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Identifying determinants of heterogeneous transmission dynamics of the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea, 2015 : a retrospective epidemiological analysis

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タイトル: Identifying determinants of heterogeneous transmission dynamics of the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea, 2015 : a retrospective epidemiological analysis
著者: Nishiura, Hiroshi 著作を一覧する
Endo, Akira 著作を一覧する
Saitoh, Masaya 著作を一覧する
Kinoshita, Ryo 著作を一覧する
Ueno, Ryo 著作を一覧する
Nakaoka, Shinji 著作を一覧する
Miyamatsu, Yuichiro 著作を一覧する
Dong, Yueping 著作を一覧する
Chowell, Gerardo 著作を一覧する
Mizumoto, Kenji 著作を一覧する
発行日: 2016年
出版者: BMJ Publishing Group
誌名: BMJ Open
巻: 6
号: 2
開始ページ: e009936
出版社 DOI: 10.1136/bmjopen-2015-009936
抄録: Objectives: To investigate the heterogeneous transmission patterns of Middle East respiratory syndrome (MERS) in the Republic of Korea, with a particular focus on epidemiological characteristics of superspreaders. Design: Retrospective epidemiological analysis. Setting: Multiple healthcare facilities of secondary and tertiary care centres in an urban setting. Participants: A total of 185 laboratory-confirmed cases with partially known dates of illness onset and most likely sources of infection. Primary and secondary outcome measures: Superspreaders were identified using the transmission tree. The reproduction number, that is, the average number of secondary cases produced by a single primary case, was estimated as a function of time and according to different types of hosts. Results: A total of five superspreaders were identified. The reproduction number throughout the course of the outbreak was estimated at 1.0 due to reconstruction of the transmission tree, while the variance of secondary cases generated by a primary case was 52.1. All of the superspreaders involved in this outbreak appeared to have generated a substantial number of contacts in multiple healthcare facilities (association: p<0.01), generating on average 4.0 (0.0-8.6) and 28.6 (0.0-63.9) secondary cases among patients who visited multiple healthcare facilities and others. The time-dependent reproduction numbers declined substantially below the value of 1 on and after 13 June 2015. Conclusions: Superspreaders who visited multiple facilities drove the epidemic by generating a disproportionate number of secondary cases. Our findings underscore the need to limit the contacts in healthcare settings. Contact tracing efforts could assist early laboratory testing and diagnosis of suspected cases.
資料タイプ: article
URI: http://hdl.handle.net/2115/63451
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 西浦 博

 

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