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A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case.
Int J Infect Dis. 2013 Sep; 17(9):e668-72.IJ

Abstract

BACKGROUND

Ninety confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) have been reported to the World Health Organization. We report the details of a second family cluster of MERS-CoV infections from Riyadh, Saudi Arabia.

METHODS

We present the clinical, laboratory and epidemiological details of 3 patients from a family cluster of MERS-CoV infections.

RESULTS

The first patient developed respiratory symptoms and fever 14 days after admission to hospital for an unrelated reason. He died 11 days later with multi-organ failure. Two of his brothers presented later to another hospital with respiratory symptoms and fever. MERS-CoV infection in the latter 2 patients was confirmed by reverse transcriptase polymerase chain reaction testing. All 3 patients had fever, cough, shortness of breath, bilateral infiltrates on chest x-ray, thrombocytopenia, lymphopenia and rises in serum creatinine kinase and alanine transaminase. No hospital or other social contacts are known to have acquired the infection. It appears that the index patient in this cluster acquired MERS-CoV infection whilst in hospital from an unrecognized mild or asymptomatic case.

CONCLUSION

MERS-CoV acquisition from unrecognized mild or asymptomatic cases may be a more important contributor to ongoing transmission than previously appreciated.

Authors+Show Affiliations

Consultant Infectious Diseases Physician, Division of Infectious Diseases, Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. asomrani@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23916548

Citation

Omrani, Ali S., et al. "A Family Cluster of Middle East Respiratory Syndrome Coronavirus Infections Related to a Likely Unrecognized Asymptomatic or Mild Case." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 17, no. 9, 2013, pp. e668-72.
Omrani AS, Matin MA, Haddad Q, et al. A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case. Int J Infect Dis. 2013;17(9):e668-72.
Omrani, A. S., Matin, M. A., Haddad, Q., Al-Nakhli, D., Memish, Z. A., & Albarrak, A. M. (2013). A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 17(9), e668-72. https://doi.org/10.1016/j.ijid.2013.07.001
Omrani AS, et al. A Family Cluster of Middle East Respiratory Syndrome Coronavirus Infections Related to a Likely Unrecognized Asymptomatic or Mild Case. Int J Infect Dis. 2013;17(9):e668-72. PubMed PMID: 23916548.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case. AU - Omrani,Ali S, AU - Matin,Mohammad Abdul, AU - Haddad,Qais, AU - Al-Nakhli,Daifullah, AU - Memish,Ziad A, AU - Albarrak,Ali M, Y1 - 2013/08/02/ PY - 2013/8/7/entrez PY - 2013/8/7/pubmed PY - 2014/3/7/medline KW - Cluster KW - MERS-CoV KW - Middle East Respiratory Syndrome Coronavirus KW - Saudi Arabia KW - Viral pneumonia SP - e668 EP - 72 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 17 IS - 9 N2 - BACKGROUND: Ninety confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) have been reported to the World Health Organization. We report the details of a second family cluster of MERS-CoV infections from Riyadh, Saudi Arabia. METHODS: We present the clinical, laboratory and epidemiological details of 3 patients from a family cluster of MERS-CoV infections. RESULTS: The first patient developed respiratory symptoms and fever 14 days after admission to hospital for an unrelated reason. He died 11 days later with multi-organ failure. Two of his brothers presented later to another hospital with respiratory symptoms and fever. MERS-CoV infection in the latter 2 patients was confirmed by reverse transcriptase polymerase chain reaction testing. All 3 patients had fever, cough, shortness of breath, bilateral infiltrates on chest x-ray, thrombocytopenia, lymphopenia and rises in serum creatinine kinase and alanine transaminase. No hospital or other social contacts are known to have acquired the infection. It appears that the index patient in this cluster acquired MERS-CoV infection whilst in hospital from an unrecognized mild or asymptomatic case. CONCLUSION: MERS-CoV acquisition from unrecognized mild or asymptomatic cases may be a more important contributor to ongoing transmission than previously appreciated. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/23916548/A_family_cluster_of_Middle_East_Respiratory_Syndrome_Coronavirus_infections_related_to_a_likely_unrecognized_asymptomatic_or_mild_case_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(13)00225-7 DB - PRIME DP - Unbound Medicine ER -