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Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia.
J Infect Dis. 2016 09 01; 214(5):712-21.JI

Abstract

BACKGROUND

Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe respiratory illness in humans. Fundamental questions about circulating viruses and transmission routes remain.

METHODS

We assessed routinely collected epidemiologic data for MERS-CoV cases reported in Saudi Arabia during 1 January-30 June 2015 and conducted a more detailed investigation of cases reported during February 2015. Available respiratory specimens were obtained for sequencing.

RESULTS

During the study period, 216 MERS-CoV cases were reported. Full genome (n = 17) or spike gene sequences (n = 82) were obtained from 99 individuals. Most sequences (72 of 99 [73%]) formed a discrete, novel recombinant subclade (NRC-2015), which was detected in 6 regions and became predominant by June 2015. No clinical differences were noted between clades. Among 87 cases reported during February 2015, 13 had no recognized risks for secondary acquisition; 12 of these 13 also denied camel contact. Most viruses (8 of 9) from these 13 individuals belonged to NRC-2015.

DISCUSSIONS

Our findings document the spread and eventual predominance of NRC-2015 in humans in Saudi Arabia during the first half of 2015. Our identification of cases without recognized risk factors but with similar virus sequences indicates the need for better understanding of risk factors for MERS-CoV transmission.

Authors+Show Affiliations

Ministry of Health.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Ministry of Health Department of Family and Community Medicine, King Saud Medical City.Ministry of Health.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Ministry of Health.Ministry of Health.Ministry of Health.Ministry of Health.Ministry of Health.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Ministry of Health Field Epidemiology Training Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.Ministry of Health Field Epidemiology Training Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.Ministry of Health Field Epidemiology Training Program, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Ministry of Health.Ministry of Health.Ministry of Health.Ministry of Health.Ministry of Health.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Ministry of Health.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

27302191

Citation

Assiri, Abdullah M., et al. "Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia." The Journal of Infectious Diseases, vol. 214, no. 5, 2016, pp. 712-21.
Assiri AM, Midgley CM, Abedi GR, et al. Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia. J Infect Dis. 2016;214(5):712-21.
Assiri, A. M., Midgley, C. M., Abedi, G. R., Bin Saeed, A., Almasri, M. M., Lu, X., Al-Abdely, H. M., Abdalla, O., Mohammed, M., Algarni, H. S., Alhakeem, R. F., Sakthivel, S. K., Nooh, R., Alshayab, Z., Alessa, M., Srinivasamoorthy, G., AlQahtani, S. Y., Kheyami, A., HajOmar, W. H., ... Gerber, S. I. (2016). Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia. The Journal of Infectious Diseases, 214(5), 712-21. https://doi.org/10.1093/infdis/jiw236
Assiri AM, et al. Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia. J Infect Dis. 2016 09 1;214(5):712-21. PubMed PMID: 27302191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of a Novel Recombinant Middle East Respiratory Syndrome Coronavirus in Humans in Saudi Arabia. AU - Assiri,Abdullah M, AU - Midgley,Claire M, AU - Abedi,Glen R, AU - Bin Saeed,Abdulaziz, AU - Almasri,Malak M, AU - Lu,Xiaoyan, AU - Al-Abdely,Hail M, AU - Abdalla,Osman, AU - Mohammed,Mutaz, AU - Algarni,Homoud S, AU - Alhakeem,Raafat F, AU - Sakthivel,Senthilkumar K, AU - Nooh,Randa, AU - Alshayab,Zainab, AU - Alessa,Mohammad, AU - Srinivasamoorthy,Ganesh, AU - AlQahtani,Saeed Yahya, AU - Kheyami,Ali, AU - HajOmar,Waleed Husein, AU - Banaser,Talib M, AU - Esmaeel,Ahmad, AU - Hall,Aron J, AU - Curns,Aaron T, AU - Tamin,Azaibi, AU - Alsharef,Ali Abraheem, AU - Erdman,Dean, AU - Watson,John T, AU - Gerber,Susan I, Y1 - 2016/06/14/ PY - 2016/02/09/received PY - 2016/04/25/accepted PY - 2016/6/16/entrez PY - 2016/6/16/pubmed PY - 2017/5/23/medline KW - MERS KW - MERS epidemiology KW - MERS phylogeny KW - MERS transmission KW - Middle East respiratory syndrome KW - Saudi Arabia KW - coronavirus KW - recombinant SP - 712 EP - 21 JF - The Journal of infectious diseases JO - J Infect Dis VL - 214 IS - 5 N2 - BACKGROUND: Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe respiratory illness in humans. Fundamental questions about circulating viruses and transmission routes remain. METHODS: We assessed routinely collected epidemiologic data for MERS-CoV cases reported in Saudi Arabia during 1 January-30 June 2015 and conducted a more detailed investigation of cases reported during February 2015. Available respiratory specimens were obtained for sequencing. RESULTS: During the study period, 216 MERS-CoV cases were reported. Full genome (n = 17) or spike gene sequences (n = 82) were obtained from 99 individuals. Most sequences (72 of 99 [73%]) formed a discrete, novel recombinant subclade (NRC-2015), which was detected in 6 regions and became predominant by June 2015. No clinical differences were noted between clades. Among 87 cases reported during February 2015, 13 had no recognized risks for secondary acquisition; 12 of these 13 also denied camel contact. Most viruses (8 of 9) from these 13 individuals belonged to NRC-2015. DISCUSSIONS: Our findings document the spread and eventual predominance of NRC-2015 in humans in Saudi Arabia during the first half of 2015. Our identification of cases without recognized risk factors but with similar virus sequences indicates the need for better understanding of risk factors for MERS-CoV transmission. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/27302191/Epidemiology_of_a_Novel_Recombinant_Middle_East_Respiratory_Syndrome_Coronavirus_in_Humans_in_Saudi_Arabia_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiw236 DB - PRIME DP - Unbound Medicine ER -