Risk of MERS importation and onward transmission: a systematic review and analysis of cases reported to WHO

摘要: The continuing circulation of MERS in the Middle East makes international dissemination disease a permanent threat. To inform risk assessment, we investigated spatiotemporal pattern global and looked for factors explaining heterogeneity observed transmission events following importation. We reviewed imported cases worldwide up to July 2015. modelled importations time based on air travel combined with incidence East. used detailed history case management after importation (time hospitalization isolation, number hospitals visited,…) logistic regression identify secondary transmission. assessed changes isolation relation collective public health attention epidemic, measured by three indicators (Google Trends, ProMED-mail, Disease Outbreak News). Modelled were found reproduce both temporal geographical structure those – Pearson correlation coefficient between predicted monthly series was large (r = 0.78, p < 10−4). increased or death (OR = 1.7 p = 0.04) more precisely duration (OR = 1.7, p = 0.02). average daily 0.02 [0.0,0.12] community 0.20 [0.03,9.0] hospital. Time from hospitalisation decreased periods high (2.33 ± 0.34 vs. 6.44 ± 0.97 days during baseline attention). Countries at should focus their resources strict infection control measures potential healthcare settings prompt identification. Individual awareness are key substantially improve such preparedness.