The global spread of Middle East respiratory syndrome: an analysis fusing traditional epidemiological tracing and molecular phylodynamics
Identifieur interne : 000979 ( Pmc/Checkpoint ); précédent : 000978; suivant : 000980The global spread of Middle East respiratory syndrome: an analysis fusing traditional epidemiological tracing and molecular phylodynamics
Auteurs : Jae Min [États-Unis] ; Eleonora Cella [Italie, États-Unis] ; Massimo Ciccozzi [Italie] ; Antonello Pelosi [Italie] ; Marco Salemi [États-Unis] ; Mattia Prosperi [États-Unis]Source :
- Global Health Research and Policy [ 2397-0642 ] ; 2016.
Abstract
Since its discovery in 2012, over 1700 confirmed cases of Middle East Respiratory Syndrome (MERS) have been documented worldwide and more than a third of those cases have died. While the greatest number of cases has occurred in Saudi Arabia, the recent export of MERS-coronavirus (MERS-CoV) to Republic of Korea showed that a pandemic is a possibility that cannot be ignored. Due to the deficit of knowledge in transmission methodology, targeted treatment and possible vaccines, understanding this virus should be a priority. Our aim was to combine epidemiological data from literature with genetic information from viruses sequenced around the world to present a phylodynamic picture of MERS spread molecular level to global scale.
We performed a qualitative meta-analysis of all laboratory confirmed cases worldwide to date based on literature, with emphasis on international transmission and healthcare associated infections. In parallel, we used publicly available MERS-CoV genomes from GenBank to create a phylogeographic tree, detailing geospatial timeline of viral evolution.
Several healthcare associated outbreaks starting with the retrospectively identified hospital outbreak in Jordan to the most recent outbreak in Riyadh, Saudi Arabia have occurred. MERS has also crossed many oceans, entering multiple nations in eight waves between 2012 and 2015. In this paper, the spatiotemporal history of MERS cases, as documented epidemiologically, was examined by Bayesian phylogenetic analysis. Distribution of sequences into geographic clusters and interleaving of MERS-CoV sequences from camels among those isolated from humans indicated that multiple zoonotic introductions occurred in endemic nations. We also report a summary of basic reproduction numbers for MERS-CoV in humans and camels.
Together, these analyses can help us identify factors associated with viral evolution and spread as well as establish efficacy of infection control measures. The results are especially pertinent to countries without current MERS-CoV endemic, since their unfamiliarity makes them particularly susceptible to uncontrollable spread of a virus that may be imported by travelers.
The online version of this article (doi:10.1186/s41256-016-0014-7) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s41256-016-0014-7
PubMed: 29202063
PubMed Central: 5693564
Affiliations:
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PMC:5693564Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p id="Par1">Since its discovery in 2012, over 1700 confirmed cases of Middle East Respiratory Syndrome (MERS) have been documented worldwide and more than a third of those cases have died. While the greatest number of cases has occurred in Saudi Arabia, the recent export of MERS-coronavirus (MERS-CoV) to Republic of Korea showed that a pandemic is a possibility that cannot be ignored. Due to the deficit of knowledge in transmission methodology, targeted treatment and possible vaccines, understanding this virus should be a priority. Our aim was to combine epidemiological data from literature with genetic information from viruses sequenced around the world to present a phylodynamic picture of MERS spread molecular level to global scale.</p>
</sec>
<sec><title>Methods</title>
<p id="Par2">We performed a qualitative meta-analysis of all laboratory confirmed cases worldwide to date based on literature, with emphasis on international transmission and healthcare associated infections. In parallel, we used publicly available MERS-CoV genomes from GenBank to create a phylogeographic tree, detailing geospatial timeline of viral evolution.</p>
</sec>
<sec><title>Results</title>
<p id="Par3">Several healthcare associated outbreaks starting with the retrospectively identified hospital outbreak in Jordan to the most recent outbreak in Riyadh, Saudi Arabia have occurred. MERS has also crossed many oceans, entering multiple nations in eight waves between 2012 and 2015. In this paper, the spatiotemporal history of MERS cases, as documented epidemiologically, was examined by Bayesian phylogenetic analysis. Distribution of sequences into geographic clusters and interleaving of MERS-CoV sequences from camels among those isolated from humans indicated that multiple zoonotic introductions occurred in endemic nations. We also report a summary of basic reproduction numbers for MERS-CoV in humans and camels.</p>
