Embarek, Peter K" uniqKey="Ben Embarek P" first="Peter K." last="Ben Embarek">Peter K. Ben Embarek</name><name sortKey="Elhakim, Mohamed" sort="Elhakim, Mohamed" uniqKey="Elhakim M" first="Mohamed" last="Elhakim">Mohamed Elhakim</name><name sortKey="Elkholy, Amgad" sort="Elkholy, Amgad" uniqKey="Elkholy A" first="Amgad" last="Elkholy">Amgad Elkholy</name><name sortKey="Malik, Mamunur Rahman" sort="Malik, Mamunur Rahman" uniqKey="Malik M" first="Mamunur Rahman" last="Malik">Mamunur Rahman Malik</name><name sortKey="Samhouri, Dalia" sort="Samhouri, Dalia" uniqKey="Samhouri D" first="Dalia" last="Samhouri">Dalia Samhouri</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></noCountry><country name="Allemagne"><noRegion><name sortKey="Conzade, Romy" sort="Conzade, Romy" uniqKey="Conzade R" first="Romy" last="Conzade">Romy Conzade</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Grant, Rebecca" sort="Grant, Rebecca" uniqKey="Grant R" first="Rebecca" last="Grant">Rebecca Grant</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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