中东以外地区最大一次中东呼吸综合征暴发,韩国,2015

The largest outbreak of Middle East respiratory syndrome outside Middle East:South Korea,2015

2015年5月11日至12月23日在韩国由一名从中东返回的旅行者引发了中东呼吸综合征暴发。186人发病,38人死亡。年龄偏大和存在基础性疾患是病人死亡的危险因素。这是中东以外地区最大一次中东呼吸综合征暴发,具有以下流行病学特征:(1)医院感染是最重要的暴发原因,但大量受攻击的是非护理人员(154/184);(2)家庭感染少见,无社区感染,传播呈多中心性;(3)呈现多代型继发感染病例,第1代感染者26例,第2代120例,第3代22例,第4代5例;(4)传播方式主要是微滴传播,直接接触传播仅约10%,大多数感染发生于和病人相处同一护理环境,最大可能是污染物传播。此外,中国发现由韩国输入的一例中东呼吸综合征病例。韩国暴发期间的MERS-COV有较高的遗传变异性和突变率。

A traveler returning from the Middle East initiated an outbreak of Middle East respiratory syndrome（MERS） in South Korea during May 11 to 23 December 2015,which resulted in 186 cases and 38 cases of death.Older age and preexisting underlying diseases were the risk factors for death.The outbreak of MERS in South Korea was the largest one outside Middle East so far.The epidemiological characteristics of the outbreak included hospital infections which was the most important cause of the outbreak but affected largely non health care staff（154/184）.The infections within household were uncommon,and the transmissions were multifocal with no community transmission.The MERS-Cov mainly spreaded via droplet transmission,and transmission via direct contact was only seen in about 10%of the cases,suggesting a possibility of fomite transmission.The first imported case of MERS in China was from South Korea.The MERS-Cov circulating in South Korea during the outbreak has high genetic variability and mutation rate.