Risk Factors for Primary Middle East Respiratory Syndrome Coronavirus Illness in Humans, Saudi Arabia, 2014

• Published in: Emerging infectious diseases Vol. 22; no. 1; pp. 49 - 55
• Main Authors: Alraddadi, Basem M., Watson, John T., Almarashi, Abdulatif, Abedi, Glen R., Turkistani, Amal, Sadran, Musallam, Housa, Abeer, Almazroa, Mohammad A., Alraihan, Naif, Banjar, Ayman, Albalawi, Eman, Alhindi, Hanan, Choudhry, Abdul Jamil, Meiman, Jonathan G., Paczkowski, Magdalena, Curns, Aaron, Mounts, Anthony, Feikin, Daniel R., Marano, Nina, Swerdlow, David L., Gerber, Susan I., Hajjeh, Rana, Madani, Tariq A.
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.01.2016; Centers for Disease Control and Prevention
• Subjects: Adult; Aged; Animals; Camelus - virology; Case-Control Studies; Coronavirus Infections - epidemiology; Coronavirus Infections - etiology; Coronavirus Infections - virology; Coronaviruses; Distribution; Expedited; Female; Humans; Male; MERS-CoV; Middle Aged; Middle East respiratory syndrome; Middle East respiratory syndrome coronavirus; Middle East Respiratory Syndrome Coronavirus - pathogenicity; Physiological aspects; primary infection; Risk Factors; Risk Factors for Primary Middle East Respiratory Syndrome Coronavirus Illness in Humans, Saudi Arabia, 2014; Saudi Arabia - epidemiology; transmission; viruses; Young Adult; Saudi Arabia; risk factors; viruses; Middle East respiratory syndrome coronavirus; case–control study; MERS-CoV; diabetes mellitus; dromedary camels; zoonosis; Saudi Arabia; transmission; heart disease; smoking; primary infection
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid2201.151340

Risk factors for primary Middle East respiratory syndrome coronavirus (MERS-CoV) illness in humans are incompletely understood. We identified all primary MERS-CoV cases reported in Saudi Arabia during March-November 2014 by excluding those with history of exposure to other cases of MERS-CoV or acute respiratory illness of unknown cause or exposure to healthcare settings within 14 days before illness onset. Using a case-control design, we assessed differences in underlying medical conditions and environmental exposures among primary case-patients and 2-4 controls matched by age, sex, and neighborhood. Using multivariable analysis, we found that direct exposure to dromedary camels during the 2 weeks before illness onset, as well as diabetes mellitus, heart disease, and smoking, were each independently associated with MERS-CoV illness. Further investigation is needed to better understand animal-to-human transmission of MERS-CoV.