A study of the probable transmission routes of MERS-CoV during the first hospital outbreak in the Republic of Korea
A study of the probable transmission routes of MERS-CoV during the first hospital outbreak in the Republic of Korea
复制标题
DOI：
10.1111/ina.12430
复制
发表时间：
2018-01-01
期刊：
影响因子：
5.8
通讯作者：
Yang, Z.
中科院分区：
文献类型：
--
作者：
Xiao, S.;Li, Y.;Yang, Z.
中东呼吸综合征冠状病毒（MERS-CoV）引起的感染因其流行率和相关死亡率而成为一个严重的健康问题。然而，病毒的传播途径仍不清楚，因此，目前推荐的控制策略缺乏证据依据。在这项研究中，我们使用多主体建模框架调查了 2015 年 5 月韩国首次医院内暴发期间 MERS-CoV 的传播途径。我们根据三种主要传播途径（远程空中传播、近距离接触和接触）确定了七种假设的传播模式。使用多代理建模框架估计每个假设的感染风险。进行最小二乘拟合，以将各种情况下预测的感染风险的分布与报告的攻击率的分布进行比较，并确定最适合的假设。在指示患者是超级传播者的情况下，我们的模型模拟表明 MERS-CoV 可能通过远程空气传播途径传播。然而，指标患者的平均病毒载量可能与文献中报告的病毒载量相当，并且传播是通过远程空气传播和密切接触途径相结合的方式发生的。
Infections caused by the Middle East respiratory syndrome coronavirus (MERS-CoV) are a serious health issue due to their prevalence and associated mortality. However, the transmission routes of the virus remain unclear, and thus, the current recommended control strategies are not evidence based. In this study, we investigated the transmission routes of MERS-CoV during the first nosocomial outbreak in the Republic of Korea in May 2015 using a multi-agent modeling framework. We identified seven hypothesized transmission modes based on the three main transmission routes (long-range airborne, close contact, and fomite). The infection risks for each hypothesis were estimated using the multi-agent modeling framework. Least-squares fitting was conducted to compare the distribution of the predicted infection risk in the various scenarios with that of the reported attack rates and to identify the hypotheses with the best fit. In the scenarios in which the index patient was a super-spreader, our model simulations suggested that MERS-CoV probably spread via the long-range airborne route. However, it is possible that the index patient shed an average viral load comparable to the loads reported in the literature, and that transmission occurred via a combined long-range airborne and close contact route.