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

Nishiura, Hiroshi; Endo, Akira; Saitoh, Masaya; Kinoshita, Ryo; Ueno, Ryo; Nakaoka, Shinji; Miyamatsu, Yuichiro; Dong, Yueping; Chowell, Gerardo; Mizumoto, Kenji

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

Nishiura, Hiroshi; Endo, Akira; Saitoh, Masaya et al.

BMJ Open, 2016, 6(2), e009936

Permalink : https://hdl.handle.net/2115/63451

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アクセス権	open access
URI	https://hdl.handle.net/2115/63451
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 ; Endo, Akira ; Saitoh, Masaya ; Kinoshita, Ryo ; Ueno, Ryo ; Nakaoka, Shinji ; Miyamatsu, Yuichiro ; Dong, Yueping ; Chowell, Gerardo ; Mizumoto, Kenji
e-Rad_Researcher 70432987 著者名 Nishiura, Hiroshi
著者名 Endo, Akira
著者名 Saitoh, Masaya
著者名 Kinoshita, Ryo
著者名 Ueno, Ryo
著者名 Nakaoka, Shinji
著者名 Miyamatsu, Yuichiro
著者名 Dong, Yueping
著者名 Chowell, Gerardo
著者名 Mizumoto, Kenji
言語	英語
発行日	2016
出版者	BMJ Publishing Group
収録物名	BMJ Open
巻(号)	6(2)
ページ	e009936
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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 4.0 International
PISSN	2044-6055
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1136/bmjopen-2015-009936