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

Justin 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 journalArticlepeer-review

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

  • MERS
  • burden
  • clinical symptoms
  • coronavirus
  • severity

ASJC Scopus subject areas

  • Epidemiology

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