Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017

Bernard-Stoecklin, Sibylle; Nikolay, Birgit; Assiri, Abdullah M.; Saeed, Abdul Aziz Bin; Embarek, Peter Karim Ben; Bushra, H. E. El; Ki, Moran; Malik, Mamunur Rahman; Fontanet, Arnaud; Cauchemez, Simon; Kerkhove, Maria D. Van

doi:10.1038/s41598-019-43586-9

Cited by 42 publications

(38 citation statements)

References 44 publications

(57 reference statements)

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“…However, patients with worsening conditions should seek prompt medical attention following a monitor of their health status for 14 days after the exposure event 41,42 . Secondly, our analysis reveals that relatively large tertiary hospitals have higher rates of MERS transmission than small community hospitals, because, in addition to poor disease control facilities, they typically have large numbers of patients and visitors who are engaged in doctor shopping 43,44 . Therefore, it is necessary to put effective quarantine and adequate facility ventilation on the agenda.…”

Section: Discussionmentioning

confidence: 93%

Topological dynamics of the 2015 South Korea MERS-CoV spread-on-contact networks

Yang

Jung

2020

Sci Rep

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network analysis to examine infectious contact relations provides an important means to uncover the topologies of individual infectious contact networks. this study aims to investigate the spread of diseases among individuals over contact networks by exploring the 2015 Middle East Respiratory Syndrome (MeRS) outbreak in Korea. We present several distinct features of MeRS transmission by employing a comprehensive approach in network research to examine both the traced relationship matrix of infected individuals and their bipartite transmission routes among healthcare facilities visited for treatment. the results indicate that a few super-spreaders were more likely to hold certain structural advantages by linking to an exceptional number of other individuals, causing several ongoing transmission events in neighbourhoods without the aid of any intermediary. thus, the infectious contact network exhibited small-world dynamics characterised by locally clustered contacts exposed to transmission paths via short path lengths. in addition, nosocomial infection analysis shows the pattern of a common-source outbreak followed by secondary person-to-person transmission of the disease. Based on the results, we suggest policy implications related to the redesign of prevention and control strategies against the spread of epidemics. open Scientific RepoRtS | (2020) 10:4327 | https://doi.

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Section: Discussionmentioning

confidence: 93%

Topological dynamics of the 2015 South Korea MERS-CoV spread-on-contact networks

Yang

Jung

2020

Sci Rep

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“…PCR detection and serology testing are vital components to outbreak management and epidemiological tracking, by showing infection patterns and identifying potential risk factors, which can be used by health policy makers or for disease tracking during future outbreaks. However, concerns have been raised regarding the lack of standardization of sample collection, analysis, and data availability post-outbreak, which contribute to the previously discussed information gap in MERS epidemiological analyses [29].…”

Section: Clinical Manifestations and Diagnosis Of Mers-covmentioning

confidence: 99%

“…Lack of availability of samples and tests as previously described has led to a serious lack of information surrounding MERS-CoV pathogenesis, which is crucial to improving healthcare practices during an outbreak. This gap in information due to differences in testing, sample collection, and lack of standardization of collection between countries further contributes to the problem [29].…”

Section: Mers-cov Pathogenesis and Clinical Manifestationsmentioning

confidence: 99%

“…With a combination of hospital and community outbreaks, many have suggested that stronger implementation of proper decontamination procedures could reduce outbreak severity and length [8,42]. It has been suggested that overcrowding, and slow isolation of patients in addition to these factors may have played a role in healthcare-associated outbreaks of MERS [29].…”

Section: Introduction To the 2013 Saudi Arabian And 2015 South Koreanmentioning

confidence: 99%

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A Comparative Analysis of Factors Influencing Two Outbreaks of Middle Eastern Respiratory Syndrome (MERS) in Saudi Arabia and South Korea

