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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Multiple introductions of MERS-CoV in a 2014 hospital outbreak in Riyadh, Saudi Arabia</title><author><name sortKey="Fagbo, S" sort="Fagbo, S" uniqKey="Fagbo S" first="S." last="Fagbo">S. Fagbo</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Skakni, L" sort="Skakni, L" uniqKey="Skakni L" first="L." last="Skakni">L. Skakni</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Chu, D K" sort="Chu, D K" uniqKey="Chu D" first="D. K." last="Chu">D. K. Chu</name><affiliation><nlm:aff id="aff0010">The University of Hong Kong, Hong Kong, China</nlm:aff></affiliation></author><author><name sortKey="Garbati, M" sort="Garbati, M" uniqKey="Garbati M" first="M." last="Garbati">M. Garbati</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Peiris, M" sort="Peiris, M" uniqKey="Peiris M" first="M." last="Peiris">M. Peiris</name><affiliation><nlm:aff id="aff0010">The University of Hong Kong, Hong Kong, China</nlm:aff></affiliation></author><author><name sortKey="Hakawi, A M" sort="Hakawi, A M" uniqKey="Hakawi A" first="A. M." last="Hakawi">A. M. Hakawi</name><affiliation><nlm:aff id="aff0015">KFMC, Riyadh, Saudi Arabia</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7128551</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128551</idno><idno type="RBID">PMC:7128551</idno><idno type="doi">10.1016/j.ijid.2016.02.080</idno><idno type="pmid">NONE</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000581</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000581</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Multiple introductions of MERS-CoV in a 2014 hospital outbreak in Riyadh, Saudi Arabia</title><author><name sortKey="Fagbo, S" sort="Fagbo, S" uniqKey="Fagbo S" first="S." last="Fagbo">S. Fagbo</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Skakni, L" sort="Skakni, L" uniqKey="Skakni L" first="L." last="Skakni">L. Skakni</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Chu, D K" sort="Chu, D K" uniqKey="Chu D" first="D. K." last="Chu">D. K. Chu</name><affiliation><nlm:aff id="aff0010">The University of Hong Kong, Hong Kong, China</nlm:aff></affiliation></author><author><name sortKey="Garbati, M" sort="Garbati, M" uniqKey="Garbati M" first="M." last="Garbati">M. Garbati</name><affiliation><nlm:aff id="aff0005">King Fahad Medical City, Riyadh, Saudi Arabia</nlm:aff></affiliation></author><author><name sortKey="Peiris, M" sort="Peiris, M" uniqKey="Peiris M" first="M." last="Peiris">M. Peiris</name><affiliation><nlm:aff id="aff0010">The University of Hong Kong, Hong Kong, China</nlm:aff></affiliation></author><author><name sortKey="Hakawi, A M" sort="Hakawi, A M" uniqKey="Hakawi A" first="A. M." last="Hakawi">A. M. Hakawi</name><affiliation><nlm:aff id="aff0015">KFMC, Riyadh, Saudi Arabia</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Infectious Diseases</title><idno type="ISSN">1201-9712</idno><idno type="eISSN">1878-3511</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader></TEI><pmc article-type="abstract"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Infect. Dis</journal-id><journal-title-group><journal-title>International Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1201-9712</issn><issn pub-type="epub">1878-3511</issn><publisher><publisher-name>Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7128551</article-id><article-id pub-id-type="publisher-id">S1201-9712(16)30059-5</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2016.02.080</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Multiple introductions of MERS-CoV in a 2014 hospital outbreak in Riyadh, Saudi Arabia</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Fagbo</surname><given-names>S.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Skakni</surname><given-names>L.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Chu</surname><given-names>D.K.</given-names></name><xref rid="aff0010" ref-type="aff">2</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Garbati</surname><given-names>M.</given-names></name><xref rid="aff0005" ref-type="aff">1</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Peiris</surname><given-names>M.</given-names></name><xref rid="aff0010" ref-type="aff">2</xref></contrib><contrib contrib-type="author" id="aut0030"><name><surname>Hakawi</surname><given-names>A.M.</given-names></name><xref rid="aff0015" ref-type="aff">3</xref></contrib></contrib-group><aff id="aff0005"><label>1</label>King Fahad Medical City, Riyadh, Saudi Arabia</aff><aff id="aff0010"><label>2</label>The University of Hong Kong, Hong Kong, China</aff><aff id="aff0015"><label>3</label>KFMC, Riyadh, Saudi Arabia</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author.</corresp></author-notes><pub-date pub-type="pmc-release"><day>29</day><month>3</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>4</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>29</day><month>3</month><year>2016</year></pub-date><volume>45</volume><fpage>21</fpage><lpage>21</lpage><permissions><copyright-statement>Copyright © 2016 Published by Elsevier Ltd.</copyright-statement><copyright-year>2016</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions></article-meta></front><body><p id="par0005"><bold>Background</bold>: In 2012, the Middle East respiratory syndrome (MERS), a zoonotic disease caused by the MERS Coronavirus (MERS-CoV) emerged in Saudi Arabia as a disease with global health implications. Though much of its transmission dynamics remain unclarified, most cases (over 1250) have occurred in Saudi Arabia with substantial contribution from hospital outbreaks. This molecular epidemiological study investigated a MERS outbreak at the King Fahad Medical City (KFMC), a 1,200-bed tertiary care hospital in Riyadh that occurred between March 29 and May 21, 2014.</p><p id="par0010"><bold>Methods & Materials</bold>: Following MOH guidelines, respiratory specimens (nasopharyngeal swab, tracheal aspirate or bronchoalveolar lavage) from persons including health care workers (HCWs) suspected to have MERS-CoV infection were tested using a reverse transcription PCR targeting the Orf1a and upstream E-gene (upE). In parallel, these samples were tested for 15 other respiratory viruses using a Multiplex PCR platform. Epidemiologic data were extracted from electronic health records, sick leave records of HCWs and direct interviews. Stored remnants of PCR positive samples were retrieved and sent to The University of Hong Kong where overlapping PCR products generated from multiple sets of PCR on synthesized cDNA were used to sequenced the entire MERS-CoV genome with >3–5 times genome coverage. BEAST (version 1.8) was used for phylogenetic analysis.</p><p id="par0015"><bold>Results</bold>: 45 MERS-CoV infected persons were documented during this period: 23 HCWs; 13 long stay in-patients; and 8 patients infected outside KFMC. The source of infection for 1 person was inconclusive. Comparison of retrieved full-length MERS-CoV sequences from 10 patients and a partial sequence from another with other publicly available MERS-CoV sequences revealed that this outbreak was part of a larger outbreak that involved several hospitals in Riyadh. The larger outbreak seemed to have originated from a zoonotic transmission event around December 2013 (95% highest posterior density interval November 8, 2013–February 10, 2014) thus indicative of probable sustained human-to-human spread over a 5-month period.</p><p id="par0020"><bold>Conclusion</bold>: Using whole genome sequencing, we demonstrated multiple introductions of MERS-CoV in a hospital outbreak that was hitherto thought to be otherwise.</p></body></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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