scholarly journals Taking stock of the first 133 MERS coronavirus cases globally – Is the epidemic changing?

2013 ◽  
Vol 18 (39) ◽  
Author(s):  
P M Penttinen ◽  
K Kaasik-Aaslav ◽  
A Friaux ◽  
A Donachie ◽  
B Sudre ◽  
...  
Keyword(s):  
Middle East ◽  
Sex Ratio ◽  
Case Fatality ◽  
Middle East Respiratory Syndrome ◽  
Nosocomial Transmission ◽  
Fatality Risk ◽  
Time Periods ◽  
Case Fatality Risk

Since June 2012, 133 Middle East respiratory syndrome coronavirus (MERS-CoV) cases have been identified in nine countries. Two time periods in 2013 were compared to identify changes in the epidemiology. The case-fatality risk (CFR) is 45% and is decreasing. Men have a higher CFR (52%) and are over-represented among cases. Thirteen out of 14 known primary cases died. The sex-ratio is more balanced in the latter period. Nosocomial transmission was implied in 26% of the cases.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

scholarly journals Limited Genetic Diversity Detected in Middle East Respiratory Syndrome-Related Coronavirus Variants Circulating in Dromedary Camels in Jordan

Viruses ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 592
Author(s):  
Stephanie N. Seifert ◽  
Jonathan E. Schulz ◽  
Stacy Ricklefs ◽  
Michael Letko ◽  
Elangeni Yabba ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Middle East ◽  
United Arab Emirates ◽  
Sequence Data ◽  
Case Fatality ◽  
High Sensitivity ◽  
Middle East Respiratory Syndrome ◽  
Full Genome Sequence ◽  
Genome Sequences ◽  
Dromedary Camels

Middle East respiratory syndrome-related coronavirus (MERS-CoV) is a persistent zoonotic pathogen with frequent spillover from dromedary camels to humans in the Arabian Peninsula, resulting in limited outbreaks of MERS with a high case-fatality rate. Full genome sequence data from camel-derived MERS-CoV variants show diverse lineages circulating in domestic camels with frequent recombination. More than 90% of the available full MERS-CoV genome sequences derived from camels are from just two countries, the Kingdom of Saudi Arabia (KSA) and United Arab Emirates (UAE). In this study, we employ a novel method to amplify and sequence the partial MERS-CoV genome with high sensitivity from nasal swabs of infected camels. We recovered more than 99% of the MERS-CoV genome from field-collected samples with greater than 500 TCID50 equivalent per nasal swab from camel herds sampled in Jordan in May 2016. Our subsequent analyses of 14 camel-derived MERS-CoV genomes show a striking lack of genetic diversity circulating in Jordan camels relative to MERS-CoV genome sequences derived from large camel markets in KSA and UAE. The low genetic diversity detected in Jordan camels during our study is consistent with a lack of endemic circulation in these camel herds and reflective of data from MERS outbreaks in humans dominated by nosocomial transmission following a single introduction as reported during the 2015 MERS outbreak in South Korea. Our data suggest transmission of MERS-CoV among two camel herds in Jordan in 2016 following a single introduction event.

scholarly journals Origins and pathogenesis of Middle East respiratory syndrome-associated coronavirus: recent advances

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1628 ◽  
Author(s):  
Stephen A. Goldstein ◽  
Susan R. Weiss
Keyword(s):  
Immune Response ◽  
Middle East ◽  
Animal Models ◽  
Case Fatality ◽  
Innate Immune ◽  
Middle East Respiratory Syndrome ◽  
Live Virus ◽  
Novel Proteins ◽  
Significant Research ◽  
African Bats

