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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Transmission of MERS-coronavirus in household contacts
New England Journal of Medicine, Volume 371, No. 9, Year 2014
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Description
BACKGROUND: Strategies to contain the Middle East respiratory syndrome coronavirus (MERS-CoV) depend on knowledge of the rate of human-to-human transmission, including subclinical infections. A lack of serologic tools has hindered targeted studies of transmission. METHODS: We studied 26 index patients with MERS-CoV infection and their 280 household contacts. The median time from the onset of symptoms in index patients to the latest blood sampling in contact patients was 17.5 days (range, 5 to 216; mean, 34.4). Probable cases of secondary transmission were identified on the basis of reactivity in two reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays with independent RNA extraction from throat swabs or reactivity on enzyme-linked immunosorbent assay against MERS-CoV S1 antigen, supported by reactivity on recombinant S-protein immunofluorescence and demonstration of neutralization of more than 50% of the infectious virus seed dose on plaque-reduction neutralization testing. RESULTS: Among the 280 household contacts of the 26 index patients, there were 12 probable cases of secondary transmission (4%; 95% confidence interval, 2 to 7). Of these cases, 7 were identified by means of RT-PCR, all in samples obtained within 14 days after the onset of symptoms in index patients, and 5 were identified by means of serologic analysis, all in samples obtained 13 days or more after symptom onset in index patients. Probable cases of secondary transmission occurred in 6 of 26 clusters (23%). Serologic results in contacts who were sampled 13 days or more after exposure were similar to overall study results for combined RT-PCR and serologic testing. CONCLUSIONS: The rate of secondary transmission among household contacts of patients with MERS-CoV infection has been approximately 5%. Our data provide insight into the rate of subclinical transmission of MERS-CoV in the home. Copyright © 2014 Massachusetts Medical Society.
Authors & Co-Authors
Drosten, C.
Germany, Bonn
Universitätsklinikum Bonn
Meyer, Benjamin J.
Germany, Bonn
Universitätsklinikum Bonn
Müller, Marcel A.
Germany, Bonn
Universitätsklinikum Bonn
Corman, Victor Max
Germany, Bonn
Universitätsklinikum Bonn
Al Masri, Malakita
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Hossain, Raheela
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Madani, Hossam
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Sieberg, Andrea
Germany, Bonn
Universitätsklinikum Bonn
Bosch, B. J.
Netherlands, Utrecht
Universiteit Utrecht
Lattwein, Erik
Germany, Lubeck
Euroimmun ag
AlHakeem, Rafat F.
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Asiri, Abdullah M.
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Hajomar, Waleed H.
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
AlBarrak, Ali M.
Saudi Arabia, Riyadh
Prince Sultan Military Medical City
Al-Tawfiq, Jaffar Ali
Saudi Arabia, Dhahran
Johns Hopkins Aramco Healthcare
United States, Indianapolis
Indiana University School of Medicine
Zumla, A. I.
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
United Kingdom, London
University College London Hospitals Nhs Foundation Trust
Al Memish, Ziad Ahmed
Saudi Arabia, Riyadh
Ministry of Health Saudi Arabia
Saudi Arabia, Riyadh
Alfaisal University
Statistics
Citations: 364
Authors: 17
Affiliations: 9
Identifiers
Doi:
10.1056/NEJMoa1405858
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Covid