A case-crossover analysis of the impact of weather on primary cases of Middle East respiratory syndrome
Identifieur interne : 000321 ( Pmc/Curation ); précédent : 000320; suivant : 000322A case-crossover analysis of the impact of weather on primary cases of Middle East respiratory syndrome
Auteurs : Emma G. Gardner ; David Kelton ; Zvonimir Poljak ; Maria Van Kerkhove [Suisse] ; Sophie Von Dobschuetz [Italie] ; Amy L. GreerSource :
- BMC Infectious Diseases [ 1471-2334 ] ; 2019.
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic in dromedary camels in the Arabian Peninsula, and zoonotic transmission to people is a sporadic event. In the absence of epidemiological data on the reservoir species, patterns of zoonotic transmission have largely been approximated from primary human cases. This study aimed to identify meteorological factors that may increase the risk of primary MERS infections in humans.
A case-crossover design was used to identify associations between primary MERS cases and preceding weather conditions within the 2-week incubation period in Saudi Arabia using univariable conditional logistic regression. Cases with symptom onset between January 2015 – December 2017 were obtained from a publicly available line list of human MERS cases maintained by the World Health Organization. The complete case dataset (
Lowest temperature (Odds Ratio = 1.27; 95% Confidence Interval = 1.04–1.56) and humidity (OR = 1.35; 95% CI = 1.10–1.65) were associated with increased cases 8–10 days later. High visibility was associated with an increased number of cases 7 days later (OR = 1.26; 95% CI = 1.01–1.57), while wind speed also showed statistically significant associations with cases 5–6 days later.
Results suggest that primary MERS human cases in Saudi Arabia are more likely to occur when conditions are relatively cold and dry. This is similar to seasonal patterns that have been described for other respiratory diseases in temperate climates. It was hypothesized that low visibility would be positively associated with primary cases of MERS, however the opposite relationship was seen. This may reflect behavioural changes in different weather conditions. This analysis provides key initial evidence of an environmental component contributing to the development of primary MERS-CoV infections.
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DOI: 10.1186/s12879-019-3729-5
PubMed: 30717685
PubMed Central: 6362578
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Emma G. Gardner<affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation>Le document en format XML
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Gardner</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Kelton, David" sort="Kelton, David" uniqKey="Kelton D" first="David" last="Kelton">David Kelton</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Poljak, Zvonimir" sort="Poljak, Zvonimir" uniqKey="Poljak Z" first="Zvonimir" last="Poljak">Zvonimir Poljak</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation></author><author><name sortKey="Van Kerkhove, Maria" sort="Van Kerkhove, Maria" uniqKey="Van Kerkhove M" first="Maria" last="Van Kerkhove">Maria Van Kerkhove</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000000121633745</institution-id><institution-id institution-id-type="GRID">grid.3575.4</institution-id><institution>World Health Organization,</institution></institution-wrap>Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Geneva</wicri:regionArea></affiliation></author><author><name sortKey="Von Dobschuetz, Sophie" sort="Von Dobschuetz, Sophie" uniqKey="Von Dobschuetz S" first="Sophie" last="Von Dobschuetz">Sophie Von Dobschuetz</name><affiliation wicri:level="1"><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="GRID">grid.420153.1</institution-id><institution-id institution-id-type="ISNI">0000 0004 1937 0300</institution-id><institution>Animal Health Service – FAO,</institution><institution>Viale delle Terme di Caracalla,</institution></institution-wrap>Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Rome</wicri:regionArea></affiliation></author><author><name sortKey="Greer, Amy L" sort="Greer, Amy L" uniqKey="Greer A" first="Amy L." last="Greer">Amy L. Greer</name><affiliation><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</nlm:aff><wicri:noCountry code="subfield">ON N1G 2W1 Canada</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic in dromedary camels in the Arabian Peninsula, and zoonotic transmission to people is a sporadic event. In the absence of epidemiological data on the reservoir species, patterns of zoonotic transmission have largely been approximated from primary human cases. This study aimed to identify meteorological factors that may increase the risk of primary MERS infections in humans.</p></sec><sec><title>Methods</title><p id="Par2">A case-crossover design was used to identify associations between primary MERS cases and preceding weather conditions within the 2-week incubation period in Saudi Arabia using univariable conditional logistic regression. Cases with symptom onset between January 2015 – December 2017 were obtained from a publicly available line list of human MERS cases maintained by the World Health Organization. The complete case dataset (<italic>N</italic> = 1191) was reduced to approximate the cases most likely to represent spillover transmission from camels (<italic>N</italic> = 446). Data from meteorological stations closest to the largest city in each province were used to calculate the daily mean, minimum, and maximum temperature (<sup>ο</sup>C), relative humidity (%), wind speed (m/s), and visibility (m). Weather variables were categorized according to strata; temperature and humidity into tertiles, and visibility and wind speed into halves.</p></sec><sec><title>Results</title><p id="Par3">Lowest temperature (Odds Ratio = 1.27; 95% Confidence Interval = 1.04–1.56) and humidity (OR = 1.35; 95% CI = 1.10–1.65) were associated with increased cases 8–10 days later. High visibility was associated with an increased number of cases 7 days later (OR = 1.26; 95% CI = 1.01–1.57), while wind speed also showed statistically significant associations with cases 5–6 days later.</p></sec><sec><title>Conclusions</title><p id="Par4">Results suggest that primary MERS human cases in Saudi Arabia are more likely to occur when conditions are relatively cold and dry. This is similar to seasonal patterns that have been described for other respiratory diseases in temperate climates. It was hypothesized that low visibility would be positively associated with primary cases of MERS, however the opposite relationship was seen. This may reflect behavioural changes in different weather conditions. This analysis provides key initial evidence of an environmental component contributing to the development of primary MERS-CoV infections.