title: Comparative Epidemiology of Human Infections with Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome Coronaviruses among Healthcare Personnel.
abstract: The largest nosocomial outbreak of Middle East respiratory syndrome (MERS) occurred in South Korea in 2015. Health Care Personnel (HCP) are at high risk of acquiring MERS-Coronavirus (MERS-CoV) infections, similar to the severe acute respiratory syndrome (SARS)-Coronavirus (SARS-CoV) infections first identified in 2003. This study described the similarities and differences in epidemiological and clinical characteristics of 183 confirmed global MERS cases and 98 SARS cases in Taiwan associated with HCP. The epidemiological findings showed that the mean age of MERS-HCP and total MERS cases were 40 (24~74) and 49 (2~90) years, respectively, much older than those in SARS [SARS-HCP: 35 (21~68) years, p = 0.006; total SARS: 42 (0~94) years, p = 0.0002]. The case fatality rates (CFR) was much lower in MERS-HCP [7.03% (9/128)] or SARS-HCP [12.24% (12/98)] than the MERS-non-HCP [36.96% (34/92), p<0.001] or SARS-non-HCP [24.50% (61/249), p<0.001], however, no difference was found between MERS-HCP and SARS-HCP [p = 0.181]. In terms of clinical period, the days from onset to death [13 (4~17) vs 14.5 (0~52), p = 0.045] and to discharge [11 (5~24) vs 24 (0~74), p = 0.010] and be hospitalized days [9.5 (3~22) vs 22 (0~69), p = 0.040] were much shorter in MERS-HCP than SARS-HCP. Similarly, days from onset to confirmation were shorter in MERS-HCP than MERS-non-HCP [6 (1~14) vs 10 (1~21), p = 0.044]. In conclusion, the severity of MERS-HCP and SARS-HCP was lower than that of MERS-non-HCP and SARS-non-HCP due to younger age and early confirmation in HCP groups. However, no statistical difference was found in MERS-HCP and SARS-HCP. Thus, prevention of nosocomial infections involving both novel Coronavirus is crucially important to protect HCP.
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
authors.forename: Shelan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Center for Geographic Information Science, Research Center for Humanities and Social Science, Academia Sinica, Taipei, Taiwan.
authors.forename: Ta-Chien
authors.initials: TC
authors.lastname: Chan
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.|Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
authors.forename: Yu-Tseng
authors.initials: YT
authors.lastname: Chu
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.|Luke International, Malawi Office and Mzuzu University, Mzuzu City, Malawi.
authors.forename: Joseph Tsung-Shu
authors.initials: JT
authors.lastname: Wu
authors.affiliation: Emergency Offices, Jinan Centre for Disease Control and Prevention, Jinan, Shandong Province, China.
authors.forename: Xingyi
authors.initials: X
authors.lastname: Geng
authors.affiliation: National Research Center for Wildlife Born Diseases, Key Lab of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhao
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
authors.affiliation: Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China.
authors.forename: Enfu
authors.initials: E
authors.lastname: Chen
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Chwan-Chuen
authors.initials: CC
authors.lastname: King
mesh_terms: D000328:Adult; D000368:Aged; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000302:isolation & purification / Q000502:physiology; D045473:Severe acute respiratory syndrome-related coronavirus / Q000302:isolation & purification / Q000502:physiology; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult