Asymptomatic MERS-CoV Infection in Humans Possibly Linked to Infected Dromedaries Imported from Oman to United Arab Emirates, May 2015

Hammadi, Zulaikha M. Al; Chu, Daniel K.W.; Eltahir, Yassir Mohammed; Hosani, Farida Al; Mulla, Mariam Al; Tarnini, Wasim; Hall, Aron J.; Perera, Ranawaka A.P.M.; AbdelKhalek, Mohamed; Peiris, Malik; Muhairi, Salama Suhail Al; Poon, Leo L. M.

doi:10.3201/eid2112.151132

Cited by 70 publications

(84 citation statements)

References 11 publications

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“…In this study, we assume that latent period is equal to incubation. It has been noted elsewhere that asymptomatic MERS‐CoV infections are not rare; however, only three asymptomatic infections were detected among 16,752 close contacts during the ROK outbreak . As these asymptomatic cases do not cause further infections, we assume that all infected people are symptomatic and admitted to hospitals and then being confirmed ( C ).…”

Section: Methods and Modelsmentioning

confidence: 88%

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Estimating and modelling the transmissibility of Middle East Respiratory Syndrome CoronaVirus during the 2015 outbreak in the Republic of Korea

Zhang

Pebody

Charlett

et al. 2017

Influenza Resp Viruses

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BackgroundEmerging respiratory infections represent a significant public health threat. Because of their novelty, there are limited measures available to control their early spread. Learning from past outbreaks is important for future preparation. The Middle Eastern Respiratory Syndrome CoronaVirus (MERS‐CoV ) 2015 outbreak in the Republic of Korea (ROK) provides one such opportunity.ObjectivesWe demonstrated through quantitative methodologies how to estimate MERS‐CoV's transmissibility and identified the effective countermeasures that stopped its spread.MethodsUsing the outbreak data, statistical methods were employed to estimate the basic reproductive number R 0, the average number of secondary cases produced by a typical primary case during its entire infectious period in a fully susceptible population. A transmission dynamics model was also proposed to estimate R 0 and to identify the most effective countermeasures. The consistency between results will provide cross‐validation of the approaches.Results R 0 ranged from 2.5 with 95% confidence interval (CI): [1.7, 3.1] (using the sequential Bayesian method) to 7.2 with 95% CI: [5.3, 9.4] (using the Nowcasting method). Estimates from transmission model were higher but overlapped with these. Personal protection and rapid confirmation of cases were identified as the most important countermeasures.ConclusionsOur estimates were in agreement with others from the ROK outbreak, albeit significantly higher than estimates based on other small outbreaks and sporadic cases of MERS‐CoV. The large‐scale outbreak in the ROK was jointly due to the high transmissibility in the healthcare‐associated setting and the Korean culture‐associated contact behaviour. Limiting such behaviour by rapidly identifying and isolating cases and avoiding high‐risk contacts effectively stopped further transmission.

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Section: Methods and Modelsmentioning

confidence: 88%

“…The ROK outbreak differed from the previous outbreaks in two ways: it was the largest outbreak outside of the Middle East so far and ended under the strong countermeasures . Analyses indicate that transmission appears to be amplified in healthcare setting .…”

Section: Discussionmentioning

confidence: 98%

Estimating and modelling the transmissibility of Middle East Respiratory Syndrome CoronaVirus during the 2015 outbreak in the Republic of Korea

Zhang

Pebody

Charlett

et al. 2017

Influenza Resp Viruses

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“…To date, secondary transmission has occasionally occurred between close contacts of individuals with laboratory-confirmed MERS-CoV in household settings. 33,34 However, secondary transmission in health-care facilities has repeatedly occurred in several countries and has, on occasion, resulted in large outbreaks (appendix p 5)-such as Jeddah, Saudi Arabia (2014), Seoul, South Korea (2015), and Riyadh, Saudi Arabia (2015, 2016, and 2018). In health-care settings, human-to-human transmission occurs between patients, between patients and healthcare workers, and from patients to visitors.…”

