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Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts-Abu Dhabi, United Arab Emirates.
Clin Infect Dis. 2019 01 18; 68(3):409-418.CI

Abstract

Background

Although there is evidence of person-to-person transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent to which disease severity affects transmission.

Methods

A seroepidemiological investigation was conducted among MERS-CoV case patients (cases) and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. Cases diagnosed between 1 January 2013 and 9 May 2014 and their household contacts were approached for enrollment. Demographic, clinical, and exposure history data were collected. Sera were screened by MERS-CoV nucleocapsid protein enzyme-linked immunosorbent assay and indirect immunofluorescence, with results confirmed by microneutralization assay.

Results

Thirty-one of 34 (91%) case patients were asymptomatic or mildly symptomatic and did not require oxygen during hospitalization. MERS-CoV antibodies were detected in 13 of 24 (54%) case patients with available sera, including 1 severely symptomatic, 9 mildly symptomatic, and 3 asymptomatic case patients. No serologic evidence of MERS-CoV transmission was found among 105 household contacts with available sera.

Conclusions

Transmission of MERS-CoV was not documented in this investigation of mostly asymptomatic and mildly symptomatic cases and their household contacts. These results have implications for clinical management of cases and formulation of isolation policies to reduce the risk of transmission.

Authors+Show Affiliations

Department of Health-Abu Dhabi, United Arab Emirates.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. United States Public Health Service, Rockville, Maryland.Department of Health-Abu Dhabi, United Arab Emirates.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Department of Health-Abu Dhabi, United Arab Emirates.Department of Health-Abu Dhabi, United Arab Emirates.Department of Health-Abu Dhabi, United Arab Emirates.Department of Health-Abu Dhabi, United Arab Emirates.Sheikh Khalifa Medical Laboratory, Abu Dhabi, United Arab Emirates.Sheikh Khalifa Medical Laboratory, Abu Dhabi, United Arab Emirates.Sheikh Khalifa Medical Laboratory, Abu Dhabi, United Arab Emirates.Department of Health-Abu Dhabi, United Arab Emirates.Department of Health-Abu Dhabi, United Arab Emirates.Department of Health-Abu Dhabi, United Arab Emirates.Sheikh Khalifa Medical Laboratory, Abu Dhabi, United Arab Emirates.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.United States Public Health Service, Rockville, Maryland. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Health Informatics and Surveillance, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.

Pub Type(s)

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

Language

eng

PubMed ID

29905769

Citation

Al Hosani, Farida Ismail, et al. "Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts-Abu Dhabi, United Arab Emirates." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 68, no. 3, 2019, pp. 409-418.
Al Hosani FI, Kim L, Khudhair A, et al. Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts-Abu Dhabi, United Arab Emirates. Clin Infect Dis. 2019;68(3):409-418.
Al Hosani, F. I., Kim, L., Khudhair, A., Pham, H., Al Mulla, M., Al Bandar, Z., Pradeep, K., Elkheir, K. A., Weber, S., Khoury, M., Donnelly, G., Younis, N., El Saleh, F., Abdalla, M., Imambaccus, H., Haynes, L. M., Thornburg, N. J., Harcourt, J. L., Miao, C., ... Gerber, S. I. (2019). Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts-Abu Dhabi, United Arab Emirates. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 68(3), 409-418. https://doi.org/10.1093/cid/ciy503
Al Hosani FI, et al. Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts-Abu Dhabi, United Arab Emirates. Clin Infect Dis. 2019 01 18;68(3):409-418. PubMed PMID: 29905769.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts-Abu Dhabi, United Arab Emirates. AU - Al Hosani,Farida Ismail, AU - Kim,Lindsay, AU - Khudhair,Ahmed, AU - Pham,Huong, AU - Al Mulla,Mariam, AU - Al Bandar,Zyad, AU - Pradeep,Krishna, AU - Elkheir,Kheir Abou, AU - Weber,Stefan, AU - Khoury,Mary, AU - Donnelly,George, AU - Younis,Naima, AU - El Saleh,Feda, AU - Abdalla,Muna, AU - Imambaccus,Hala, AU - Haynes,Lia M, AU - Thornburg,Natalie J, AU - Harcourt,Jennifer L, AU - Miao,Congrong, AU - Tamin,Azaibi, AU - Hall,Aron J, AU - Russell,Elizabeth S, AU - Harris,Aaron M, AU - Kiebler,Craig, AU - Mir,Roger A, AU - Pringle,Kimberly, AU - Alami,Negar N, AU - Abedi,Glen R, AU - Gerber,Susan I, PY - 2018/02/08/received PY - 2018/06/12/accepted PY - 2018/6/16/pubmed PY - 2020/3/7/medline PY - 2018/6/16/entrez SP - 409 EP - 418 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 68 IS - 3 N2 - Background: Although there is evidence of person-to-person transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent to which disease severity affects transmission. Methods: A seroepidemiological investigation was conducted among MERS-CoV case patients (cases) and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. Cases diagnosed between 1 January 2013 and 9 May 2014 and their household contacts were approached for enrollment. Demographic, clinical, and exposure history data were collected. Sera were screened by MERS-CoV nucleocapsid protein enzyme-linked immunosorbent assay and indirect immunofluorescence, with results confirmed by microneutralization assay. Results: Thirty-one of 34 (91%) case patients were asymptomatic or mildly symptomatic and did not require oxygen during hospitalization. MERS-CoV antibodies were detected in 13 of 24 (54%) case patients with available sera, including 1 severely symptomatic, 9 mildly symptomatic, and 3 asymptomatic case patients. No serologic evidence of MERS-CoV transmission was found among 105 household contacts with available sera. Conclusions: Transmission of MERS-CoV was not documented in this investigation of mostly asymptomatic and mildly symptomatic cases and their household contacts. These results have implications for clinical management of cases and formulation of isolation policies to reduce the risk of transmission. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/29905769/Serologic_Follow_up_of_Middle_East_Respiratory_Syndrome_Coronavirus_Cases_and_Contacts_Abu_Dhabi_United_Arab_Emirates_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciy503 DB - PRIME DP - Unbound Medicine ER -