Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Jun 7;6(6):e51.
doi: 10.1038/emi.2017.40.

Comparative epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia and South Korea

Xin Chen  1 , Abrar Ahmad Chughtai  1 , Amalie Dyda  1 , Chandini Raina MacIntyre  1   2
Affiliations
Comparative Study

Comparative epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia and South Korea

Xin Chen et al. Emerg Microbes Infect. .

Abstract

MERS-CoV infection emerged in the Kingdom of Saudi Arabia (KSA) in 2012 and has spread to 26 countries. However, 80% of all cases have occurred in KSA. The largest outbreak outside KSA occurred in South Korea (SK) in 2015. In this report, we describe an epidemiological comparison of the two outbreaks. Data from 1299 cases in KSA (2012-2015) and 186 cases in SK (2015) were collected from publicly available resources, including FluTrackers, the World Health Organization (WHO) outbreak news and the Saudi MOH (MOH). Descriptive analysis, t-tests, Chi-square tests and binary logistic regression were conducted to compare demographic and other characteristics (comorbidity, contact history) of cases by nationality. Epidemic curves of the outbreaks were generated. The mean age of cases was 51 years in KSA and 54 years in SK. Older males (⩾70 years) were more likely to be infected or to die from MERS-CoV infection, and males exhibited increased rates of comorbidity in both countries. The epidemic pattern in KSA was more complex, with animal-to-human, human-to-human, nosocomial and unknown exposure, whereas the outbreak in SK was more clearly nosocomial. Of the 1186 MERS cases in KSA with reported risk factors, 158 (13.3%) cases were hospital associated compared with 175 (94.1%) in SK, and an increased proportion of cases with unknown exposure risk was found in KSA (710, 59.9%). In a globally connected world, travel is a risk factor for emerging infections, and health systems in all countries should implement better triage systems for potential imported cases of MERS-CoV to prevent large epidemics.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The distribution of MERS cases and deaths in KSA (2012-2015) and SK (2015)#. (A) Number and proportion of MERS cases by sex and age group; (B) Number of deaths by sex and age group; (C) Sex-specific CFR by age group; (D) MERS cases by contact risk factors. *Others include contact risk factors of sheep-linked, camel and sheep-linked, camel and community-linked and camel, sheep and hospital-linked.
Figure 2
Figure 2
Number of MERS cases by the week of onset of symptoms. (A) Kingdom of Saudi Arabia, 2012–2015 (n=805); (B) South Korea, 2015 (n=172).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization. Background and Summary of Novel Coronavirus Infection. Geneva: WHO, 2013. Available at http://www.who.int/csr/disease/coronavirus_infections/Update12_MERSCoV_u... (accessed 15 January 2016).
    1. FluTrackers. 2012–2015 Case List of MoH/WHO Novel Coronavirus MERS nCoV Announced Cases. Florida: FluTrackers.com Inc.; 2016. Available at https://flutrackers.com/forum/forum/novel-coronavirus-ncov-mers-2012-201... (accessed 15 February 2016).
    1. Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet 2015; 386: 995–1007. - PMC - PubMed
    1. Reusken CB, Farag EA, Jonges M et al. Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels, Qatar, April 2014. Euro Surveill 2014; 19. pii:20829. - PubMed
    1. Azhar EI, El-Kafrawy SA, Farraj SA et al. Evidence for camel-to-human transmission of MERS coronavirus. N Engl J Med 2014; 370: 2499–2505. - PubMed

Publication types

MeSH terms

LinkOut - more resources

-