Syndromic Surveillance System for MERS-CoV as New Early Warning and Identification Approach
Identifieur interne : 000646 ( Pmc/Corpus ); précédent : 000645; suivant : 000647Syndromic Surveillance System for MERS-CoV as New Early Warning and Identification Approach
Auteurs : Maryam Salamatbakhsh ; Kazhal Mobaraki ; Jamal AhmadzadehSource :
- Risk Management and Healthcare Policy [ 1179-1594 ] ; 2020.
Abstract
This commentary presents a novel outlook for public health authorities in the affected countries to detect and respond quickly to the emerging public health threats such as Middle East respiratory syndrome coronavirus (MERS-CoV). Implementing an innovative electronic surveillance system called syndromic surveillance system is essential for global health security.
Url:
DOI: 10.2147/RMHP.S239984
PubMed: 32104115
PubMed Central: 7008581
Links to Exploration step
PMC:7008581Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Syndromic Surveillance System for MERS-CoV as New Early Warning and Identification Approach</title><author><name sortKey="Salamatbakhsh, Maryam" sort="Salamatbakhsh, Maryam" uniqKey="Salamatbakhsh M" first="Maryam" last="Salamatbakhsh">Maryam Salamatbakhsh</name><affiliation><nlm:aff id="AFF0001"><institution>Critical Care Nursing, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></nlm:aff></affiliation></author><author><name sortKey="Mobaraki, Kazhal" sort="Mobaraki, Kazhal" uniqKey="Mobaraki K" first="Kazhal" last="Mobaraki">Kazhal Mobaraki</name><affiliation><nlm:aff id="AFF0002"><institution>Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></nlm:aff></affiliation></author><author><name sortKey="Ahmadzadeh, Jamal" sort="Ahmadzadeh, Jamal" uniqKey="Ahmadzadeh J" first="Jamal" last="Ahmadzadeh">Jamal Ahmadzadeh</name><affiliation><nlm:aff id="AFF0002"><institution>Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32104115</idno><idno type="pmc">7008581</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008581</idno><idno type="RBID">PMC:7008581</idno><idno type="doi">10.2147/RMHP.S239984</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000646</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000646</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Syndromic Surveillance System for MERS-CoV as New Early Warning and Identification Approach</title><author><name sortKey="Salamatbakhsh, Maryam" sort="Salamatbakhsh, Maryam" uniqKey="Salamatbakhsh M" first="Maryam" last="Salamatbakhsh">Maryam Salamatbakhsh</name><affiliation><nlm:aff id="AFF0001"><institution>Critical Care Nursing, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></nlm:aff></affiliation></author><author><name sortKey="Mobaraki, Kazhal" sort="Mobaraki, Kazhal" uniqKey="Mobaraki K" first="Kazhal" last="Mobaraki">Kazhal Mobaraki</name><affiliation><nlm:aff id="AFF0002"><institution>Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></nlm:aff></affiliation></author><author><name sortKey="Ahmadzadeh, Jamal" sort="Ahmadzadeh, Jamal" uniqKey="Ahmadzadeh J" first="Jamal" last="Ahmadzadeh">Jamal Ahmadzadeh</name><affiliation><nlm:aff id="AFF0002"><institution>Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></nlm:aff></affiliation></author></analytic><series><title level="j">Risk Management and Healthcare Policy</title><idno type="eISSN">1179-1594</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><p>This commentary presents a novel outlook for public health authorities in the affected countries to detect and respond quickly to the emerging public health threats such as Middle East respiratory syndrome coronavirus (MERS-CoV). Implementing an innovative electronic surveillance system called syndromic surveillance system is essential for global health security.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="article-commentary"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Risk Manag Healthc Policy</journal-id><journal-id journal-id-type="iso-abbrev">Risk Manag Healthc Policy</journal-id><journal-id journal-id-type="publisher-id">RMHP</journal-id><journal-id journal-id-type="pmc">rmhp</journal-id><journal-title-group><journal-title>Risk Management and Healthcare Policy</journal-title></journal-title-group><issn pub-type="epub">1179-1594</issn><publisher><publisher-name>Dove</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32104115</article-id><article-id pub-id-type="pmc">7008581</article-id><article-id pub-id-type="publisher-id">239984</article-id><article-id pub-id-type="doi">10.2147/RMHP.S239984</article-id><article-categories><subj-group subj-group-type="heading"><subject>Commentary</subject></subj-group></article-categories><title-group><article-title>Syndromic Surveillance System for MERS-CoV as New Early Warning and Identification Approach</article-title><alt-title alt-title-type="running-authors">Salamatbakhsh et al</alt-title><alt-title