title: Increase in Middle East Respiratory Syndrome-Coronavirus Cases in Saudi Arabia Linked to Hospital Outbreak With Continued Circulation of Recombinant Virus, July 1-August 31, 2015.
abstract: During July-August 2015, the number of cases of Middle East respiratory syndrome (MERS) reported from Saudi Arabia increased dramatically. We reviewed the 143 confirmed cases from this period and classified each based upon likely transmission source. We found that the surge in cases resulted predominantly (90%) from secondary transmission largely attributable to an outbreak at a single healthcare facility in Riyadh. Genome sequencing of MERS coronavirus from 6 cases demonstrated continued circulation of the recently described recombinant virus. A single unique frameshift deletion in open reading frame 5 was detected in the viral sequence from 1 case.
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Assiri
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Holly M
authors.initials: HM
authors.lastname: Biggs
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Glen R
authors.initials: GR
authors.lastname: Abedi
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Lu
authors.affiliation: Ministry of Health, Riyadh, Saudi Arabia; Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Bin Saeed
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Osman
authors.initials: O
authors.lastname: Abdalla
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Mutaz
authors.initials: M
authors.lastname: Mohammed
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Hail M
authors.initials: HM
authors.lastname: Al-Abdely
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Homoud S
authors.initials: HS
authors.lastname: Algarni
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Raafat F
authors.initials: RF
authors.lastname: Alhakeem
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Malak M
authors.initials: MM
authors.lastname: Almasri
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Alsharef
authors.affiliation: Ministry of Health , Riyadh , Saudi Arabia.
authors.forename: Randa
authors.initials: R
authors.lastname: Nooh
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Dean D
authors.initials: DD
authors.lastname: Erdman
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Susan I
authors.initials: SI
authors.lastname: Gerber
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: John T
authors.initials: JT
authors.lastname: Watson
keywords: Middle East respiratory syndrome coronavirus; Saudi Arabia; coronavirus infections; disease outbreaks; infectious disease transmission