PubMed Journals: Epidemiol Rev

  Source:		PMID: 31781765

    		Epidemiol Rev. 2019 Nov 29. pii: mxz009. doi:
     		10.1093/epirev/mxz009. [Epub ahead of print]

			A review of asymptomatic and sub-clinical
			Middle East Respiratory Syndrome
			Coronavirus Infections.

			Grant R(1)(2), Malik MR(3), Elkholy A(3), Van
			Kerkhove MD(1).

			Author Information
			(1) Department of Infectious Hazard
			Management, WHO Health Emergencies
			Programme, World Health Organization,
			Geneva, Switzerland.
			(2) Centre for Global Health, Institut Pasteur,
			Paris, France.
			(3) Infectious Hazard Management Unit,
			Department of Health Emergencies, World
			Health Organization Regional Office for the
			Eastern Mediterranean, Cairo, Egypt.

			The epidemiology of
			Middle East Respiratory syndrome coronavirus
			(MERS-CoV) since 2012 has been largely
			characterised by recurrent zoonotic spill-over
			from dromedary camels followed by limited
			human-to-human transmission, predominantly
			in health care settings. The full extent of
			infection of MERS-CoV is not clear, nor is the
			extent and/or role of asymptomatic infections in
			transmission. We conducted a review of
			molecular and serological investigations
			through PubMed and EMBASE from
			September 2012 to 15 November 2018
			attempting to measure sub-clinical or
			asymptomatic MERS-CoV infection within and
			outside of health care settings. We performed
			retrospective analysis of laboratory-confirmed
			MERS-CoV infections reported to the
			World Health Organization to 27 November
			2018 to summarize what is known about
			asymptomatic infections identified through
			national surveillance systems. We identified 23
			studies reporting evidence of MERS-CoV
			infection outside health care settings, mainly of
			camel workers, showing ranges of
			seroprevalence of 0-67% depending on the
			study location. We identified 20 studies in
			health care settings, of health care worker
			(HCW) and family contacts, of which 11
			documented molecular evidence of MERS-CoV
			infection among asymptomatic contacts. Since
			2012, 298 laboratory confirmed cases were
			reported as asymptomatic to the World Health
			Organization, 164 of whom were HCW. Viral
			shedding studies of asymptomatic MERS
			infections have demonstrated the potential to
			transmit MERS-CoV to others. Our results
			highlight the possibility for onward transmission
			of MERS-CoV from asymptomatic individuals.
			Screening of HCW contacts of confirmed
			MERS-CoV patients is currently recommended,
			but systematic screening of non-HCW contacts
			outside of health care facilities should be

			┬ęThe Author(s) 2019. Published by Oxford
			University Press on behalf of the Johns Hopkins
			Bloomberg School of Public Health.

			DOI: 10.1093/epirev/mxz009 PMID: 31781765

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