Skip Navigation
Skip to contents

PHRP : Osong Public Health and Research Perspectives



Page Path
HOME > Osong Public Health Res Perspect > Volume 6(4); 2015 > Article
Original Article Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015
Osong Public Health and Research Perspectives 2015;6(4):269-278.
Published online: September 5, 2015
  • 53 Download
  • 166 Crossref
  • 176 Scopus

Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea

• Received: July 31, 2015   • Accepted: August 27, 2015

Copyright © 2015 Korea Centers for Disease Control and Prevention. Published by Elsevier Korea LLC. All rights reserved.

This article has been corrected. See "Corrigendum to “Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015” [Volume 6, Issue 4, August 2015, 269–278]" in Volume 7 on page 138.
  • Objectives
    The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015.
  • Methods
    Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient.
  • Results
    A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incubation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90–12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64–14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.
  • Conclusion
    A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.
Middle East respiratory syndrome (MERS) is a viral respiratory illness caused by a novel human beta-coronavirus (CoV) 1, 2. Since it was first reported from Saudi Arabia in September 2012, 1,211 patients have been detected worldwide, as of June 5, 2015 [3]. Secondary infection through human-to-human transmission was confirmed from previous outbreaks 4, 5, 6, and outbreaks in healthcare settings comprise a large proportion of the outbreak 4, 7. Although the exact route of transmission is still unclear, the respiratory droplet route is currently most likely [8]. Until June 2015, most of the cases of MERS-CoV infection occurred in the Middle East. Although a few cases were reported in other countries, none exceeded five [3].
The outbreak of MERS-CoV infection in the Republic of Korea started when a 68-year-old South Korean man developed fever and myalgia on May 11 after returning from a business trip to Bahrain, United Arab Emirates, and Saudi Arabia. MERS-CoV infection was diagnosed on May 20. However, by then he had already contacted approximately 600 people during his visits to two clinics and admission to a secondary hospital (Hospital C) located in Pyeongtaek, Gyeonggi-do. Twenty-six cases of MERS-CoV infection were confirmed among these initial contacts, and consecutive transmission based on nosocomial infection rapidly proceeded throughout the nation.
This unprecedented nationwide MERS-CoV outbreak in the Republic of Korea imposed a huge threat not merely to public health and safety, but also to the economy, the tourist industry, and social activity. The forecast for gross domestic product was downgraded by 0.3%, >135,000 foreign tourists canceled their visit to the Republic of Korea, >2,700 schools were closed, and >16,000 people underwent house quarantine. These highlight the importance of appropriate infection control intervention. However, although evidence-based investigation is essential for effective intervention, information concerning the epidemiology of MERS-CoV infection is currently limited. Herein, we provide an overall epidemiologic description of the MERS-CoV infection outbreak in the Republic of Korea, which is the largest outbreak outside of the Arabian Peninsula.
2.1 Definitions
A person was defined as a confirmed MERS-CoV infection case when there was laboratory evidence of MERS-CoV infection, irrespective of clinical signs and symptoms. The onset of illness was defined as the time when a patient newly developed any symptom relating to MERS-CoV infection such as fever, chills, myalgia, shortness of breath, cough, sore throat, headache, nausea, vomiting, diarrhea, or abdominal pain. Cases were classified into healthcare personnel (doctor, nurse, and radiologic technologist), patient, caregiver (both paid and family caregivers), and others. Close contact was defined as a person who did not wear appropriate personal protective equipment (gloves, gown, N95 mask, goggles, or face mask), and: (1) stayed within 2 m of the patient; (2) stayed in the same room or ward with the patent; or (3) directly contacted respiratory secretions of the patient [9]. In order to describe patients who caused sizable subsequent infection transmission, we arbitrarily defined a superspreading event as one patient transmitting the infection to more than four patients. The patient who caused the superspreading event was defined as a superspreader.