Middle East respiratory syndrome-associated coronavirus (MERS-CoV) has been a significant research focus since its discovery in 2012. Since 2012, 2,040 cases and 712 deaths have been recorded (as of August 11, 2017), representing a strikingly high case fatality rate of 36%. Over the last several years, MERS-CoV research has progressed in several parallel and complementary directions. This review will focus on three particular areas: the origins and evolution of MERS-CoV, the challenges and achievements in the development of MERS-CoV animal models, and our understanding of how novel proteins unique to MERS-CoV counter the host immune response. The origins of MERS-CoV, likely in African bats, are increasingly clear, although important questions remain about the establishment of dromedary camels as a reservoir seeding human outbreaks. Likewise, there have been important advances in the development of animal models, and both non-human primate and mouse models that seem to recapitulate human disease are now available. How MERS-CoV evades and inhibits the host innate immune response remains less clear. Although several studies have identified MERS-CoV proteins as innate immune antagonists, little of this work has been conducted using live virus under conditions of actual infection, but rather with ectopically expressed proteins. Accordingly, considerable space remains for major contributions to understanding unique ways in which MERS-CoV interacts with and modulates the host response. Collectively, these areas have seen significant advances over the last several years but continue to offer exciting opportunities for discovery.

scholarly journals Estimating the Case Fatality Risk of COVID-19 using Cases from Outside China

2020 ◽  
Author(s):  
Nick Wilson ◽  
Amanda Kvalsvig ◽  
Lucy Telfar Barnard ◽  
Michael G Baker
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Meta Analysis ◽  
Case Fatality ◽  
Large Uncertainty ◽  
Icu Patients ◽  
Fatality Risk ◽  
Case Fatality Risk ◽  
Respiratory Conditions

AbstractThere is large uncertainty around the case fatality risk (CFR) for COVID-19 in China. Therefore, we considered symptomatic cases outside of China (countries/settings with 20+ cases) and the proportion who are in intensive care units (4.0%, 14/349 on 13 February 2020). Given what is known about CFRs for ICU patients with severe respiratory conditions from a meta-analysis, we estimated a CFR of 1.37% (95%CI: 0.57% to 3.22%) for COVID- 19 cases outside of China.

scholarly journals Middle East Respiratory Syndrome (MERS) Infection in Hematological and Oncological Patients: A Case Series from a Tertiary Care Center in Saudi Arabia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5871-5871 ◽  
Author(s):  
Ahmed Alaskar ◽  
Mohammed Bosaeed ◽  
Hina Rehan ◽  
May Anne Mendoza ◽  
Bader Alahmari ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Clinical Presentation ◽  
Conflicts Of Interest ◽  
Tertiary Care ◽  
Case Series ◽  
Case Fatality ◽  
Middle East Respiratory Syndrome ◽  
Future Research ◽  
Fatality Rate

We present the largest to date of a case series of nine patients with hematological and oncological malignancies who were infected with Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV is a novel beta-coronavirus with a high fatality rate in comorbid patients. The majority of MERS cases globally were reported from Saudi Arabia (1983 cases, including 745 related deaths with a case-fatality rate of 37.5%) according to the WHO update of February 2019. All were clinically stable before acquiring the virus. Most of the cases had an active disease as relapse or refractory with three cases being neutropenic. The clinical presentation and radiological features of the patients were variable and inconsistent (Table 1). Diagnosis was confirmed with RT-PCR assays targeting upstream of the E gene and the open-reading frame gene 1a which had to be done repeatedly and required an average of 3 (with max. of 7) samples for a test to be positive (Table 2). All the patients developed respiratory failure, were admitted to the critical care unit (ICU) and required mechanical ventilation. The length of hospital stay ranged from 15 - 48, with an average of 24 days. Unfortunately, all nine patients died within days after admission to the ICU. In addition, the time from diagnosis to death has an average of 9 days ranging from 2-24 days, respectively. In conclusion, MERS CoV infection in hematology/oncology patients has a very poor prognosis regardless of the status of the underlying disease. The clinical presentation is not distinctive and confirming the diagnosis requires numerous respiratory samples. Measures to prevent nosocomial outbreaks should include proper compliance with personal protection equipment by health-care workers when managing patients with suspected and confirmed MERS-CoV infection and prompt isolation of infected patients. Future research is required to enhance our understanding of the disease and to evaluate superior diagnostic and therapeutic options. Disclosures No relevant conflicts of interest to declare.

scholarly journals An Observational, Laboratory-Based Study of Outbreaks of Middle East Respiratory Syndrome Coronavirus in Jeddah and Riyadh, Kingdom of Saudi Arabia, 2014

