title: Clinical and Epidemiologic Characteristics of Spreaders of Middle East Respiratory Syndrome Coronavirus during the 2015 Outbreak in Korea.
abstract: Nosocomial transmission is an important characteristic of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection. Risk factors for transmission of MERS-CoV in healthcare settings are not well defined. During the Korean outbreak in 2015, 186 patients had laboratory-confirmed MERS-CoV infection. Those suspected as a source of viral transmission were categorized into the spreader groups (super-spreader [n = 5] and usual-spreader [n = 10]) and compared to the non-spreader group (n = 171). Body temperature of ≥ 38.5°C (adjusted odds ratio [aOR], 5.54; 95% confidence interval [CI], 1.38-22.30; P = 0.016), pulmonary infiltration of ≥ 3 lung zones (aOR, 7.33; 95% CI, 1.93-27.79; P = 0.003), and a more nonisolated in-hospital days (aOR, 1.32 per 1 day; 95% CI, 1.09-1.60; P = 0.004) were significant risk factors in the spreader group. There was no different clinical factor between super-spreaders and usual-spreaders. Nonisolated in-hospital days was the only factor which tended to be higher in super-spreaders than usual-spreaders (Mean, 6.6 vs. 2.9 days; P = 0.061). Early active quarantine might help reducing the size of an outbreak.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Chang Kyung
authors.identifier: http://orcid.org/0000-0003-1952-072X
authors.initials: CK
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Ho
authors.identifier: http://orcid.org/0000-0002-4517-3840
authors.initials: KH
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Pyoeng Gyun
authors.identifier: http://orcid.org/0000-0001-6794-7918
authors.initials: PG
authors.lastname: Choe
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Wan Beom
authors.identifier: http://orcid.org/0000-0003-0022-9625
authors.initials: WB
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ji Hwan
authors.identifier: http://orcid.org/0000-0002-7628-1182
authors.initials: JH
authors.lastname: Bang
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Eu Suk
authors.identifier: http://orcid.org/0000-0001-7132-0157
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Won
authors.identifier: http://orcid.org/0000-0002-0550-1897
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hong Bin
authors.identifier: http://orcid.org/0000-0001-6262-372X
authors.initials: HB
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Nam Joong
authors.identifier: http://orcid.org/0000-0001-6793-9467
authors.initials: NJ
authors.lastname: Kim
authors.affiliation: JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea.|Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea.
authors.forename: Sung Il
authors.identifier: http://orcid.org/0000-0003-4085-1494
authors.initials: SI
authors.lastname: Cho
authors.affiliation: JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea.|Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea.
authors.forename: Jong Koo
authors.identifier: http://orcid.org/0000-0003-4833-1178
authors.initials: JK
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.|JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul, Korea. mdohmd@snu.ac.kr.
authors.forename: Myoung Don
authors.identifier: http://orcid.org/0000-0002-2344-7695
authors.initials: MD
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D001831:Body Temperature; D018352:Coronavirus Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007902:Length of Stay; D008168:Lung / Q000821:virology; D008297:Male; D008875:Middle Aged; D065207:Middle East Respiratory Syndrome Coronavirus / Q000302:isolation & purification; D015999:Multivariate Analysis; D016017:Odds Ratio; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
keywords: Hospital Infection; Infection Transmission; Korea; MERS-CoV; Outbreak