Multihospital Outbreak of a Middle East Respiratory Syndrome Coronavirus Deletion Variant, Jordan: A Molecular, Serologic, and Epidemiologic Investigation

Details

• Journal Article:
  Open Forum Infect Dis
• Personal Author:
  Payne, Daniel C. ; Biggs, Holly M. ; Al-Abdallat, Mohammad Mousa ; Alqasrawi, Sultan ; Lu, Xiaoyan ; Abedi, Glen R. ; Haddadin, Aktham ; Iblan, Ibrahim ; Alsanouri, Tarek ; Al Nsour, Mohannad ; Sheikh Ali, Sami ; Rha, Brian ; Trivedi, Suvang U. ; Rasheed, Mohammed Ata Ur ; Tamin, Azaibi ; Lamers, Mart M. ; Haagmans, Bart L. ; Erdman, Dean D. ; Thornburg, Natalie J. ; Gerber, Susan I.
  More +
• Description:
  Background ; An outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in Jordan in 2015 involved a variant virus that acquired distinctive deletions in the accessory open reading frames. We conducted a molecular and seroepidemiologic investigation to describe the deletion variant’s transmission patterns and epidemiology. ; Methods ; We reviewed epidemiologic and medical chart data and analyzed viral genome sequences from respiratory specimens of MERS-CoV cases. In early 2016, sera and standardized interviews were obtained from MERS-CoV cases and their contacts. Sera were evaluated by nucleocapsid and spike protein enzyme immunoassays and microneutralization. ; Results ; Among 16 cases, 11 (69%) had health care exposure and 5 (31%) were relatives of a known case; 13 (81%) were symptomatic, and 7 (44%) died. Genome sequencing of MERS-CoV from 13 cases revealed 3 transmissible deletions associated with clinical illness during the outbreak. Deletion variant sequences were epidemiologically clustered and linked to a common transmission chain. Interviews and sera were collected from 2 surviving cases, 23 household contacts, and 278 health care contacts; 1 (50%) case, 2 (9%) household contacts, and 3 (1%) health care contacts tested seropositive. ; Conclusions ; The MERS-CoV deletion variants retained human-to-human transmissibility and caused clinical illness in infected persons despite accumulated mutations. Serology suggested limited transmission beyond that detected during the initial outbreak investigation.
• Subjects:
  • Major Article
  • coronavirus
  • emerging infectious disease
  • genome deletion
  • MERS-CoV
  • Middle East respiratory syndrome
  • outbreak investigation
  • sero-epidemiology
• Source:
  Open Forum Infect Dis. 2018; 5(5).
• DOI:
  http://dx.doi.org/10.1093/ofid/ofy095
• Pubmed ID:
  30294616
• Pubmed Central ID:
  PMC5965092
• Document Type:
  Text ; Journal Article
• Genre:
  Journal Article
• Place as Subject:
  Jordan
• Volume:
  5
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/60070/cdc_60070_DS1.pdf
• File Type:
  [PDF - 265.64 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e76fb9895f9eed2e76be88a2aaf723b8df240f3a4c34310e7f1e81ba94dfadf7eb6bfb1679c690e6fa909bdee2b395d655144d306e99189828a239f6201393f1