2.2 Data source and assessment of exposure
We carried out an epidemiological research by direct interview of the patients who were confirmed with MERS-CoV infection. Data concerning demographic characteristics, the initial symptom and date of its onset, healthcare facilities for the case visited, presence of personal protective equipment, and a list of contacts were collected. The duration and route of exposure were further determined through reviewing closed circuit television and tracking the health insurance review and assessment service, global positioning system of the patient's cellular phone, and recent credit card inquiry transactions. Based on these data, potential exposures were identified for each confirmed case. When a confirmed case had multiple potential exposures, the most probable exposure was determined through the consensus of the authors. Simultaneously, we thoroughly reviewed the medical records of the patients in order to identify underlying comorbidities, radiological evidence of pneumonia, aerosol generating procedures, and final prognosis. National health insurance data was used to validate underlying diseases of the confirmed patients.
2.3 Clinical samples and laboratory confirmation
Sputum or tracheal-aspirate samples of the patients were collected in a sterile cap and transferred to qualified national, local, or commercial facilities immediately. For patients whose sputum specimen was not acquirable, a specimen from a nasopharyngeal or oropharyngeal swab was obtained. Laboratory diagnosis was performed according to the World Health Organization guidelines of the MERS laboratory test [10]. For molecular detection of MERS-CoV RNA, two real-time reverse-transcription polymerase chain reaction assays targeting an upstream of MERS-CoV envelope protein gene and the open reading frame 1a (ORF 1a) gene were used [11].
2.4 Sequencing and phylogenetic analysis
Full genome sequence using Sanger and Illumina sequencing was obtained from direct polymerase chain reaction products using sputum specimens from the index patient. Imported high quality reads were mapped against the JX869059 reference sequence using the CLC Genomic Workbench Version 8.0.1 (CLC bio, Aarhus, Denmark). Fasta consensus sequences obtained from deep sequencing and a group of 15 MERS-CoV complete genome sequences retrieved from GenBank were aligned using MAFFT (Multiple Alignment using Fast Fourier Transform) algorithm [12]. Phylogenetic reconstructions were performed by maximum likelihood criterion using RAxML (Randomized Axelerated Maximum Likelihood) version 8.2.6 ( [13]. Trees were visualized using FigTree v.1.4 (
2.5 Statistical analysis
The incubation period was estimated by identifying the earliest and latest time of possible exposure and the time of symptom onset for each case. Treating these times as interval-censored estimates of the incubation period for each person, we fit a log-normal distribution to these data using maximum-likelihood techniques. We then examined the robustness of our estimates with multiple definitions of onset and with the exclusion of particular cases. The serial interval was estimated by identifying the times of symptom onset in the patient and in the person who transmitted the infection (infected–infector pairs) and then fitting a log-normal distribution to these interval-censored data [14]. We estimated the medians and 5th and 95th percentiles of the incubation period and the serial interval using the quintiles of log-normal distribution fit to each data set. The Chi-square test and Fisher's exact test were used, as appropriate, to compare variables such as age, sex, symptoms at presentation, and underlying disease in association with mortality. Risk factors associated with mortality were assessed using logistic regression analysis. All statistical tests were two-tailed and were considered statistically significant at p < 0.05. Statistical analysis was performed using Microsoft Excel 2007 (Microsoft Corp., Redmond, WA, USA), SPSS Statistics Software, version 20.0 (IBM Corp., Armonk, NY, USA), and R statistical package, version 2.15.1 (R Foundation for Statistical Computing, Vienna, Austria).
3.1 Description of the outbreak
A total of 186 confirmed patients of MERS-CoV infection were identified in the Republic of Korea between May 20, 2015 and July 13, 2015. The outbreak proceeded with three phases of transmission and spread to 16 healthcare facilities (Figure 1). The median age of confirmed MERS-CoV patients was 55 years (Interquartile range 42–66), and 111 patients (59.7%) were male (Table 1). Twenty-five (13.4%) cases were healthcare personnel, 82 (44.1%) were patients who had been exposed during admission or at clinics, and 61(32.8%) were caregivers. Common symptoms at presentation were fever/chills (74.2%) and myalgia (25.3%). Diabetes mellitus was the most common comorbidity (28.0%), followed by malignancy (23.1%). The majority (98%) of patients were infected with MERS-CoV in healthcare facilities.