Willman

Kobasa

Kindrachuk

2019

Viruses

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In 2012, an emerging viral infection was identified in Saudi Arabia that subsequently spread to 27 additional countries globally, though cases may have occurred elsewhere. The virus was ultimately named Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), and has been endemic in Saudi Arabia since 2012. As of September 2019, 2468 laboratory-confirmed cases with 851 associated deaths have occurred with a case fatality rate of 34.4%, according to the World Health Organization. An imported case of MERS occurred in South Korea in 2015, stimulating a multi-month outbreak. Several distinguishing factors emerge upon epidemiological and sociological analysis of the two outbreaks including public awareness of the MERS outbreak, and transmission and synchronization of governing healthcare bodies. South Korea implemented a stringent healthcare model that protected patients and healthcare workers alike through prevention and high levels of public information. In addition, many details about MERS-CoV virology, transmission, pathological progression, and even the reservoir, remain unknown. This paper aims to delineate the key differences between the two regional outbreaks from both a healthcare and personal perspective including differing hospital practices, information and public knowledge, cultural practices, and reservoirs, among others. Further details about differing emergency outbreak responses, public information, and guidelines put in place to protect hospitals and citizens could improve the outcome of future MERS outbreaks.

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“…Diagnosed cases of MERS-CoV in countries outside the Arabian Peninsula are primarily traveler associated. The potential for global spread of MERS-CoV was realized in 2015 when a single traveler returning to South Korea initiated an outbreak that infected 186 people resulting in 20% fatality and caused widespread fear that crippled the economy for nearly 6 months [2][3][4]. Human-to-human transmission is often associated with close contact in the health care setting, but can also occur between family members within a household [5].…”

Section: Introductionmentioning

confidence: 99%

Genetically Engineering a Susceptible Mouse Model for MERS-CoV-Induced Acute Respiratory Distress Syndrome

Leist

Cockrell

2019

Methods in Molecular Biology

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Since 2012, monthly cases of Middle East respiratory syndrome coronavirus (MERS-CoV) continue to cause severe respiratory disease that is fatal in~35% of diagnosed individuals. The ongoing threat to global public health and the need for novel therapeutic countermeasures have driven the development of animal models that can reproducibly replicate the pathology associated with MERS-CoV in human infections. The inability of MERS-CoV to replicate in the respiratory tracts of mice, hamsters, and ferrets stymied initial attempts to generate small animal models. Identification of human dipeptidyl peptidase IV (hDPP4) as the receptor for MERS-CoV infection opened the door for genetic engineering of mice. Precise molecular engineering of mouse DPP4 (mDPP4) with clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 technology maintained inherent expression profiles, and limited MERS-CoV susceptibility to tissues that naturally express mDPP4, notably the lower respiratory tract wherein MERS-CoV elicits severe pulmonary pathology. Here, we describe the generation of the 288-330 +/+ MERS-CoV mouse model in which mice were made susceptible to MERS-CoV by modifying two amino acids on mDPP4 (A288 and T330), and the use of adaptive evolution to generate novel MERS-CoV isolates that cause fatal respiratory disease. The 288-330 +/+ mice are currently being used to evaluate novel drug, antibody, and vaccine therapeutic countermeasures for MERS-CoV. The chapter starts with a historical perspective on the emergence of MERS-CoV and animal models evaluated for MERS-CoV pathogenesis, and then outlines the development of the 288-330 +/+ mouse model, assays for assessing a MERS-CoV pulmonary infection in a mouse model, and describes some of the challenges associated with using genetically engineered mice.

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Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017

Cited by 42 publications

References 44 publications

Topological dynamics of the 2015 South Korea MERS-CoV spread-on-contact networks

Topological dynamics of the 2015 South Korea MERS-CoV spread-on-contact networks

A Comparative Analysis of Factors Influencing Two Outbreaks of Middle Eastern Respiratory Syndrome (MERS) in Saudi Arabia and South Korea

Genetically Engineering a Susceptible Mouse Model for MERS-CoV-Induced Acute Respiratory Distress Syndrome

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