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J Infect Public Health. 2019 Dec 5. pii: S1876-0341(19)30351-X. doi: 10.1016/j.jiph.2019.11.011. [Epub ahead of print]

Climate factors and incidence of Middle East respiratory syndrome coronavirus.

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Tropical Diseases Center, National Health Laboratory, Saudi Center for Disease Prevention and Control (Saudi CDC), Riyadh, Saudi Arabia.
Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Department of Preventive Medicine & Biostatistics/Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA. Electronic address:



Our understanding of climate factors and their links to the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreaks is incomplete. This study aimed to estimate the monthly incidence of MERS-CoV cases and to investigate their correlation to climate factors.


The study used aggregated monthly MERS-CoV cases that reported to the Saudi Center for Disease Prevention and Control from the Riyadh Region between November 1, 2012 and December 31, 2018. Data on the meteorological situation throughout the study period was calculated based on Google reports on the Riyadh Region (24.7136°N, 46.6753°E). The Poisson regression was used to estimate the incidence rate ratio (IRR) and its 95% confidence intervals (CI) for each climate factor.


A total of 712 MERS-CoV cases were included in the analysis (mean age 54.2±9.9 years), and more than half (404) (56.1%) MERS-CoV cases were diagnosed during a five-month period from April to August. The highest peak timing positioned in August 2015, followed by April 2014, June 2017, March 2015, and June 2016. High temperatures (IRR=1.054, 95% CI: 1.043-1.065) and a high ultraviolet index (IRR=1.401, 95% CI: 1.331-1.475) were correlated with a higher incidence of MERS-CoV cases. However, low relative humidity (IRR=0.956, 95% CI: 0.948-0.964) and low wind speed (IRR=0.945, 95% CI: 0.912-0.979) were correlated with a lower incidence of MERS-CoV cases.


The novel coronavirus, MERS-CoV, is influenced by climate conditions with increasing incidence between April and August. High temperature, high ultraviolet index, low wind speed, and low relative humidity are contributors to increased MERS-CoV cases. The climate factors must be evaluated in hospitals and community settings and integrated into guidelines to serve as source of control measures to prevent and eliminate the risk of infection.


MERS-CoV; Meteorological factors; Weather conditions

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