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name></author><author><name sortKey="Osterhaus, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name></author><author><name sortKey="Fouchier, Ram" uniqKey="Fouchier R">RAM Fouchier</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Muller, Ma" uniqKey="Muller M">MA Müller</name></author><author><name sortKey="Meyer, B" uniqKey="Meyer B">B Meyer</name></author><author><name sortKey="Corman, Vm" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id><journal-title-group><journal-title>BMC Infectious Diseases</journal-title></journal-title-group><issn pub-type="epub">1471-2334</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30717685</article-id><article-id pub-id-type="pmc">6362578</article-id><article-id pub-id-type="publisher-id">3729</article-id><article-id pub-id-type="doi">10.1186/s12879-019-3729-5</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>A case-crossover analysis of the impact of weather on primary cases of Middle East respiratory syndrome</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-5270-6916</contrib-id><name><surname>Gardner</surname><given-names>Emma G.</given-names></name><address><email>egardn01@uoguelph.ca</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kelton</surname><given-names>David</given-names></name><address><email>dkelton@uoguelph.ca</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Poljak</surname><given-names>Zvonimir</given-names></name><address><email>zpoljak@uoguelph.ca</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Van Kerkhove</surname><given-names>Maria</given-names></name><address><email>vankerkhovem@who.int</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>von Dobschuetz</surname><given-names>Sophie</given-names></name><address><email>sophie.vondobschuetz@fao.org</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Greer</surname><given-names>Amy L.</given-names></name><address><email>agreer@uoguelph.ca</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 1936 8198</institution-id><institution-id institution-id-type="GRID">grid.34429.38</institution-id><institution>Ontario Veterinary College,</institution><institution>University of Guelph,</institution></institution-wrap>50 Stone Road E, Guelph, ON N1G 2W1 Canada</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="ISNI">0000000121633745</institution-id><institution-id institution-id-type="GRID">grid.3575.4</institution-id><institution>World Health Organization,</institution></institution-wrap>Geneva, Switzerland</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="GRID">grid.420153.1</institution-id><institution-id institution-id-type="ISNI">0000 0004 1937 0300</institution-id><institution>Animal Health Service – FAO,</institution><institution>Viale delle Terme di Caracalla,</institution></institution-wrap>Rome, Italy</aff></contrib-group><pub-date pub-type="epub"><day>4</day><month>2</month><year>2019</year></pub-date><pub-date pub-type="pmc-release"><day>4</day><month>2</month><year>2019</year></pub-date><pub-date pub-type="collection"><year>2019</year></pub-date><volume>19</volume><elocation-id>113</elocation-id><history><date date-type="received"><day>9</day><month>7</month><year>2018</year></date><date date-type="accepted"><day>15</day><month>1</month><year>2019</year></date></history><permissions><copyright-statement>© The Author(s). 2019</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>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p id="Par1">Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic in dromedary camels in the Arabian Peninsula, and zoonotic transmission to people is a sporadic event. In the absence of epidemiological data on the reservoir species, patterns of zoonotic transmission have largely been approximated from primary human cases. This study aimed to identify meteorological factors that may increase the risk of primary MERS infections in humans.</p></sec><sec><title>Methods</title><p id="Par2">A case-crossover design was used to identify associations between primary MERS cases and preceding weather conditions within the 2-week incubation period in Saudi Arabia using univariable conditional logistic regression. Cases with symptom onset between January 2015 – December 2017 were obtained from a publicly available line list of human MERS cases maintained by the World Health Organization. The complete case dataset (<italic>N</italic> = 1191) was reduced to approximate the cases most likely to represent spillover transmission from camels (<italic>N</italic> = 446). Data from meteorological stations closest to the largest city in each province were used to calculate the daily mean, minimum, and maximum temperature (<sup>ο</sup>C), relative humidity (%), wind speed (m/s), and visibility (m). Weather variables were categorized according to strata; temperature and humidity into tertiles, and visibility and wind speed into halves.</p></sec><sec><title>Results</title><p id="Par3">Lowest temperature (Odds Ratio = 1.27; 95% Confidence Interval = 1.04–1.56) and humidity (OR = 1.35; 95% CI = 1.10–1.65) were associated with increased cases 8–10 days later. High visibility was associated with an increased number of cases 7 days later (OR = 1.26; 95% CI = 1.01–1.57), while wind speed also showed statistically significant associations with cases 5–6 days later.</p></sec><sec><title>Conclusions</title><p id="Par4">Results suggest that primary MERS human cases in Saudi Arabia are more likely to occur when conditions are relatively cold and dry. This is similar to seasonal patterns that have been described for other respiratory diseases in temperate climates. It was hypothesized that low visibility would be positively associated with primary cases of MERS, however the opposite relationship was seen. This may reflect behavioural changes in different weather conditions. This analysis provides key initial evidence of an environmental component contributing to the development of primary MERS-CoV infections.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Middle East respiratory syndrome</kwd><kwd>MERS-CoV</kwd><kwd>Case-crossover</kwd><kwd>Veterinary public health</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100002790</institution-id><institution>Canadian Network for Research and Innovation in Machining Technology, Natural Sciences and Engineering Research Council of Canada</institution></institution-wrap></funding-source><award-id>PGSD2 - 505055 – 2017</award-id></award-group></funding-group><funding-group><award-group><funding-source><institution>Ontario Veterinary College Fellowship</institution></funding-source></award-group></funding-group><funding-group><award-group><funding-source><institution-wrap><institution-id institution-id-type="FundRef">http://dx.doi.org/10.13039/501100001804</institution-id><institution>Canada Research Chairs</institution></institution-wrap></funding-source></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2019</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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