Estimating the severity and subclinical burden of middle east respiratory syndrome coronavirus infection in the Kingdom of Saudi Arabia

Justin T Lessler, Henrik Salje, Maria D. Van Kerkhove, Neil M. Ferguson, Simon Cauchemez, Isabel Rodriquez-Barraquer, Rafat Hakeem, Thibaut Jombart, Ricardo Aguas, Ali Al-Barrak, Derek A T Cummings

Research output: Contribution to journalArticle

Abstract

Not all persons infected with Middle East respiratory syndrome coronavirus (MERS-CoV) develop severe symptoms, which likely leads to an underestimation of the number of people infected and an overestimation of the severity. To estimate the number of MERS-CoV infections that have occurred in the Kingdom of Saudi Arabia, we applied a statistical model to a line list describing 721 MERS-CoV infections detected between June 7, 2012, and July 25, 2014. We estimated that 1,528 (95% confidence interval (CI): 1,327, 1,883) MERS-CoV infections occurred in this interval, which is 2.1 (95% CI: 1.8, 2.6) times the number reported. The probability of developing symptoms ranged from 11% (95% CI: 4, 25) in persons under 10 years of age to 88% (95% CI: 72, 97) in those 70 years of age or older. An estimated 22% (95% CI: 18, 25) of those infected with MERS-CoV died. MERS-CoV is deadly, but this work shows that its clinical severity differs markedly between groups and that many cases likely go undiagnosed.

Original languageEnglish (US)
Pages (from-to)657-663
Number of pages7
JournalAmerican Journal of Epidemiology
Volume183
Issue number7
DOIs
StatePublished - Apr 1 2016

Keywords

  • burden
  • clinical symptoms
  • coronavirus
  • MERS
  • severity

ASJC Scopus subject areas

  • Epidemiology

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  • Cite this

    Lessler, J. T., Salje, H., Van Kerkhove, M. D., Ferguson, N. M., Cauchemez, S., Rodriquez-Barraquer, I., Hakeem, R., Jombart, T., Aguas, R., Al-Barrak, A., & Cummings, D. A. T. (2016). Estimating the severity and subclinical burden of middle east respiratory syndrome coronavirus infection in the Kingdom of Saudi Arabia. American Journal of Epidemiology, 183(7), 657-663. https://doi.org/10.1093/aje/kwv452