MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
Euro Surveill. 2013 Jun 13;18(24):20503.
Detection of human cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection internationally is a global public health concern. Rigorous risk assessment is particularly challenging in a context where surveillance may be subject to under-ascertainment and a selection bias towards more severe cases. We would like to assess whether the virus is capable of causing widespread human epidemics, and whether self-sustaining transmission is already under way. Here we review possible transmission scenarios for MERS-CoV and their implications for risk assessment and control. We discuss how existing data, future investigations and analyses may help in reducing uncertainty and refining the public health risk assessment and present analytical approaches that allow robust assessment of epidemiological characteristics, even from partial and biased surveillance data. Finally, we urge that adequate data be collected on future cases to permit rigorous assessment of the transmission characteristics and severity of MERS-CoV, and the public health threat it may pose. Going beyond minimal case reporting, open international collaboration, under the guidance of the World Health Organization and the International Health Regulations, will impact on how this potential epidemic unfolds and prospects for control.
国际上对中东呼吸综合征冠状病毒（MERS-CoV）感染人类病例的检测是全球公共卫生关注的焦点。在监测可能存在漏报和偏向更严重病例的选择偏差的情况下，进行严格的风险评估尤其具有挑战性。我们希望评估该病毒是否有能力引起广泛的人类流行，以及是否已经出现自我维持的传播。在这里，我们回顾了 MERS-CoV 的可能传播情景及其对风险评估和控制的影响。我们讨论了现有数据、未来的调查和分析如何有助于减少不确定性，并完善公共卫生风险评估，并提出了允许从部分和有偏差的监测数据中进行稳健的流行病学特征评估的分析方法。最后，我们敦促在未来病例中收集足够的数据，以允许对 MERS-CoV 的传播特征和严重程度以及它可能构成的公共卫生威胁进行严格评估。超越最低限度的病例报告，在世卫组织和国际卫生条例的指导下开展国际合作，将影响这一潜在疫情的发展和控制前景。
