title: Risk Factors for Primary Middle East Respiratory Syndrome Coronavirus Illness in Humans, Saudi Arabia, 2014.
abstract: Risk factors for primary Middle East respiratory syndrome coronavirus (MERS-CoV) illness in humans are incompletely understood. We identified all primary MERS-CoV cases reported in Saudi Arabia during March-November 2014 by excluding those with history of exposure to other cases of MERS-CoV or acute respiratory illness of unknown cause or exposure to healthcare settings within 14 days before illness onset. Using a case-control design, we assessed differences in underlying medical conditions and environmental exposures among primary case-patients and 2-4 controls matched by age, sex, and neighborhood. Using multivariable analysis, we found that direct exposure to dromedary camels during the 2 weeks before illness onset, as well as diabetes mellitus, heart disease, and smoking, were each independently associated with MERS-CoV illness. Further investigation is needed to better understand animal-to-human transmission of MERS-CoV.
authors.forename: Basem M
authors.initials: BM
authors.lastname: Alraddadi
authors.forename: John T
authors.initials: JT
authors.lastname: Watson
authors.forename: Abdulatif
authors.initials: A
authors.lastname: Almarashi
authors.forename: Glen R
authors.initials: GR
authors.lastname: Abedi
authors.forename: Amal
authors.initials: A
authors.lastname: Turkistani
authors.forename: Musallam
authors.initials: M
authors.lastname: Sadran
authors.forename: Abeer
authors.initials: A
authors.lastname: Housa
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Almazroa
authors.forename: Naif
authors.initials: N
authors.lastname: Alraihan
authors.forename: Ayman
authors.initials: A
authors.lastname: Banjar
authors.forename: Eman
authors.initials: E
authors.lastname: Albalawi
authors.forename: Hanan
authors.initials: H
authors.lastname: Alhindi
authors.forename: Abdul Jamil
authors.initials: AJ
authors.lastname: Choudhry
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Meiman
authors.forename: Magdalena
authors.initials: M
authors.lastname: Paczkowski
authors.forename: Aaron
authors.initials: A
authors.lastname: Curns
authors.forename: Anthony
authors.initials: A
authors.lastname: Mounts
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Nina
authors.initials: N
authors.lastname: Marano
authors.forename: David L
authors.initials: DL
authors.lastname: Swerdlow
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
authors.forename: Rana
authors.initials: R
authors.lastname: Hajjeh
authors.forename: Tariq A
authors.initials: TA
authors.lastname: Madani
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002162:Camelus / Q000821:virology; D016022:Case-Control Studies; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000209:etiology* / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000472:pathogenicity*; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D055815:Young Adult
keywords: MERS-CoV; Middle East respiratory syndrome coronavirus; Saudi Arabia; case–control study; diabetes mellitus; dromedary camels; heart disease; primary infection; risk factors; smoking; transmission; viruses; zoonosis