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State of Knowledge and Data Gaps of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Humans

Abstract : BACKGROUND: Between September 2012 and 22 October 2013, 144 laboratory-confirmed and 17 probable MERS-CoV cases from nine countries were notified to WHO. METHODS: We summarize what is known about the epidemiology, virology, phylogeny and emergence of MERS-CoV to inform public health policies. RESULTS: The median age of patients (n=161) was 50 years (range 14 months to 94 years), 64.5% were male and 63.4% experienced severe respiratory disease. 76.0% of patients were reported to have ≥1 underlying medical condition and fatal cases, compared to recovered or asymptomatic cases were more likely to have an underlying condition (86.8% vs. 42.4%, p<0.001). Analysis of genetic sequence data suggests multiple independent introductions into human populations and modelled estimates using epidemiologic and genetic data suggest R0 is <1, though the upper range of estimates may exceed 1. Index/sporadic cases (cases with no epidemiologic-link to other cases) were more likely to be older (median 59.0 years vs. 43.0 years, p<0.001) compared to secondary cases, although these proportions have declined over time. 80.9% vs. 67.2% of index/sporadic and secondary cases, respectively, reported ≥1 underlying condition. Clinical presentation ranges from asymptomatic to severe pneumonia with acute respiratory distress syndrome and multi-organ failure. Nearly all symptomatic patients presented with respiratory symptoms and 1/3 of patients also had gastrointestinal symptoms. CONCLUSIONS: Sustained human-to-human transmission of MERS-CoV has not been observed. Outbreaks have been extinguished without overly aggressive isolation and quarantine suggesting that transmission of virus may be stopped with implementation of appropriate infection control measures.
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Contributor : AbdelHakim Ben Hassine Connect in order to contact the contributor
Submitted on : Tuesday, February 19, 2019 - 2:22:39 PM
Last modification on : Wednesday, September 28, 2022 - 5:56:30 AM

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Who Mers-Cov Research Group, Afif Ben Salah, Arnaud Fontanet, Jean-Claude Manuguerra, Sylvie van Der Werf, et al.. State of Knowledge and Data Gaps of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Humans. PLoS Currents, 2013, ⟨10.1371/currents.outbreaks.0bf719e352e7478f8ad85fa30127ddb8⟩. ⟨pasteur-02024923⟩



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