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Unraveling the drivers of MERS-CoV transmission
journal contribution
posted on 2023-06-09, 14:36 authored by Simon Cauchemez, Pierre NouvelletPierre Nouvellet, Anne Cori, Thibaut Jombart, Tini Garske, Hannah Clapham, Sean Moore, Harriet Linden Mills, Henrik Salje, Caitlin Collins, Isabel Rodriquez-Barraquer, Steven Riley, Shaun Truelove, Homoud Algarni, Rafat Alhakeem, Khalid AlHarbi, Abdulhafiz Turkistani, Ricardo J Aguas, Derek A T Cummings, Maria D Van Kerkhove, Christl A Donnelly, Justin Lessler, Christophe Fraser, Ali Al-Barrak, Neil M FergusonWith more than 1,700 laboratory-confirmed infections, Middle East respiratory syndrome coronavirus (MERS-CoV) remains a significant threat for public health. However, the lack of detailed data on modes of transmission from the animal reservoir and between humans means that the drivers of MERS-CoV epidemics remain poorly characterized. Here, we develop a statistical framework to provide a comprehensive analysis of the transmission patterns underlying the 681 MERS-CoV cases detected in the Kingdom of Saudi Arabia (KSA) between January 2013 and July 2014. We assess how infections from the animal reservoir, the different levels of mixing, and heterogeneities in transmission have contributed to the buildup of MERS-CoV epidemics in KSA. We estimate that 12% [95% credible interval (CI): 9%, 15%] of cases were infected from the reservoir, the rest via human-to-human transmission in clusters (60%; CI: 57%, 63%), within (23%; CI: 20%, 27%), or between (5%; CI: 2%, 8%) regions. The reproduction number at the start of a cluster was 0.45 (CI: 0.33, 0.58) on average, but with large SD (0.53; CI: 0.35, 0.78). It was >1 in 12% (CI: 6%, 18%) of clusters but fell by approximately one-half (47% CI: 34%, 63%) its original value after 10 cases on average. The ongoing exposure of humans to MERS-CoV from the reservoir is of major concern, given the continued risk of substantial outbreaks in health care systems. The approach we present allows the study of infectious disease transmission when data linking cases to each other remain limited and uncertain.
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Publication status
- Published
File Version
- Published version
Journal
Proceedings of the National Academy of SciencesISSN
0027-8424Publisher
National Academy of SciencesExternal DOI
Issue
32Volume
113Page range
9081-9086Department affiliated with
- Evolution, Behaviour and Environment Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2018-08-17First Compliant Deposit (FCD) Date
2018-08-16Usage metrics
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