3.2 Incubation period and serial interval
The incubation period of confirmed cases was 6.83 days [95% confidence interval (CI), 6.31–7.36] (Figure 2); distributions that were fit to our observed data indicated that 95% of infected patients would have an onset of symptoms by Day 13.48 (95% CI of 95th percentile, 12.23–14.73), whereas 5% would have an onset of symptoms by Day 2.27 (95% CI of 5th percentile, 1.98–2.48). We estimated that the serial interval was 12.5 days (95% CI, 11.8–13.2) (Figure 3). The distributions that were fit to our observed data indicate that the serial interval was 20.65 days in 95% of cases (95% CI of 95th percentile, 19.15–22.15) and 6.15 days in 5% of cases (95% CI of 5th percentile, 3.65–8.65).
3.3 Chains of transmission
From May 15 through May 17, the index patient infected 26 secondary cases in Hospital C (Figure 4). An initial epidemiological investigation focused on the healthcare personnel, family members, and the patients who either had prolonged close contact or shared the same hospital room with the index patient. On May 28, as MERS-CoV infection was diagnosed among patients in other rooms, investigation was extended to those who stayed in the same ward. However, eight secondary patients who had not been detected already moved to another ward and infected 10 tertiary patients. Some of the patients had been discharged before May 28. Active surveillance was performed to trace these patients and we were able to find tertiary transmission across seven different hospitals. Patient 14 infected 80 tertiary cases in Hospital H, Patient 15 infected six tertiary cases in Hospital L, and Patient 16 infected 24 tertiary cases in Hospitals M and N, respectively. After the implementation of infection control interventions, a small number of quaternary transmissions occurred, and nearly half of these cases were caused by Patient 76 who was infected in Hospital H.
3.4 Characteristics of superspreader
Five patients met the definition of a superspreader (Table 2). A total of 83.2% of the transmission events were epidemiologically linked to these five patients. The median age of the superspreaders was 41 years (range, 41–68 years). Four were men and the median body mass index was 24 (range, 19–30). Comorbidity was observed in two cases; asthma in Patient 1 and multiple myeloma and diabetes mellitus in Patient 76. All cases were febrile and had pneumonia at presentation. Patient 1, Patient 14, and Patient 16 who had a severe cough infected 28 cases, 85 cases, and 23 cases, respectively. By contrast, Patient 15 and Patient 76 who rarely coughed infected six cases and 11 cases, respectively. Patient 14 mostly stayed in the emergency department, Patient 1, Patient 15, and Patient 26 were mainly hospitalized in multipatient rooms, and Patient 76 stayed in both. The median duration of hospitalization was 10 days (2–11days) and the number of close contacts ranged from 277 to 805. Patient 14 wore an N95 mask intermittently, whereas other superspreaders did not wear any type of mask.
3.5 Mortality cases
As of July 13, 36 deaths have occurred and the mortality rate was 19.4%. In the univariate analysis, older age (≥65years) was strongly associated with mortality (Table 3). History of diabetes mellitus, malignancy, and the presence of underlying respiratory disease (i.e., asthma, chronic obstructive pulmonary disease), cardiac disease (i.e., ischemic heart disease, arrhythmia, and/or heart failure), and chronic kidney disease were also significantly associated with mortality. However, in the multivariate regression analysis, adjusted for sex, age, and underlying diseases, only older age [odds ratio (OR) = 4.86, 95% CI 1.90–12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64–14.65) appeared to be significant.
