Travel-related MERS-CoV cases: an assessment of exposures and risk factors in a group of Dutch travellers returning from the Kingdom of Saudi Arabia, May 2014.
Travel-related MERS-CoV cases: an assessment of exposures and risk factors in a group of Dutch travellers returning from the Kingdom of Saudi Arabia, May 2014.
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DOI：
10.1186/1742-7622-11-16
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发表时间：
2014
影响因子：
2.3
通讯作者：
van Gageldonk-Lafeber AB
中科院分区：
文献类型：
--
作者：
Fanoy EB;van der Sande MA;Kraaij-Dirkzwager M;Dirksen K;Jonges M;van der Hoek W;Koopmans MP;van der Werf D;Sonder G;van der Weijden C;van der Heuvel J;Gelinck L;Bouwhuis JW;van Gageldonk-Lafeber AB
2014年5月，两名荷兰居民从沙特阿拉伯王国（KSA）的麦地那和麦加朝圣返回时被诊断出中东呼吸综合征冠状病毒（MERS-CoV）感染，病毒基因组密切相关。这些患者与其他29名荷兰旅行者一起旅行。我们对该旅行团进行了流行病学评估，以确定可能的感染源和潜在的危险因素。所有旅行者，包括这两个病例，都完成了一份调查问卷，重点是潜在的人类，动物和食物暴露于MERS-CoV。该调查表是根据世卫组织中东呼吸综合征冠状病毒调查表修改的，考虑到旅行团的具体路线和活动。12名非病例饮用未经高温消毒的骆驼奶，并与骆驼接触。大部分旅客，包括两名病人中的一名（病例1），都去过当地市场，其中6人在那里消费水果。包括病例1在内的两名旅行者在麦地那一家医院就诊时接触了咳嗽患者。包括病例1在内的4名旅行者前往麦加的两家医院。所有旅行者在病例1患病期间都与他有过接触，最初没有呼吸道症状。这些病例被发现比其他旅行者年龄大，而且都有合并症。这项流行病学研究揭示了MERS-CoV疫情调查的复杂性，报告了MERS-CoV的多种潜在暴露，如医疗保健访问，骆驼暴露和暴露于未经处理的食品。在医院就诊期间暴露于MERS-CoV被认为是病例1的可能感染源，但不是病例2的感染源。对于病例2，无法确定最可能的来源。通过直接接触动物或乳制品接触MERS CoV似乎不太可能发生在荷兰的两例病例中。此外，也不能排除暴露于一种常见但仍未查明的来源。需要对阿拉伯半岛的感染源进行更全面的研究，以加强和具体说明中东呼吸综合征冠状病毒感染的预防。
In May 2014, Middle East respiratory syndrome coronavirus (MERS-CoV) infection, with closely related viral genomes, was diagnosed in two Dutch residents, returning from a pilgrimage to Medina and Mecca, Kingdom of Saudi Arabia (KSA). These patients travelled with a group of 29 other Dutch travellers. We conducted an epidemiological assessment of the travel group to identify likely source(s) of infection and presence of potential risk factors. All travellers, including the two cases, completed a questionnaire focussing on potential human, animal and food exposures to MERS-CoV. The questionnaire was modified from the WHO MERS-CoV questionnaire, taking into account the specific route and activities of the travel group. Twelve non-cases drank unpasteurized camel milk and had contact with camels. Most travellers, including one of the two patients (Case 1), visited local markets, where six of them consumed fruits. Two travellers, including Case 1, were exposed to coughing patients when visiting a hospital in Medina. Four travellers, including Case 1, visited two hospitals in Mecca. All travellers had been in contact with Case 1 while he was sick, with initially non-respiratory complaints. The cases were found to be older than the other travellers and both had co-morbidities. This epidemiological study revealed the complexity of MERS-CoV outbreak investigations with multiple potential exposures to MERS-CoV reported such as healthcare visits, camel exposure, and exposure to untreated food products. Exposure to MERS-CoV during a hospital visit is considered a likely source of infection for Case 1 but not for Case 2. For Case 2, the most likely source could not be determined. Exposure to MERS-CoV via direct contact with animals or dairy products seems unlikely for the two Dutch cases. Furthermore, exposure to a common but still unidentified source cannot be ruled out. More comprehensive research into sources of infection in the Arabian Peninsula is needed to strengthen and specify the prevention of MERS-CoV infections.