Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015.
Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015.
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DOI：
10.1016/j.phrp.2015.08.006
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发表时间：
2015-08
影响因子：
4.3
通讯作者：
Korea Centers for Disease Control and Prevention
中科院分区：
文献类型：
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作者：
Korea Centers for Disease Control and Prevention
韩国的中东呼吸综合征冠状病毒（MERS-CoV）疫情是从中东回国后出现发烧症状的指示病例开始的。他在C医院感染了26例，并在全国范围内连续进行医院传播。我们提供了截至2015年7月爆发的流行病学描述。通过对确诊患者的直接访谈和查阅病历进行流行病学调查。我们还分析了潜伏期、连续间隔、超传播者的特征以及与死亡率相关的因素。从索引患者的痰标本中获得全基因组序列。韩国16家医院共发现186例中东呼吸综合征冠状病毒感染确诊患者。医院暴露患者占44.1%，护理人员占32.8%，卫生保健人员占13.4%。最常见的症状是发烧和发冷。估计潜伏期为6.83天，序列间隔为12.5天。共有83.2%的传播事件在流行病学上与5名超级传播者有关，他们在发病时都患有肺炎，并接触了数百人。年龄较大[比值比(OR) = 4.86, 95%可信区间（CI） 1.90 ~ 12.45]和潜在呼吸系统疾病（OR = 4.90, 95% CI 1.64 ~ 14.65）与死亡率显著相关。系统发育分析显示，指示病例的中东呼吸综合征冠状病毒与最近来自沙特阿拉伯利雅得的一种病毒聚集最接近。一例输入性中东呼吸综合征冠状病毒感染病例对公共卫生安全构成巨大威胁。这突出了强有力的准备和最佳感染预防控制的重要性。从当前疫情中吸取的经验教训将有助于制定更多最新的指导方针和全球卫生安全。
The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015. Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient. A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incubation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90–12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64–14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia. A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.