Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014

Emerging Infectious Diseases. 2016;22(8):1395-1402 DOI 10.3201/eid2208.152015


Journal Homepage

Journal Title: Emerging Infectious Diseases

ISSN: 1080-6040 (Print); 1080-6059 (Online)

Publisher: Centers for Disease Control and Prevention

LCC Subject Category: Medicine: Internal medicine: Infectious and parasitic diseases

Country of publisher: United States

Language of fulltext: English

Full-text formats available: PDF, HTML, XML



M. Allison Arwady

Basem M. Alraddadi

Colin Basler

Esam I. Azhar

Eltayb Abuelzein

Abdulfattah I. Sindy

Bakr M. Bin Sadiq

Abdulhakeem O. Althaqafi

Omaima Shabouni

Ayman Banjar

Lia M. Haynes

Susan I. Gerber

Daniel R. Feikin

Tariq A. Madani


Peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 8 weeks


Abstract | Full Text

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.