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Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015.

- Osong Public Health Res Perspect (2015)

Bottom Line: Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90-12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64-14.65) were significantly associated with mortality.Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

View Article: PubMed Central - PubMed

ABSTRACT

Objectives: The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015.

Methods: Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient.

Results: A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incubation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90-12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64-14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.

Conclusion: A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

No MeSH data available.


Related in: MedlinePlus

Serial interval of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in the Republic of Korea, 2015. Panel A shows the density estimation of serial intervals using gamma distribution. Panel B shows the empirical cumulative density estimation of serial intervals.
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fig3: Serial interval of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in the Republic of Korea, 2015. Panel A shows the density estimation of serial intervals using gamma distribution. Panel B shows the empirical cumulative density estimation of serial intervals.

Mentions: The incubation period of confirmed cases was 6.83 days [95% confidence interval (CI), 6.31–7.36] (Figure 2); distributions that were fit to our observed data indicated that 95% of infected patients would have an onset of symptoms by Day 13.48 (95% CI of 95th percentile, 12.23–14.73), whereas 5% would have an onset of symptoms by Day 2.27 (95% CI of 5th percentile, 1.98–2.48). We estimated that the serial interval was 12.5 days (95% CI, 11.8–13.2) (Figure 3). The distributions that were fit to our observed data indicate that the serial interval was 20.65 days in 95% of cases (95% CI of 95th percentile, 19.15–22.15) and 6.15 days in 5% of cases (95% CI of 5th percentile, 3.65–8.65).


Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015.

- Osong Public Health Res Perspect (2015)

Serial interval of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in the Republic of Korea, 2015. Panel A shows the density estimation of serial intervals using gamma distribution. Panel B shows the empirical cumulative density estimation of serial intervals.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588443&req=5

fig3: Serial interval of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in the Republic of Korea, 2015. Panel A shows the density estimation of serial intervals using gamma distribution. Panel B shows the empirical cumulative density estimation of serial intervals.
Mentions: The incubation period of confirmed cases was 6.83 days [95% confidence interval (CI), 6.31–7.36] (Figure 2); distributions that were fit to our observed data indicated that 95% of infected patients would have an onset of symptoms by Day 13.48 (95% CI of 95th percentile, 12.23–14.73), whereas 5% would have an onset of symptoms by Day 2.27 (95% CI of 5th percentile, 1.98–2.48). We estimated that the serial interval was 12.5 days (95% CI, 11.8–13.2) (Figure 3). The distributions that were fit to our observed data indicate that the serial interval was 20.65 days in 95% of cases (95% CI of 95th percentile, 19.15–22.15) and 6.15 days in 5% of cases (95% CI of 5th percentile, 3.65–8.65).

Bottom Line: Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90-12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64-14.65) were significantly associated with mortality.Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

View Article: PubMed Central - PubMed

ABSTRACT

Objectives: The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015.

Methods: Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient.

Results: A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incubation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90-12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64-14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.

Conclusion: A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

No MeSH data available.


Related in: MedlinePlus