</sec>
<sec><title>Conclusion</title>
<p id="Par4">Together, these analyses can help us identify factors associated with viral evolution and spread as well as establish efficacy of infection control measures. The results are especially pertinent to countries without current MERS-CoV endemic, since their unfamiliarity makes them particularly susceptible to uncontrollable spread of a virus that may be imported by travelers.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s41256-016-0014-7) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Glob Health Res Policy</journal-id>
<journal-id journal-id-type="iso-abbrev">Glob Health Res Policy</journal-id>
<journal-title-group><journal-title>Global Health Research and Policy</journal-title>
</journal-title-group>
<issn pub-type="epub">2397-0642</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">29202063</article-id>
<article-id pub-id-type="pmc">5693564</article-id>
<article-id pub-id-type="publisher-id">14</article-id>
<article-id pub-id-type="doi">10.1186/s41256-016-0014-7</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>The global spread of Middle East respiratory syndrome: an analysis fusing traditional epidemiological tracing and molecular phylodynamics</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-4112-9583</contrib-id>
<name><surname>Min</surname>
<given-names>Jae</given-names>
</name>
<address><email>jaemin@ufl.edu</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cella</surname>
<given-names>Eleonora</given-names>
</name>
<address><email>eleonora.cella@yahoo.it</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
<xref ref-type="aff" rid="Aff3">3</xref>
<xref ref-type="aff" rid="Aff4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ciccozzi</surname>
<given-names>Massimo</given-names>
</name>
<address><email>massimo.ciccozzi@iss.it</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
<xref ref-type="aff" rid="Aff5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pelosi</surname>
<given-names>Antonello</given-names>
</name>
<address><email>antonello.pelosi@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Salemi</surname>
<given-names>Marco</given-names>
</name>
<address><email>salemi@pathology.ufl.edu</email>
</address>
<xref ref-type="aff" rid="Aff4">4</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Prosperi</surname>
<given-names>Mattia</given-names>
</name>
<address><phone>1-352-273-5860</phone>
<email>m.prosperi@phhp.ufl.edu</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<aff id="Aff1"><label>1</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.15276.37</institution-id>
<institution-id institution-id-type="ISNI">0000000419368091</institution-id>
<institution>Department of Epidemiology,</institution>
<institution>College of Public Health & Health Professions and College of Medicine, University of Florida,</institution>
</institution-wrap>
2004 Mowry Rd, Gainesville, FL 32610-0231 USA</aff>
<aff id="Aff2"><label>2</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.416651.1</institution-id>
<institution-id institution-id-type="ISNI">0000000091206856</institution-id>
<institution>Department of Infectious, Parasitic and Immune-mediated Diseases,</institution>
<institution>National Institute of Health,</institution>
</institution-wrap>
Viale Regina Elena, 299, 00161 Rome, Italy</aff>
<aff id="Aff3"><label>3</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.7841.a</institution-id>
<institution>Department of Public Health and Infectious Diseases,</institution>
<institution>Sapienza University of Rome,</institution>
</institution-wrap>
Piazzale Aldo Moro, 5, 00185 Rome, Italy</aff>
<aff id="Aff4"><label>4</label>
<institution-wrap><institution-id institution-id-type="GRID">grid.15276.37</institution-id>
<institution-id institution-id-type="ISNI">0000000419368091</institution-id>
<institution>Department of Pathology, Immunology and Laboratory Medicine,</institution>
<institution>Emerging Pathogens Institute, University of Florida,</institution>
</institution-wrap>
2055 Mowry Rd, Gainesville, FL 32611 USA</aff>
<aff id="Aff5"><label>5</label>
Department of Clinical Pathology and Microbiology Laboratory, University of Biomedical Campus, Via Alvaro del Portillo, 21, Rome, Italy</aff>
</contrib-group>
<pub-date pub-type="epub"><day>28</day>
<month>9</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>28</day>
<month>9</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>1</volume>
<elocation-id>14</elocation-id>
<history><date date-type="received"><day>14</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>14</day>
