Transmission scenarios for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and how to tell them apart.
Transmission scenarios for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and how to tell them apart.
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DOI：
10.2807/ese.18.24.20503-en
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发表时间：
2013-06
期刊：
影响因子：
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通讯作者：
S. Cauchemez;M. D. Kerkhove;S. Riley;C. Donnelly;C. Fraser;N. Ferguson
中科院分区：
文献类型：
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作者：
S. Cauchemez;M. D. Kerkhove;S. Riley;C. Donnelly;C. Fraser;N. Ferguson
国际上发现的中东呼吸综合征冠状病毒（MERS-CoV）人间感染病例是一个全球公共卫生问题。在监测可能存在不充分确定和对更严重病例的选择偏见的情况下，严格的风险评估尤其具有挑战性。我们要评估该病毒是否能够引起广泛的人类流行病，以及是否已经在进行自我维持的传播。在此，我们综述了中东呼吸综合征冠状病毒可能的传播情景及其对风险评估和控制的影响。我们讨论了现有数据、未来调查和分析如何有助于减少不确定性和改进公共卫生风险评估，并提出了分析方法，即使是根据部分和有偏见的监测数据，也可以对流行病学特征进行强有力的评估。最后，我们敦促收集有关未来病例的充分数据，以便对中东呼吸综合征冠状病毒的传播特征和严重程度及其可能构成的公共卫生威胁进行严格评估。除了最低限度的病例报告之外，在世界卫生组织和《国际卫生条例》指导下的公开国际合作将影响这一潜在流行病的发展方式和控制前景。
Detection of human cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection internationally is a global public health concern. Rigorous risk assessment is particularly challenging in a context where surveillance may be subject to under-ascertainment and a selection bias towards more severe cases. We would like to assess whether the virus is capable of causing widespread human epidemics, and whether self-sustaining transmission is already under way. Here we review possible transmission scenarios for MERS-CoV and their implications for risk assessment and control. We discuss how existing data, future investigations and analyses may help in reducing uncertainty and refining the public health risk assessment and present analytical approaches that allow robust assessment of epidemiological characteristics, even from partial and biased surveillance data. Finally, we urge that adequate data be collected on future cases to permit rigorous assessment of the transmission characteristics and severity of MERS-CoV, and the public health threat it may pose. Going beyond minimal case reporting, open international collaboration, under the guidance of the World Health Organization and the International Health Regulations, will impact on how this potential epidemic unfolds and prospects for control.