2014 ◽  
Vol 60 (3) ◽  
pp. 369-377 ◽  
Author(s):  
Christian Drosten ◽  
Doreen Muth ◽  
Victor M. Corman ◽  
Raheela Hussain ◽  
Malaki Al Masri ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Middle East ◽  
Middle East Respiratory Syndrome ◽  
Nosocomial Transmission ◽  
Interferon Response ◽  
Nucleotide Polymorphisms ◽  
Diagnostic Laboratory ◽  
Virus Shedding ◽  
Negative Results ◽  
Sudden Rise

Abstract Background.  In spring 2014, a sudden rise in the number of notified Middle East respiratory syndrome coronavirus (MERS-CoV) infections occurred across Saudi Arabia with a focus in Jeddah. Hypotheses to explain the outbreak pattern include increased surveillance, increased zoonotic transmission, nosocomial transmission, and changes in viral transmissibility, as well as diagnostic laboratory artifacts. Methods.  Diagnostic results from Jeddah Regional Laboratory were analyzed. Viruses from the Jeddah outbreak and viruses occurring during the same time in Riyadh, Al-Kharj, and Madinah were fully or partially sequenced. A set of 4 single-nucleotide polymorphisms distinctive to the Jeddah outbreak were determined from additional viruses. Viruses from Riyadh and Jeddah were isolated and studied in cell culture. Results.  Up to 481 samples were received per day for reverse transcription polymerase chain reaction (RT-PCR) testing. A laboratory proficiency assessment suggested positive and negative results to be reliable. Forty-nine percent of 168 positive-testing samples during the Jeddah outbreak stemmed from King Fahd Hospital. All viruses from Jeddah were monophyletic and similar, whereas viruses from Riyadh were paraphyletic and diverse. A hospital-associated transmission cluster, to which cases in Indiana (United States) and the Netherlands belonged, was discovered in Riyadh. One Jeddah-type virus was found in Riyadh, with matching travel history to Jeddah. Virus isolates representing outbreaks in Jeddah and Riyadh were not different from MERS-CoV EMC/2012 in replication, escape of interferon response, or serum neutralization. Conclusions.  Virus shedding and virus functions did not change significantly during the outbreak in Jeddah. These results suggest the outbreaks to have been caused by biologically unchanged viruses in connection with nosocomial transmission.

scholarly journals A Comparison of Case Fatality Risk of COVID-19 between Singapore and Japan

2020 ◽  
Vol 9 (10) ◽  
pp. 3326
Author(s):  
Taishi Kayano ◽  
Hiroshi Nishiura
Keyword(s):  
Age Distribution ◽  
Case Fatality ◽  
Standardized Mortality Ratio ◽  
Fatality Risk ◽  
Illness Onset ◽  
High Virulence ◽  
Mortality Ratio ◽  
The Many ◽  
Case Fatality Risk ◽  
Protection Against Infection

The crude case fatality risk (CFR) for coronavirus disease (COVID-19) in Singapore is remarkably small. We aimed to estimate the unbiased CFR by age for Singapore and Japan and compare these estimates by calculating the standardized mortality ratio (SMR). Age-specific CFRs for COVID-19 were estimated in real time, adjusting for the delay from illness onset to death. The SMR in Japan was estimated by using the age distribution of the Singapore population. Among cases aged 60–69 years and 70–79 years, the age-specific CFRs in Singapore were estimated as 1.84% (95% confidence interval: 0.46–4.72%) and 5.57% (1.41–13.97%), respectively, and those in Japan as 5.52% (4.55–6.62%) and 15.49% (13.81–17.27%), respectively. The SMR of COVID-19 in Japan, when compared with Singapore as the baseline, was estimated to be 1.46 (1.09–2.96). The overall CFR for Singapore is lower than that for Japan. It is possible that the circulating variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Singapore causes a milder clinical course of COVID-19 infection compared with other strains. If infection with a low-virulence SARS-CoV-2 variant provides protection against infection by high-virulence strains, the existence of such a strain is encouraging news for the many countries struggling to suppress this virus.

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