3.6 Phylogenetic analysis
The MERS-CoV of the index case produced the best match with the virus from an outbreak in Riyadh, Saudi Arabia in February 2015 (Riyadh_KKUH_0708_20150225) by pairwise comparisons (Figure 5). The nucleotide identity was 99.61%. Phylogenetic analysis of the 16 MERS-CoV complete genomes showed that MERS-CoV/KOR/KNIH/001_05_2015 and Riyadh_KKUH_0708_20150225 are the closest relatives of viruses from Qatar and Hafr-Al-Batin in the 2013 outbreak.
The outbreak of MERS-CoV infection in the Republic of Korea is the first of its kind and the largest known outbreak outside the Arabian Peninsula [15]. Because knowledge on the nature of the virus and its mode of transmission was limited, the extensive spread of MERS-CoV infection in the early phase of the outbreak raised great concern. However, the present outbreak could be understood within the range of knowledge from previous outbreaks. The outbreak progressed in the manner of human-to-human transmission, was amplified under the healthcare setting, and showed heterogeneity in transmission. However, delayed diagnosis and the unique medical and patient-care system of the Republic of Korea caused superspreading events.
Nosocomial transmission has been a main characteristic of MERS-CoV infection. The rapid increase of MERS cases since 2013 resulted from healthcare-associated outbreaks in the Middle East 4, 8. Transmission occurred during admission or outpatient visits, at emergency departments, or at outpatient facilities including renal dialysis units 4, 7, 16. In addition to the transmission between patients or healthcare personnel, transmission to hospital visitors was also reported 6, 7. Nosocomial transmission was also predominant in the present outbreak. Of 182 confirmed cases of MERS-CoV infection whose setting of contact is identified, all but one case were infected in healthcare facilities or in ambulances. However, the range of exposure was more extensive than that of outbreaks in the Middle East, infecting multiple visitors, radiologic technologists, hospital security agents in emergency departments, emergency medical technicians, and caregivers. To date, there was no evidence of sustained transmission in the community.
MERS-CoV transmission showed heterogeneity of infectiousness as observed in severe acute respiratory syndrome 4, 17, 18, 19. Similarly, the majority (91.3%) of cases resulted in no transmission and the remaining small proportion caused most of the transmission events in this outbreak. However, superspreading events were more prominent than previous reports. Prolonged duration of exposure before diagnosis and proper isolation, practice of seeking care at multiple healthcare facilities, frequent interhospital transfer, significant numbers of paid caregivers, and large numbers of contacts in large crowded tertiary referral hospitals might have contributed to multiple spreading events. Moreover, the custom of family members and friends to accompany or visit patients, and to provide care with staying in the same hospital rooms (mostly multibed rooms) or in the crowded emergency rooms, may have also contributed to the increased number of contacts. Regarding clinical manifestation, all patients who resulted in multiple transmissions had pneumonia, and those with severe cough infected more cases than others who rarely coughed. There was no evidence of viral mutation which can modify the mode of transmission or virulence [11].
The outbreak progressed in the manner of human-to-human transmission. However, it is still uncertain whether the transmission occurred merely through the respiratory droplet route or through another route of transmission (i.e., airborne transmission). Although the respiratory droplet route is currently regarded as the most likely route of transmission [8], the outbreaks in Hospital C and Hospital H were far more extensive compared with previous hospital outbreaks, and surveillances for other possible routes are under process. Irrespective of the route of transmission, viral transmission actually occurred between rooms in the same ward and throughout the emergency room of Hospital H, which is as wide as 1,970 m2. Transmission across rooms has been previously reported [4], but the present outbreak demonstrated its high feasibility and magnitude. To successfully control the MERS-CoV outbreak, it is essential to implement droplet and contact precautions and trace every individual, including patients, healthcare personnel, and visitors, who stayed in the same ward or same emergency room.
