TY - JOUR
T1 - Estimating the severity and subclinical burden of middle east respiratory syndrome coronavirus infection in the Kingdom of Saudi Arabia
AU - Lessler, Justin
AU - Salje, Henrik
AU - Van Kerkhove, Maria D.
AU - Ferguson, Neil M.
AU - Cauchemez, Simon
AU - Rodriquez-Barraquer, Isabel
AU - Hakeem, Rafat
AU - Jombart, Thibaut
AU - Aguas, Ricardo
AU - Al-Barrak, Ali
AU - Cummings, Derek A.T.
N1 - Publisher Copyright:
© 2016 The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Not all persons infected with Middle East respiratory syndrome coronavirus (MERS-CoV) develop severe symptoms, which likely leads to an underestimation of the number of people infected and an overestimation of the severity. To estimate the number of MERS-CoV infections that have occurred in the Kingdom of Saudi Arabia, we applied a statistical model to a line list describing 721 MERS-CoV infections detected between June 7, 2012, and July 25, 2014. We estimated that 1,528 (95% confidence interval (CI): 1,327, 1,883) MERS-CoV infections occurred in this interval, which is 2.1 (95% CI: 1.8, 2.6) times the number reported. The probability of developing symptoms ranged from 11% (95% CI: 4, 25) in persons under 10 years of age to 88% (95% CI: 72, 97) in those 70 years of age or older. An estimated 22% (95% CI: 18, 25) of those infected with MERS-CoV died. MERS-CoV is deadly, but this work shows that its clinical severity differs markedly between groups and that many cases likely go undiagnosed.
AB - Not all persons infected with Middle East respiratory syndrome coronavirus (MERS-CoV) develop severe symptoms, which likely leads to an underestimation of the number of people infected and an overestimation of the severity. To estimate the number of MERS-CoV infections that have occurred in the Kingdom of Saudi Arabia, we applied a statistical model to a line list describing 721 MERS-CoV infections detected between June 7, 2012, and July 25, 2014. We estimated that 1,528 (95% confidence interval (CI): 1,327, 1,883) MERS-CoV infections occurred in this interval, which is 2.1 (95% CI: 1.8, 2.6) times the number reported. The probability of developing symptoms ranged from 11% (95% CI: 4, 25) in persons under 10 years of age to 88% (95% CI: 72, 97) in those 70 years of age or older. An estimated 22% (95% CI: 18, 25) of those infected with MERS-CoV died. MERS-CoV is deadly, but this work shows that its clinical severity differs markedly between groups and that many cases likely go undiagnosed.
KW - MERS
KW - burden
KW - clinical symptoms
KW - coronavirus
KW - severity
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U2 - 10.1093/aje/kwv452
DO - 10.1093/aje/kwv452
M3 - Article
C2 - 26851269
AN - SCOPUS:84964579676
SN - 0002-9262
VL - 183
SP - 657
EP - 663
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 7
ER -