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J Clin Virol. MERS coronavirus: Data gaps for laboratory preparedness
[Source: Journal of Clinical Virology, full page: (LINK). Abstract, edited.]
Journal of Clinical Virology, Available online 7 November 2013 / In Press, Accepted Manuscript.
Review
MERS coronavirus: Data gaps for laboratory preparedness
Rita de Sousa<SUP>a</SUP><SUP> </SUP><SUP>b</SUP>, Chantal Reusken<SUP>a</SUP><SUP>c</SUP>, Marion Koopmans<SUP>a</SUP><SUP>c</SUP>
<SUP></SUP>
<SUP>a</SUP> Centre for Infectious Disease Research, Diagnostics and Screening, Division Virology, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; <SUP>b</SUP> The European Programme for Public Health Microbiology Training (EUPHEM), European Center for Disease Control, Stockholm, Sweden; <SUP>c</SUP> Department of Viroscience, Erasmus Medical Centre, Rotterdam, the Netherlands
Received 15 October 2013 - Revised 29 October 2013 - Accepted 30 October 2013 - Available online 7 November 2013
Abstract
Since the emergence of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, many questions remain on modes of transmission and sources of virus. In outbreak situations, especially with emerging organisms causing severe human disease, it is important to understand the full spectrum of disease, and shedding kinetics in relation to infectivity and the ability to transmit the micro-organism. Laboratory response capacity during the early stages of an outbreak focuses on development of virological and immunological methods for patient diagnosis, for contact tracing, and for epidemiological studies into sources, modes of transmission, identification of risk groups, and animal reservoirs. However, optimal use of this core public health laboratory capacity requires a fundamental understanding of kinetics of viral shedding and antibody response, of assay validation and of interpretation of test outcomes. We reviewed available data from MERS- CoV case reports, and compared this with data on kinetics of shedding and immune response from published literature on other human coronaviruses (hCoVs). We identify and discuss important data gaps, and biases that limit the laboratory preparedness to this novel disease. Public health management will benefit from standardised reporting of methods used, details of test outcomes by sample type, sampling date, in relation to symptoms and risk factors, along with the currently reported demographic, clinical and epidemiological findings.
Keywords: Middle East Respiratory Syndrome Coronavirus; Laboratory preparedness; Coronavirus SARS
Corresponding author. Director of Virology Division, Centre for Infectious Disease Research, Diagnostics and Screening, National Institute for Public Health and the Environment, Bilthoven, the Netherlandsm, Antonie van Leeuwenhoeklaan 9; 3720BA Bilthoven, The Netherlands, Tel.: +31 6 52098601.
Copyright ? 2013 Published by Elsevier B.V.
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Journal of Clinical Virology, Available online 7 November 2013 / In Press, Accepted Manuscript.
Review
MERS coronavirus: Data gaps for laboratory preparedness
Rita de Sousa<SUP>a</SUP><SUP> </SUP><SUP>b</SUP>, Chantal Reusken<SUP>a</SUP><SUP>c</SUP>, Marion Koopmans<SUP>a</SUP><SUP>c</SUP>
<SUP></SUP>
<SUP>a</SUP> Centre for Infectious Disease Research, Diagnostics and Screening, Division Virology, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; <SUP>b</SUP> The European Programme for Public Health Microbiology Training (EUPHEM), European Center for Disease Control, Stockholm, Sweden; <SUP>c</SUP> Department of Viroscience, Erasmus Medical Centre, Rotterdam, the Netherlands
Received 15 October 2013 - Revised 29 October 2013 - Accepted 30 October 2013 - Available online 7 November 2013
Abstract
Since the emergence of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 2012, many questions remain on modes of transmission and sources of virus. In outbreak situations, especially with emerging organisms causing severe human disease, it is important to understand the full spectrum of disease, and shedding kinetics in relation to infectivity and the ability to transmit the micro-organism. Laboratory response capacity during the early stages of an outbreak focuses on development of virological and immunological methods for patient diagnosis, for contact tracing, and for epidemiological studies into sources, modes of transmission, identification of risk groups, and animal reservoirs. However, optimal use of this core public health laboratory capacity requires a fundamental understanding of kinetics of viral shedding and antibody response, of assay validation and of interpretation of test outcomes. We reviewed available data from MERS- CoV case reports, and compared this with data on kinetics of shedding and immune response from published literature on other human coronaviruses (hCoVs). We identify and discuss important data gaps, and biases that limit the laboratory preparedness to this novel disease. Public health management will benefit from standardised reporting of methods used, details of test outcomes by sample type, sampling date, in relation to symptoms and risk factors, along with the currently reported demographic, clinical and epidemiological findings.
Keywords: Middle East Respiratory Syndrome Coronavirus; Laboratory preparedness; Coronavirus SARS
Corresponding author. Director of Virology Division, Centre for Infectious Disease Research, Diagnostics and Screening, National Institute for Public Health and the Environment, Bilthoven, the Netherlandsm, Antonie van Leeuwenhoeklaan 9; 3720BA Bilthoven, The Netherlands, Tel.: +31 6 52098601.
Copyright ? 2013 Published by Elsevier B.V.
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