alt-title-type="running-title">Salamatbakhsh et al</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Salamatbakhsh</surname><given-names>Maryam</given-names></name><xref ref-type="aff" rid="AFF0001">1</xref></contrib><contrib contrib-type="author"><name><surname>Mobaraki</surname><given-names>Kazhal</given-names></name><xref ref-type="aff" rid="AFF0002">2</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0001-8170-0460</contrib-id><name><surname>Ahmadzadeh</surname><given-names>Jamal</given-names></name><xref ref-type="corresp" rid="AN0001"></xref><xref ref-type="aff" rid="AFF0002">2</xref></contrib><aff id="AFF0001"><label>1</label><institution>Critical Care Nursing, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></aff><aff id="AFF0002"><label>2</label><institution>Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences</institution>,<addr-line>Urmia</addr-line>,<country>Iran</country></aff></contrib-group><author-notes><corresp id="AN0001">Correspondence: Jamal Ahmadzadeh <institution>Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences</institution>, <addr-line>Resalat Street</addr-line>, <addr-line>Urmia</addr-line>, <country>Iran</country><phone>Tel +98-9143444924</phone><fax>Fax +98-4432240642</fax> Email ahmadzadeh.j@umsu.ac.ir</corresp></author-notes><pub-date pub-type="epub"><day>05</day><month>2</month><year>2020</year></pub-date><pub-date pub-type="collection"><year>2020</year></pub-date><volume>13</volume><fpage>93</fpage><lpage>95</lpage><history><date date-type="received"><day>25</day><month>11</month><year>2019</year></date><date date-type="accepted"><day>24</day><month>1</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 Salamatbakhsh et al.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Salamatbakhsh et al.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at <ext-link ext-link-type="uri" xlink:href="https://www.dovepress.com/terms.php">https://www.dovepress.com/terms.php</ext-link> and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (<ext-link ext-link-type="uri" xlink:href="https://www.dovepress.com/terms.php">https://www.dovepress.com/terms.php</ext-link>).</license-p></license></permissions><abstract><title>Abstract</title><p>This commentary presents a novel outlook for public health authorities in the affected countries to detect and respond quickly to the emerging public health threats such as Middle East respiratory syndrome coronavirus (MERS-CoV). Implementing an innovative electronic surveillance system called syndromic surveillance system is essential for global health security.</p></abstract><kwd-group kwd-group-type="author"><title>Keywords</title><kwd>syndromic surveillance system</kwd><kwd>traditional surveillance system</kwd><kwd>Middle East respiratory syndrome</kwd></kwd-group><counts><ref-count count="11"></ref-count><page-count count="3"></page-count></counts></article-meta></front><body><p>The global village in which we live has been transformed considerably in the past few decades due to epidemiological transition, changes in demography and the structure of people’s lives, the threat of bioterrorism, and altered incidence and prevalence of diseases.<xref rid="CIT0001" ref-type="bibr">1</xref>,<xref rid="CIT0002" ref-type="bibr">2</xref> In 2012, a novel virus not previously detected in humans was identified for the first time in Saudi Arabia.<xref rid="CIT0003" ref-type="bibr">3</xref> From 23.09.2017 to 26.07.2019, the virus, now known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV), infected more than 2454 people worldwide, leading to 848 MERS-CoV-associated deaths [global case fatality rate equal to 34.5%]. Typical MERS symptoms include cough, fever, and shortness of breath. Pneumonia is also common, but not always present and gastrointestinal symptoms, including diarrhea, have been reported. To date, 27 countries in the world have reported cases of MERS-CoV.<xref rid="CIT0004" ref-type="bibr">4</xref></p><p>The aforementioned problems have prompted the world health systems (especially health systems in the affected countries) to make changes in order to improve and promote the capability of their health systems. In the meantime, emerging infectious diseases such as MERS-CoV require surveillance systems providing an adequate lead time for optimal public health response.</p><p>Consequently, the affected countries should strengthen the traditional surveillance system, simultaneously implementing and initiating a new care system known as syndromic surveillance system to prevent, control, and minimize the complications and the burden associated with MERS-CoV.