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Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015.
BMJ Open. 2017 01 12; 7(1):e011865.BO

Abstract

OBJECTIVES

As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia.

DESIGN

Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined.

RESULTS

A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001).

CONCLUSIONS

To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed.

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Authors+Show Affiliations

Alhamlan FS
Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Majumder MS
Massachusetts Institute of Technology, Cambridge, Massachusetts, USA. Boston Children's Hospital, Boston, Massachusetts, USA.
Brownstein JS
Boston Children's Hospital, Boston, Massachusetts, USA.
Hawkins J
Boston Children's Hospital, Boston, Massachusetts, USA.
Al-Abdely HM
Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia.
Alzahrani A
Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia.
Obaid DA
Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Al-Ahdal MN
Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
BinSaeed A
Public Health Deputy, Ministry of Health, Riyadh, Saudi Arabia.

MeSH

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolCoronavirus InfectionsCross InfectionData CollectionData Interpretation, StatisticalDisease OutbreaksFemaleFeverHealth PersonnelHumansInfantInfant, NewbornInfection ControlMaleMiddle AgedMiddle East Respiratory Syndrome CoronavirusPopulation SurveillanceRisk FactorsSaudi ArabiaTravel

Pub Type(s)

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

Language

eng

PubMed ID

28082362

Citation

Alhamlan, F S., et al. "Case Characteristics Among Middle East Respiratory Syndrome Coronavirus Outbreak and Non-outbreak Cases in Saudi Arabia From 2012 to 2015." BMJ Open, vol. 7, no. 1, 2017, pp. e011865.
Alhamlan FS, Majumder MS, Brownstein JS, et al. Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. BMJ Open. 2017;7(1):e011865.
Alhamlan, F. S., Majumder, M. S., Brownstein, J. S., Hawkins, J., Al-Abdely, H. M., Alzahrani, A., Obaid, D. A., Al-Ahdal, M. N., & BinSaeed, A. (2017). Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. BMJ Open, 7(1), e011865. https://doi.org/10.1136/bmjopen-2016-011865
Alhamlan FS, et al. Case Characteristics Among Middle East Respiratory Syndrome Coronavirus Outbreak and Non-outbreak Cases in Saudi Arabia From 2012 to 2015. BMJ Open. 2017 01 12;7(1):e011865. PubMed PMID: 28082362.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. AU - Alhamlan,F S, AU - Majumder,M S, AU - Brownstein,J S, AU - Hawkins,J, AU - Al-Abdely,H M, AU - Alzahrani,A, AU - Obaid,D A, AU - Al-Ahdal,M N, AU - BinSaeed,A, Y1 - 2017/01/12/ PY - 2017/1/14/entrez PY - 2017/1/14/pubmed PY - 2018/1/2/medline KW - INFECTIOUS DISEASES SP - e011865 EP - e011865 JF - BMJ open JO - BMJ Open VL - 7 IS - 1 N2 - OBJECTIVES: As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. DESIGN: Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. RESULTS: A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). CONCLUSIONS: To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/28082362/Case_characteristics_among_Middle_East_respiratory_syndrome_coronavirus_outbreak_and_non_outbreak_cases_in_Saudi_Arabia_from_2012_to_2015_ DB - PRIME DP - Unbound Medicine ER -