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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

Evolutionary history of the Middle East respiratory syndrome coronavirus (MERS-CoV). A phylogenetic tree was constructed using RAxML. The scale bar shows evolutionary distance inferred by RAxML algorithm. The MERS-CoV in the Republic of Korea outbreak is indicated by a red cycle. Support for the ML phylogenetic trees was evaluated using 1,000 bootstrap replicates. Note numbers represent % bootstrap replicates >70%.
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fig5: Evolutionary history of the Middle East respiratory syndrome coronavirus (MERS-CoV). A phylogenetic tree was constructed using RAxML. The scale bar shows evolutionary distance inferred by RAxML algorithm. The MERS-CoV in the Republic of Korea outbreak is indicated by a red cycle. Support for the ML phylogenetic trees was evaluated using 1,000 bootstrap replicates. Note numbers represent % bootstrap replicates >70%.

Mentions: The MERS-CoV of the index case produced the best match with the virus from an outbreak in Riyadh, Saudi Arabia in February 2015 (Riyadh_KKUH_0708_20150225) by pairwise comparisons (Figure 5). The nucleotide identity was 99.61%. Phylogenetic analysis of the 16 MERS-CoV complete genomes showed that MERS-CoV/KOR/KNIH/001_05_2015 and Riyadh_KKUH_0708_20150225 are the closest relatives of viruses from Qatar and Hafr-Al-Batin in the 2013 outbreak.


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

- Osong Public Health Res Perspect (2015)

Evolutionary history of the Middle East respiratory syndrome coronavirus (MERS-CoV). A phylogenetic tree was constructed using RAxML. The scale bar shows evolutionary distance inferred by RAxML algorithm. The MERS-CoV in the Republic of Korea outbreak is indicated by a red cycle. Support for the ML phylogenetic trees was evaluated using 1,000 bootstrap replicates. Note numbers represent % bootstrap replicates >70%.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

fig5: Evolutionary history of the Middle East respiratory syndrome coronavirus (MERS-CoV). A phylogenetic tree was constructed using RAxML. The scale bar shows evolutionary distance inferred by RAxML algorithm. The MERS-CoV in the Republic of Korea outbreak is indicated by a red cycle. Support for the ML phylogenetic trees was evaluated using 1,000 bootstrap replicates. Note numbers represent % bootstrap replicates >70%.
Mentions: The MERS-CoV of the index case produced the best match with the virus from an outbreak in Riyadh, Saudi Arabia in February 2015 (Riyadh_KKUH_0708_20150225) by pairwise comparisons (Figure 5). The nucleotide identity was 99.61%. Phylogenetic analysis of the 16 MERS-CoV complete genomes showed that MERS-CoV/KOR/KNIH/001_05_2015 and Riyadh_KKUH_0708_20150225 are the closest relatives of viruses from Qatar and Hafr-Al-Batin in the 2013 outbreak.

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