Section: Epidemiological Patterns Of Human Casesmentioning

confidence: 99%

Middle East respiratory syndrome

et al. 2020

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The Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonotic pathogen that was first identified in humans in Saudi Arabia and Jordan in 2012. Intermittent sporadic cases, community clusters, and nosocomial outbreaks of MERS-CoV continue to occur. Between April 2012 and December 2019, 2499 laboratory-confirmed cases of MERS-CoV infection, including 858 deaths (34·3% mortality) were reported from 27 countries to WHO, the majority of which were reported by Saudi Arabia (2106 cases, 780 deaths). Large outbreaks of human-to-human transmission have occurred, the largest in Riyadh and Jeddah in 2014 and in South Korea in 2015. MERS-CoV remains a high-threat pathogen identified by WHO as a priority pathogen because it causes severe disease that has a high mortality rate, epidemic potential, and no medical countermeasures. This Seminar provides an update on the current knowledge and perspectives on MERS epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features, management, infection control, development of new therapeutics and vaccines, and highlights unanswered questions and priorities for research, improved management, and prevention.

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“…Several studies show that, in the Middle East, humans are infected with MERS-CoV through direct or indirect contact with dromedary camels, indicating that dromedary camels are implicated as amplifying host of MERS-CoV and a strong potential source of zoonotic infection (Al Hammadi et al, 2015;Who Mers-Cov Research, 2013). Furthermore, MERS-CoV appears to be circulating outside the Middle East since the virus has been detected in dromedary camels in East, West, and North Africa (Reusken et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Characterization of novel monoclonal antibodies against the MERS-coronavirus spike protein and their application in species-independent antibody detection by competitive ELISA

Fukushi

Fukuma

Kurosu

et al. 2018

Journal of Virological Methods

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Since discovering the Middle East respiratory syndrome coronavirus (MERS-CoV) as a causative agent of severe respiratory illness in the Middle East in 2012, serological testing has been conducted to assess antibody responses in patients and to investigate the zoonotic reservoir of the virus. Although the virus neutralization test is the gold standard assay for MERS diagnosis and for investigating the zoonotic reservoir, it uses live virus and so must be performed in high containment laboratories. Competitive ELISA (cELISA), in which a labeled monoclonal antibody (MAb) competes with test serum antibodies for target epitopes, may be a suitable alternative because it detects antibodies in a species-independent manner. In this study, novel MAbs against the spike protein of MERS-CoV were produced and characterized. One of these MAbs was used to develop a cELISA. The cELISA detected MERS-CoV-specific antibodies in sera from MERS-CoV-infected rats and rabbits immunized with the spike protein of MERS-CoV. The MAb-based cELISA was validated using sera from Ethiopian dromedary camels. Relative to the neutralization test, the cELISA detected MERS-CoV-specific antibodies in 66 Ethiopian dromedary camels with a sensitivity and specificity of 98% and 100%, respectively. The cELISA and neutralization test results correlated well (Pearson's correlation coefficients=0.71-0.76, depending on the cELISA serum dilution). This cELISA may be useful for MERS epidemiological investigations on MERS-CoV infection.

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Asymptomatic MERS-CoV Infection in Humans Possibly Linked to Infected Dromedaries Imported from Oman to United Arab Emirates, May 2015

Cited by 70 publications

References 11 publications

Estimating and modelling the transmissibility of Middle East Respiratory Syndrome CoronaVirus during the 2015 outbreak in the Republic of Korea

Estimating and modelling the transmissibility of Middle East Respiratory Syndrome CoronaVirus during the 2015 outbreak in the Republic of Korea

Middle East respiratory syndrome

Characterization of novel monoclonal antibodies against the MERS-coronavirus spike protein and their application in species-independent antibody detection by competitive ELISA

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