<xref rid="CIT0005" ref-type="bibr">5</xref>,<xref rid="CIT0006" ref-type="bibr">6</xref></p><p>In the traditional surveillance system, the diagnosis of a disease in patients will be determined after defining the disease, completing the forms for that health event and correcting them, and performing para-clinical tests for confirming the diagnosis (laboratory confirmation). Afterward, the patient’s data will be collected by surveillance methods such as active or passive measures, which are analyzed and eventually released. Despite the accuracy of these processes, they are complex and time-consuming. Only large epidemics will be recorded and reported in this type of surveillance system, and the incidents that can cause widespread epidemics at the border or inside a country require prompt detection and timely reporting. Otherwise, the health measures for controlling the spread of the disease can be postponed. Delayed reporting of events to obtain a definitive answer, which will be problematic in critical circumstances, can lead to the loss of time, shortage of reports, and reduced quality of the surveillance in the routine or traditional surveillance system in comparison to a modern syndromic surveillance (SS) system. The traditional surveillance system has not yet been fully electronic, which can lead to the loss of time. The quantitative decline in reports and management information (ie, information for action) could reduce the capacity of health policymakers to deal with national/international diseases. A solution to overcome this limitation is setting up and incorporating a syndromic surveillance system in affected countries alongside the traditional surveillance system.</p><p>In SS system, the care for health of the general population will be continuously achieved by special software as well as nationwide comprehensive telephone and computer network (web-based) systems. In other words, it is done according to a clear timetable (daily, weekly and monthly) as well as early signs and symptoms (syndromic-based) without attention to the diagnosis of the disease, which means surveillance of health-related data prior to diagnosis. The basis of the above-mentioned modern system is the chief complaint on behalf of patients and it even responds to rumors of events. The main purpose of SS system is early detection of community-based epidemics. In this novel system, when the number of affected cases exceeds the defined threshold (pre-diagnostic data), the computer system automatically alerts reference laboratories and reaction teams to initiate epidemiological activities to counter the outbreak. In this regard, it is important to note that the SS system is not a replacement for traditional surveillance system nor does it substitute for direct physician reporting of unusual or suspect cases of public health concern.<xref rid="CIT0007" ref-type="bibr">7</xref> Traditional surveillance system provides sufficient information to identify disease clusters, although it often operates with considerable delay. Thus, the syndromic surveillance system is only supportive and complementary for a traditional surveillance system (ie, integrated disease surveillance) and data from both traditional and syndromic systems can be used to improve prevention programs. Designing and implementing a SS system for MERS-CoV and even for other emerging infections in affected countries have the following benefits:
<list list-type="bullet"><list-item><p>Establishment of a rapid alert system to provide signals for scrutiny of public health authorities to detect early outbreaks related to MERS-CoV infection (timeliness).</p></list-item><list-item><p>Predicting the size, rate, severity, and pattern of the MERS epidemic.</p></list-item><list-item><p>The sensitivity, flexibility, simplicity, and generality of the syndromic surveillance system accelerate mass mobilization to counter the MERS-CoV outbreak.</p></list-item><list-item><p>Drawing different epidemiologic curves and identifying the patterns of MERS disease.</p></list-item><list-item><p>Timely and effective actions for bioterrorism attacks. The SS can function as an early warning system.</p></list-item><list-item><p>Identifying the clusters of signs and symptoms in order to initiate remedial measures to reduce complications and mortality related to MERS-CoV infection.</p></list-item></list></p><p>In summary, the incidence of a large number of MERS-CoV cases and high mortality rates 8 years after the onset of MERS-CoV epidemic (2012–2019) are critical to a global public health response. As can be found in our previously published articles,<xref rid="CIT0002" ref-type="bibr">2</xref>,<xref rid="CIT0003" ref-type="bibr">3</xref>,<xref rid="CIT0008" ref-type="bibr">8</xref>–<xref rid="CIT0011" ref-type="bibr">11</xref> the incidence of MERS-CoV has been on the rise in several Middle East countries, including Saudi Arabia, United Arab Emirates, Oman, Jordan, Iran, Kuwait, Egypt, Qatar, Yemen, Bahrain, and Lebanon. Concomitant with the increase in our knowledge about the clinical presentation and epidemiology of MERS-CoV, the need for a systematic and comprehensive novel approach such as syndromic surveillance system is felt to reinforce the current activities for prevention and control of MERS pandemic.