Clinical presentation in this outbreak was similar to the previous outbreaks in the Middle East [7]. Fever is the most common symptom along with myalgia. It is noteworthy that only 12.9% of patients had gastrointestinal symptoms, which is relatively lower than its prevalence of 20–30% documented elsewhere [4]. This may partly be explained by the limitation of current data which is based on primary epidemiologic investigation reports. The estimated incubation period of the present outbreak was 6.83 days, which is similar to that of previous outbreaks [4]. Estimated distribution indicated that most of the infected patients would have symptoms by Day 13.48, and this may reinforce the current policy regarding the duration of quarantine. Estimated serial interval was 12.5 days in this outbreak, which was longer than that of 7.6 days in the previous report [4]. Compared with the previous report, our results have strength in the aspect that they are based on a larger sample size and every case is confirmed by a laboratory test. However, we might have wrongly attributed tertiary or quaternary infection to secondary or tertiary infection in the process of determining the most probable exposure, and thus overestimated the serial interval.
Risk factors for mortality include older age and underlying respiratory diseases, which is similar to the previous study [20]. In our study and other studies alike, patients aged ≥65 years were eight to nine times more likely to die from MERS-CoV infection [20]. Although evidence suggests that chronic kidney diseases are known to be associated with a particularly higher fatality in MERS-CoV infected patients [21], this was not evident in our multivariate analysis. Although underlying diseases of the initial epidemiologic report were cross validated with the national health insurance database, complete clinical data needs to be supplemented in order to draw a more accurate picture on the association of underlying diseases and prognosis.
In the early phase of the outbreak, containment measures were conducted in accordance with current international guidelines which recommended identifying and monitoring close contacts 22, 23. Identification and monitoring of contacts were limited to healthcare personnel who directly managed the index patient, and patients and their families who were in the same hospital room with the index patient. However, when a patient was first confirmed beyond this initial criterion, containment measures had to be reestablished to include a wider spectrum of contacts. Unfortunately, this was not timely enough to prevent infected patients, including superspreaders, from discharging from or transferring to other hospitals. This initial flaw in identifying the appropriate population at risk and delayed response with regards to management of superspreaders, along with suboptimal infection prevention and control in healthcare facilities, eventually culminated in the infection of >180 patients.
Efforts were made to reinforce containment measures. Active surveillance and contact management including contact identification, listing, and follow up on all contacts on a daily basis was conducted. Confirmed cases were isolated and treated in designated hospitals while exposed individuals were quarantined in their homes for 14 days after last exposure. A MERS-CoV test was immediately conducted if the exposed individuals reported suspicious symptoms. Infection control practices in hospitals were reinforced and public awareness was increased. The number of new cases has slowly declined towards the end of June.
Our study has several limitations. Although clinical features of the infected patients were largely based on information attained through accurate epidemiologic investigation, this does not provide knowledge as to the entire clinical course of respective patients. Given this, information regarding clinical data and underlying diseases was validated and supplemented with other reliable sources such as health insurance data and medical records, to minimize the effect of such limitations. There were also a few patients with atypical or no symptoms and several cases whose dates of onset were unclear, which also warrants further investigation. The strength of this study is that, to our knowledge, this is the first report describing the epidemiologic and clinical features of 186 lab-confirmed patients of the outbreak. A wealth of information sources such as closed circuit television, location detection technologies, as well as credit card inquiry transactions, were collected and analyzed.
A single MERS-CoV infection case from abroad resulting in a sizable outbreak in the healthcare setting of a developed country highlights the importance of robust preparedness, vigilant surveillance, and optimal infection prevention control in hospitals. Although evidence-based technical guidelines for investigation are an integral part of effective containment, only limited information is currently available on the transmission dynamics of MERS-CoV. It is anticipated that the lessons learned from this outbreak will contribute to more up-to-date guidelines of MERS-CoV investigation and global health security.
All authors have no conflicts of interest to declare.
