• Farida Ismail Al Hosani, Lindsay Kim, Ahmed Khudhair, Huong Pham, Mariam Al Mulla, Zyad Al Bandar, Krishna Pradeep, Kheir Abou Elkheir, Stefan Weber, Mary Khoury, George Donnelly, Naima Younis, Feda El Saleh, Muna Abdalla, Hala Imambaccus, Lia M Haynes, Natalie J Thornburg, Jennifer L Harcourt, Congrong Miao, Azaibi Tamin, Aron J Hall, Elizabeth S Russell, Aaron M Harris, Craig Kiebler, Roger A Mir, Kimberly Pringle, Negar N Alami, Glen R Abedi, and Susan I Gerber.
• Department of Health-Abu Dhabi, United Arab Emirates.
• Clin. Infect. Dis. 2019 Jan 18; 68 (3): 409-418.

BackgroundAlthough there is evidence of person-to-person transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent to which disease severity affects transmission.MethodsA seroepidemiological investigation was conducted among MERS-CoV case patients (cases) and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. Cases diagnosed between 1 January 2013 and 9 May 2014 and their household contacts were approached for enrollment. Demographic, clinical, and exposure history data were collected. Sera were screened by MERS-CoV nucleocapsid protein enzyme-linked immunosorbent assay and indirect immunofluorescence, with results confirmed by microneutralization assay.ResultsThirty-one of 34 (91%) case patients were asymptomatic or mildly symptomatic and did not require oxygen during hospitalization. MERS-CoV antibodies were detected in 13 of 24 (54%) case patients with available sera, including 1 severely symptomatic, 9 mildly symptomatic, and 3 asymptomatic case patients. No serologic evidence of MERS-CoV transmission was found among 105 household contacts with available sera.ConclusionsTransmission of MERS-CoV was not documented in this investigation of mostly asymptomatic and mildly symptomatic cases and their household contacts. These results have implications for clinical management of cases and formulation of isolation policies to reduce the risk of transmission.

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