</p><p>The incidence of MERS in the affected Middle East countries demands a useful approach for discovering new outbreaks of this disease as well as similar emerging infections because of the shortage of specialist staff. By implementing the SS system along with the existing surveillance systems, health authorities can accelerate global efforts for early detection of community-based epidemics such as MERS-CoV to reduce the transmission risk of the virus from an infected patient to others. We strongly suggest this system to local health authorities and policymakers in the affected countries, especially in Saudi Arabia as the epicenter of the disease with over 80% of MERS cases. To overcome this fatal infection, the authorities should provide information for action, consider educational programs about the syndromic surveillance system for their health-care workers and regularly refresh those skills. Perhaps a limitation in implementation of the modern SS system for MERS-CoV in affected Middle East countries is the higher cost and lack of efficiently trained human resources.</p></body><back><ack><title>Acknowledgments</title><p>The authors take this opportunity to thank all the WHO personnel as well as reporting countries with confirmed MERS cases for data collection and sending their data to WHO. This article on behalf of Jamal Ahmadzadeh is dedicated to Kazhal Mobaraki for her sincerity, honesty and endeavor in motivating me at any time to conduct the research. This article on behalf of Kazhal Mobaraki is dedicated to Jamal Ahmadzadeh for the care that he gave.</p></ack><sec id="S0002" sec-type="COI-statement"><title>Disclosure</title><p>The authors report no conflicts of interest in this work.</p></sec><ref-list><title>References</title><ref id="CIT0001"><label>1.</label><mixed-citation publication-type="journal"><string-name><surname>Mobaraki</surname><given-names>K</given-names></string-name>, <string-name><surname>Ahmadzadeh</surname><given-names>J</given-names></string-name>. <article-title>Current epidemiological status of Middle East respiratory syndrome coronavirus in the world from 1.1. 2017 to 17.1. 2018: a cross-sectional study</article-title>. <source><italic toggle="yes">BMC Infect Dis</italic></source>. <year>2019</year>;<volume>19</volume>(<issue>1</issue>):<fpage>351</fpage>. doi:<pub-id pub-id-type="doi">10.1186/s12879-019-3987-2</pub-id><pub-id pub-id-type="pmid">31029095</pub-id></mixed-citation></ref><ref id="CIT0002"><label>2.</label><mixed-citation publication-type="journal"><string-name><surname>Salamatbakhsh</surname><given-names>M</given-names></string-name>, <string-name><surname>Mobaraki</surname><given-names>K</given-names></string-name>, <string-name><surname>Sadeghimohammadi</surname><given-names>S</given-names></string-name>, <string-name><surname>Ahmadzadeh</surname><given-names>J</given-names></string-name>. <article-title>The global burden of premature mortality due to the Middle East respiratory syndrome (MERS) using standard expected years of life lost, 2012 to 2019</article-title>. <source><italic toggle="yes">BMC Public Health</italic></source>. <year>2019</year>;<volume>19</volume>(<issue>1</issue>):<fpage>1523</fpage>. doi:<pub-id pub-id-type="doi">10.1186/s12889-019-7899-2</pub-id><pub-id pub-id-type="pmid">31727042</pub-id></mixed-citation></ref><ref id="CIT0003"><label>3.</label><mixed-citation publication-type="journal"><string-name><surname>Ahmadzadeh</surname><given-names>J</given-names></string-name>, <string-name><surname>Mobaraki</surname><given-names>K</given-names></string-name>, <string-name><surname>Mousavi</surname><given-names>SJ</given-names></string-name>, <string-name><surname>Aghazadeh-Attari</surname><given-names>J</given-names></string-name>, <string-name><surname>Mirza-Aghazadeh-Attari</surname><given-names>M</given-names></string-name>, <string-name><surname>Mohebbi</surname><given-names>I</given-names></string-name>. <article-title>The risk factors associated with MERS-CoV patient fatality: A global survey</article-title>. <source><italic toggle="yes">Diagn Microbiol Infect Dis</italic></source>. <year>2019</year>;<fpage>114876</fpage>. doi:<pub-id pub-id-type="doi">10.1016/j.diagmicrobio.2019.114876</pub-id><pub-id pub-id-type="pmid">31959375</pub-id></mixed-citation></ref><ref id="CIT0004"><label>4.</label><mixed-citation publication-type="data"><collab>World Organization Health</collab>. <article-title>Middle East respiratory syndrome coronavirus (MERS-CoV)</article-title>. <comment>Available from</comment>: <ext-link ext-link-type="uri" xlink:href="http://www.who.int/emergencies/mers-cov/en/">http://www.who.int/emergencies/mers-cov/en/</ext-link>.