title: Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014.
abstract: Risk factors for human-to-human transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) are largely unknown. After MERS-CoV infections occurred in an extended family in Saudi Arabia in 2014, relatives were tested by using real-time reverse transcription PCR (rRT-PCR) and serologic methods. Among 79 relatives, 19 (24%) were MERS-CoV positive; 11 were hospitalized, and 2 died. Eleven (58%) tested positive by rRT-PCR; 8 (42%) tested negative by rRT-PCR but positive by serology. Compared with MERS-CoV-negative adult relatives, MERS-CoV-positive adult relatives were older and more likely to be male and to have chronic medical conditions. Risk factors for household transmission included sleeping in an index patient's room and touching respiratory secretions from an index patient. Casual contact and simple proximity were not associated with transmission. Serology was more sensitive than standard rRT-PCR for identifying infected relatives, highlighting the value of including serology in future investigations.
authors.forename: M Allison
authors.initials: MA
authors.lastname: Arwady
authors.forename: Basem
authors.initials: B
authors.lastname: Alraddadi
authors.forename: Colin
authors.initials: C
authors.lastname: Basler
authors.forename: Esam I
authors.initials: EI
authors.lastname: Azhar
authors.forename: Eltayb
authors.initials: E
authors.lastname: Abuelzein
authors.forename: Abdulfattah I
authors.initials: AI
authors.lastname: Sindy
authors.forename: Bakr M Bin
authors.initials: BM
authors.lastname: Sadiq
authors.forename: Abdulhakeem O
authors.initials: AO
authors.lastname: Althaqafi
authors.forename: Omaima
authors.initials: O
authors.lastname: Shabouni
authors.forename: Ayman
authors.initials: A
authors.lastname: Banjar
authors.forename: Lia M
authors.initials: LM
authors.lastname: Haynes
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.forename: Tariq A
authors.initials: TA
authors.lastname: Madani
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016358:Contact Tracing; D018352:Coronavirus Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D065207:Middle East Respiratory Syndrome Coronavirus / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012698:Serologic Tests
chemical_list: D000914:Antibodies, Viral
keywords: Middle East respiratory syndrome coronavirus; RT-PCR; Saudi Arabia; disease transmission; infectious; serologic tests; viruses