Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Ethical Considerations
2.3. Contact with Dromedary Camels as Reported by Member States
2.4. Descriptive Analysis
3. Results
3.1. Subject Characteristics
3.2. Direct and Indirect Contact with Dromedaries
3.3. Comparison of Primary and Non-Primary Cases
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | All Cases (n = 1125) | Primary Cases (n = 348) | Non-Primary Cases (n = 455) | Unclassified Cases (n = 322) | |||||
---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | ||
Age | |||||||||
Mean (years) | 54.9 | 57.7 | 53.4 | 54.1 | |||||
SD (years) | 17.3 | 15.8 | 17.9 | 17.6 | |||||
Sex | |||||||||
Male | 808 | 71.8 | 301 | 86.5 | 284 | 62.4 | 223 | 69.3 | |
Female | 313 | 27.8 | 45 | 12.9 | 171 | 37.6 | 97 | 30.1 | |
Not reported | 4 | 0.4 | 2 | 0.6 | 0 | 0 | 2 | 0.6 | |
Country of MERS-CoV exposure | |||||||||
Within the Middle East | |||||||||
Islamic Republic of Iran | 1 | 0.1 | 0 | 0 | 1 | 0.2 | 0 | 0 | |
Jordan | 13 | 1.2 | 0 | 0 | 4 | 0.9 | 9 | 2.8 | |
Kingdom of Saudi Arabia | 911 | 90.0 | 335 | 96.3 | 276 | 60.7 | 300 | 93.2 | |
Kuwait | 2 | 0.2 | 2 | 0.6 | 0 | 0 | 0 | 0 | |
Oman | 10 | 0.9 | 4 | 1.2 | 1 | 0.2 | 5 | 1.6 | |
Qatar | 9 | 0.8 | 5 | 1.4 | 0 | 0 | 4 | 1.2 | |
United Arab Emirates | 6 | 0.5 | 2 | 0.6 | 0 | 0 | 4 | 1.2 | |
Outside the Middle East | |||||||||
Republic of Korea | 172 | 15.3 | 0 | 0 | 172 | 37.8 | 0 | 0 | |
Not reported | 1 | 0.1 | 0 | 0 | 1 | 0.2 | 0 | 0 | |
Severity | |||||||||
Asymptomatic/mild | 99 | 8.8 | 7 | 2.0 | 64 | 14.1 | 28 | 8.7 | |
Pneumonia/non-ICU | 241 | 21.4 | 102 | 29.3 | 54 | 11.9 | 85 | 26.4 | |
Severe/fatal | 553 | 49.2 | 209 | 60.1 | 190 | 41.8 | 154 | 47.8 | |
Not reported | 232 | 20.6 | 30 | 8.6 | 147 | 32.3 | 55 | 17.1 | |
Outcome | |||||||||
Survived | 245 | 21.8 | 79 | 22.7 | 109 | 24.0 | 57 | 17.7 | |
Died | 414 | 36.8 | 151 | 43.4 | 149 | 32.8 | 114 | 35.4 | |
Not reported | 466 | 41.4 | 118 | 33.9 | 197 | 43.3 | 151 | 46.9 |
Contact | All Cases (n = 1125) | Primary Cases (n = 348) | Non-Primary Cases (n = 455) | Unclassified Cases (n = 322) | |||||
---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | ||
Any contact with dromedaries | |||||||||
Yes | 235 | 20.9 | 191 | 54.9 | 5 | 1.1 | 39 | 12.1 | |
No | 276 | 24.5 | 62 | 17.8 | 162 | 35.6 | 52 | 16.2 | |
Not reported | 614 | 54.6 | 95 | 27.3 | 288 | 63.3 | 231 | 71.7 | |
Direct contact with dromedaries * | |||||||||
Yes | 201 | 17.9 | 164 | 47.1 | 3 | 0.7 | 34 | 10.6 | |
No | 285 | 25.3 | 68 | 19.5 | 162 | 35.6 | 55 | 17.1 | |
Not reported | 639 | 56.8 | 116 | 33.3 | 290 | 63.7 | 233 | 72.4 | |
Indirect contact with dromedaries * | |||||||||
Yes | 186 | 16.5 | 155 | 44.5 | 3 | 0.7 | 28 | 8.7 | |
No | 280 | 24.9 | 73 | 21.0 | 152 | 33.4 | 55 | 17.1 | |
Not reported | 659 | 58.6 | 120 | 34.5 | 300 | 65.9 | 239 | 74.2 | |
Type of dromedary product consumed | |||||||||
Unpasteurized milk | 163 | 14.5 | 137 | 39.4 | 3 | 0.7 | 23 | 7.1 | |
Milk (unspecified) | 3 | 0.3 | 3 | 0.9 | 0 | 0 | 0 | 0 | |
Meat | 2 | 0.2 | 2 | 0.6 | 0 | 0 | 0 | 0 | |
Unspecified | 18 | 1.6 | 13 | 3.7 | 0 | 0 | 5 | 1.6 |
Characteristics | Primary Cases (n = 348) | Non-Primary Cases (n = 455) | ||||
---|---|---|---|---|---|---|
n | % | n | % | p Value | ||
Age | ||||||
Mean (years) | 57.7 | 53.4 | <0.001 | |||
Sex | <0.001 | |||||
Male | 301 | 86.5 | 284 | 62.4 | ||
Female | 45 | 12.9 | 171 | 37.6 | ||
Outcome | 0.08 | |||||
Survived | 79 | 22.7 | 109 | 24.0 | ||
Died | 151 | 43.4 | 149 | 32.8 | ||
Exposures | ||||||
Any contact with dromedaries | <0.001 | |||||
Yes | 191 | 54.9 | 5 | 1.1 | ||
No | 62 | 17.8 | 162 | 35.6 | ||
Direct contact with dromedaries * | <0.001 | |||||
Yes | 164 | 47.1 | 3 | 0.7 | ||
No | 68 | 19.5 | 162 | 35.6 | ||
Indirect contact with dromedaries * | <0.001 | |||||
Yes | 155 | 44.5 | 3 | 0.7 | ||
No | 73 | 21.0 | 152 | 33.4 |
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Conzade, R.; Grant, R.; Malik, M.R.; Elkholy, A.; Elhakim, M.; Samhouri, D.; Ben Embarek, P.K.; Van Kerkhove, M.D. Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases. Viruses 2018, 10, 425. https://doi.org/10.3390/v10080425
Conzade R, Grant R, Malik MR, Elkholy A, Elhakim M, Samhouri D, Ben Embarek PK, Van Kerkhove MD. Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases. Viruses. 2018; 10(8):425. https://doi.org/10.3390/v10080425
Chicago/Turabian StyleConzade, Romy, Rebecca Grant, Mamunur Rahman Malik, Amgad Elkholy, Mohamed Elhakim, Dalia Samhouri, Peter K. Ben Embarek, and Maria D. Van Kerkhove. 2018. "Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases" Viruses 10, no. 8: 425. https://doi.org/10.3390/v10080425