title: Estimating the Severity and Subclinical Burden of Middle East Respiratory Syndrome Coronavirus Infection in the Kingdom of Saudi Arabia.
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.
authors: Justin
authors: J
authors: Lessler
authors: Henrik
authors: H
authors: Salje
authors: Maria D
authors: MD
authors: Van Kerkhove
authors: Neil M
authors: NM
authors: Ferguson
authors: Simon
authors: S
authors: Cauchemez
authors: Isabel
authors: I
authors: Rodriquez-Barraquer
authors: Rafat
authors: R
authors: Hakeem
authors: Thibaut
authors: T
authors: Jombart
authors: Ricardo
authors: R
authors: Aguas
authors: Ali
authors: A
authors: Al-Barrak
authors: Derek A T
authors: DA
authors: Cummings
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058345:Asymptomatic Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018352:Coronavirus Infections / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus; D012529:Saudi Arabia / Q000453:epidemiology; D055815:Young Adult
keywords: MERS; burden; clinical symptoms; coronavirus; severity