<month>9</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2016</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International 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>
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<abstract id="Abs1"><sec><title>Background</title>
<p id="Par1">Since its discovery in 2012, over 1700 confirmed cases of Middle East Respiratory Syndrome (MERS) have been documented worldwide and more than a third of those cases have died. While the greatest number of cases has occurred in Saudi Arabia, the recent export of MERS-coronavirus (MERS-CoV) to Republic of Korea showed that a pandemic is a possibility that cannot be ignored. Due to the deficit of knowledge in transmission methodology, targeted treatment and possible vaccines, understanding this virus should be a priority. Our aim was to combine epidemiological data from literature with genetic information from viruses sequenced around the world to present a phylodynamic picture of MERS spread molecular level to global scale.</p>
</sec>
<sec><title>Methods</title>
<p id="Par2">We performed a qualitative meta-analysis of all laboratory confirmed cases worldwide to date based on literature, with emphasis on international transmission and healthcare associated infections. In parallel, we used publicly available MERS-CoV genomes from GenBank to create a phylogeographic tree, detailing geospatial timeline of viral evolution.</p>
</sec>
<sec><title>Results</title>
<p id="Par3">Several healthcare associated outbreaks starting with the retrospectively identified hospital outbreak in Jordan to the most recent outbreak in Riyadh, Saudi Arabia have occurred. MERS has also crossed many oceans, entering multiple nations in eight waves between 2012 and 2015. In this paper, the spatiotemporal history of MERS cases, as documented epidemiologically, was examined by Bayesian phylogenetic analysis. Distribution of sequences into geographic clusters and interleaving of MERS-CoV sequences from camels among those isolated from humans indicated that multiple zoonotic introductions occurred in endemic nations. We also report a summary of basic reproduction numbers for MERS-CoV in humans and camels.</p>
</sec>
<sec><title>Conclusion</title>
<p id="Par4">Together, these analyses can help us identify factors associated with viral evolution and spread as well as establish efficacy of infection control measures. The results are especially pertinent to countries without current MERS-CoV endemic, since their unfamiliarity makes them particularly susceptible to uncontrollable spread of a virus that may be imported by travelers.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s41256-016-0014-7) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Middle East Respiratory Syndrome</kwd>
<kwd>Coronavirus</kwd>
<kwd>Epidemiology</kwd>
<kwd>Phylodynamics</kwd>
</kwd-group>
<funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100007601</institution-id>
<institution>Horizon 2020</institution>
</institution-wrap>
</funding-source>
<award-id>634650</award-id>
<principal-award-recipient><name><surname>Prosperi</surname>
<given-names>Mattia</given-names>
</name>
</principal-award-recipient>
</award-group>
</funding-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2016</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Italie</li>
<li>États-Unis</li>
</country>
<region><li>Floride</li>
<li>Latium</li>
</region>
<settlement><li>Rome</li>
</settlement>
</list>
<tree><country name="États-Unis"><region name="Floride"><name sortKey="Min, Jae" sort="Min, Jae" uniqKey="Min J" first="Jae" last="Min">Jae Min</name>
</region>
<name sortKey="Cella, Eleonora" sort="Cella, Eleonora" uniqKey="Cella E" first="Eleonora" last="Cella">Eleonora Cella</name>
<name sortKey="Prosperi, Mattia" sort="Prosperi, Mattia" uniqKey="Prosperi M" first="Mattia" last="Prosperi">Mattia Prosperi</name>
<name sortKey="Salemi, Marco" sort="Salemi, Marco" uniqKey="Salemi M" first="Marco" last="Salemi">Marco Salemi</name>
</country>
<country name="Italie"><region name="Latium"><name sortKey="Cella, Eleonora" sort="Cella, Eleonora" uniqKey="Cella E" first="Eleonora" last="Cella">Eleonora Cella</name>
</region>
<name sortKey="Cella, Eleonora" sort="Cella, Eleonora" uniqKey="Cella E" first="Eleonora" last="Cella">Eleonora Cella</name>
<name sortKey="Ciccozzi, Massimo" sort="Ciccozzi, Massimo" uniqKey="Ciccozzi M" first="Massimo" last="Ciccozzi">Massimo Ciccozzi</name>
<name sortKey="Ciccozzi, Massimo" sort="Ciccozzi, Massimo" uniqKey="Ciccozzi M" first="Massimo" last="Ciccozzi">Massimo Ciccozzi</name>
<name sortKey="Pelosi, Antonello" sort="Pelosi, Antonello" uniqKey="Pelosi A" first="Antonello" last="Pelosi">Antonello Pelosi</name>
</country>
</tree>
</affiliations>
</record>
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