</mixed-citation></ref><ref id="CIT0005"><label>5.</label><mixed-citation publication-type="book"><string-name><surname>Gordis</surname><given-names>L</given-names></string-name>. <source><italic toggle="yes">Surveillance. Epidemiology</italic></source>. <edition>4th ed</edition><publisher-loc>Saunders</publisher-loc>: <publisher-name>Philadelphia</publisher-name>; <year>2008</year>:<fpage>42</fpage>–<lpage>45</lpage>.</mixed-citation></ref><ref id="CIT0006"><label>6.</label><mixed-citation publication-type="journal"><string-name><surname>Van Den Wijngaard</surname><given-names>CC</given-names></string-name>, <string-name><surname>Van Asten</surname><given-names>L</given-names></string-name>, <string-name><surname>Van Pelt</surname><given-names>W</given-names></string-name>, et al. <article-title>Syndromic surveillance for local outbreaks of lower-respiratory infections: would it work?</article-title><source><italic toggle="yes">PLoS One</italic></source>. <year>2010</year>;<volume>5</volume>(<issue>4</issue>):<fpage>e10406</fpage>.<pub-id pub-id-type="pmid">20454449</pub-id></mixed-citation></ref><ref id="CIT0007"><label>7.</label><mixed-citation publication-type="journal"><string-name><surname>Henning</surname><given-names>KJ</given-names></string-name>. <article-title>What is syndromic surveillance</article-title>. <source><italic toggle="yes">Morb Mortal Wkly Rep</italic></source>. <year>2004</year>;<volume>53</volume>(<issue>Supplement</issue>):<fpage>7</fpage>–<lpage>11</lpage>.</mixed-citation></ref><ref id="CIT0008"><label>8.</label><mixed-citation publication-type="journal"><string-name><surname>Aghazadeh-Attari</surname><given-names>J</given-names></string-name>, <string-name><surname>Mohebbi</surname><given-names>I</given-names></string-name>, <string-name><surname>Mansorian</surname><given-names>B</given-names></string-name>, et al. <article-title>Epidemiological factors and worldwide pattern of Middle East respiratory syndrome coronavirus from 2013 to 2016</article-title>. <source><italic toggle="yes">Int J Gen Med</italic></source>. <year>2018</year>;<volume>11</volume>:<fpage>121</fpage>. doi:<pub-id pub-id-type="doi">10.2147/IJGM.S160741</pub-id><pub-id pub-id-type="pmid">29670390</pub-id></mixed-citation></ref><ref id="CIT0009"><label>9.</label><mixed-citation publication-type="journal"><string-name><surname>Ahmadzadeh</surname><given-names>J</given-names></string-name>, <string-name><surname>Mobaraki</surname><given-names>K</given-names></string-name>. <article-title>Epidemiological status of the Middle East respiratory syndrome coronavirus in 2019: an update from January 1 to March 31, 2019</article-title>. <source><italic toggle="yes">Int J Gen Med</italic></source>. <year>2019</year>;<volume>12</volume>:<fpage>305</fpage>. doi:<pub-id pub-id-type="doi">10.2147/IJGM.S215396</pub-id><pub-id pub-id-type="pmid">31692574</pub-id></mixed-citation></ref><ref id="CIT0010"><label>10.</label><mixed-citation publication-type="journal"><string-name><surname>Mobaraki</surname><given-names>K</given-names></string-name>, <string-name><surname>Ahmadzadeh</surname><given-names>J</given-names></string-name>. <article-title>An update to Middle East respiratory syndrome coronavirus and risk of a pandemic in 2019</article-title>. <source><italic toggle="yes">Clin Microbiol Infect Dis</italic></source>. <year>2019</year>;<volume>50</volume>(<issue>8</issue>):<page-range>42.1</page-range>.</mixed-citation></ref><ref id="CIT0011"><label>11.</label><mixed-citation publication-type="journal"><string-name><surname>Mobaraki</surname><given-names>K</given-names></string-name>, <string-name><surname>Salamatbakhsh</surname><given-names>M</given-names></string-name>, <string-name><surname>Ahmadzadeh</surname><given-names>J</given-names></string-name>. <article-title>Standard expected years of life lost as a neglected index for calculating the burden of premature mortality due to Middle East respiratory syndrome</article-title>. <source><italic toggle="yes">Health Secur</italic></source>. <year>2019</year>;<volume>17</volume>(<issue>5</issue>):<fpage>407</fpage>–<lpage>409</lpage>. doi:<pub-id pub-id-type="doi">10.1089/hs.2019.0074</pub-id><pub-id pub-id-type="pmid">31593510</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/MersV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000646 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000646 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= MersV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:7008581
|texte= Syndromic Surveillance System for MERS-CoV as New Early Warning and Identification Approach
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:32104115" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a MersV1
| This area was generated with Dilib version V0.6.33. |  |