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Int J Infect Dis. 2015 Sep;38:65-7. doi: 10.1016/j.ijid.2015.07.014. Epub 2015 Jul 26.

Probable transmission chains of Middle East respiratory syndrome coronavirus and the multiple generations of secondary infection in South Korea.

Author information

1
Stanley Ho Centre for Infectious Diseases, 205 Postgraduate Education Centre, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, People's Republic of China. Electronic address: sslee@cuhk.edu.hk.
2
Stanley Ho Centre for Infectious Diseases, 205 Postgraduate Education Centre, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, People's Republic of China.

Abstract

BACKGROUND:

In May 2015, South Korea reported its first case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in a 68-year-old man with a history of travel in the Middle East. In the presence of secondary infections, an understanding of the transmission dynamics of the virus is crucial. The aim of this study was to characterize the transmission chains of MERS-CoV infection in the current South Korean outbreak.

METHODS:

Individual-level data from multiple sources were collected and used for epidemiological analyses.

RESULTS:

As of July 14, 2015, 185 confirmed cases of MERS have been reported in the Korean outbreak. Three generations of secondary infection, with over half belonging to the second generation, could be delineated. Hospital infection was found to be the most important cause of virus transmission, affecting largely non-healthcare workers (154/184). Healthcare switching has probably accounted for the emergence of multiple generations of secondary infection. Fomite transmission may explain a significant proportion of the infections occurring in the absence of direct contact with infected cases.

CONCLUSIONS:

Publicly available data from multiple sources, including the media, are useful to describe the epidemic history of an outbreak. The effective control of MERS-CoV hinges on the upholding of infection control standards and an understanding of health-seeking behaviours in the community.

KEYWORDS:

Coronavirus; Epidemiology; Infectious diseases outbreaks; MERS

PMID:
26216766
DOI:
10.1016/j.ijid.2015.07.014
[Indexed for MEDLINE]
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