The authors and KCDC EIS officers who contributed to this article are as follows: Seung Woo Kim, Tae Un Yang, Yoolwon Jeong, Jung Wan Park, Keon-Joo Lee, Kyung Min Kim, Jongseok Oh, Yong-shik Park, Woncheol Lee, Jong Rak Jung, Changhwan Lee, Joonkee Lee, Heun Choi, WooSuck Suh, Dae-Won Kim, Hoon gil Jo, Minsung Kim, Jungmo Ahn, Kanghyoung Lee, Sang Hyup Lee, Seongil Park, Kyuchul Lee, Min Kim, Jin Won Mo, Daegwang Lee, Up Huh, Hyungmin Kee, Jaejoon Kim, Jae Young Cheon, John Kwon, Eui Jun Lee, Hyung Joo Lim, Jiung Ryu, Young Woo Ryu, and Jung Rae Cho.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-No Derivative Works License ( which permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • 1. Hijawi B., Abdallat M., Sayaydeh A.. Novel coronavirus infections in Jordan, April 2012: epidemiological findings from a retrospective investigation. East Mediterr Health J 19(Suppl. 1): 2013;S12−S18. PMID: 23888790.ArticlePubMed
  • 2. Zaki A.M., van Boheemen S., Bestebroer T.M.. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 367(19): 2012 Nov;1814−1820. PMID: 23075143.Article
  • 3. European Centre for Disease Prevention and Control (ECDC) . Severe respiratory disease associated with Middle East respiratory syndrome coronavirus (MERS-CoV). 16th update, 05 June, 2015. 2015, ECDC. Stockholm (Sweden).
  • 4. Assiri A., McGeer A., Perl T.M.. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med 369(5): 2013 Aug;407−416. PMID: 23782161.Article
  • 5. Drosten C., Muth D., Corman V.M.. An observational, laboratory-based study of outbreaks of Middle East respiratory syndrome coronavirus in Jeddah and Riyadh, Kingdom of Saudi Arabia, 2014. Clin Infect Dis 60(3): 2015 Feb;369−377. PMID: 25323704.Article
  • 6. Health Protection Agency (HPA) UK Novel Coronavirus Investigation team . Evidence of person-to-person transmission within a family cluster of novel coronavirus infections, United Kingdom, February 2013. Euro Surveill 18(11): 2013 Mar;20427PMID: 23517868.Article
  • 7. Oboho I.K., Tomczyk S.M., Al-Asmari A.M.. 2014 MERS-CoV outbreak in Jeddah—a link to health care facilities. N Engl J Med 372(9): 2015 Feb;846−854. PMID: 25714162.Article
  • 8. Zumla A., Hui D.S., Perlman S.. Middle East respiratory syndrome. Lancet 2015;[Epub 2015 June 3].Article
  • 9. Ministry of Health and Welfare (MOHW), Korea Centers for Disease Control and Prevention (KCDC) . Guidelines on Middle East respiratory syndrome Sejong (Republic of Korea): MOHW, KCDC. 2015.
  • 10. World Health Organization . Laboratory testing for Middle East respiratory syndrome coronavirus. Interim recommendations. 2014, WHO. Geneva (Switzerland).
  • 11. Kim Y.-J., Cho Y.-J., Kim D.-W.. Complete genome sequence of Middle East respiratory syndrome coronavirus KOR/KNIH/002_05_2015 isolated in South Korea. Genome Announc 3(4): 2015 Aug;e00787−e00815. PMID: 26272558.
  • 12. Katoh K., Standley D.M.. MAFFT multiple sequence alignment software version 7: improvements in performance and usability. Mol Biol Evol 30(4): 2013 Apr;772−780. PMID: 23329690.Article
  • 13. Stamatakis A.. RAxML version 8: a tool for phylogenetic analysis and post-analysis of large phylogenies. Bioinformatics 30(9): 2014 May;1312−1313. PMID: 24451623.Article
  • 14. Reich N.G., Lessler J., Cummings D.A.. Estimating incubation period distributions with coarse data. Stat Med 28(22): 2009 Sep;2769−2784. PMID: 19598148.Article
  • 15. European Centre for Disease Prevention and Control (ECDC) . Middle East respiratory syndrome coronavirus (MERS-CoV). 18th update. June, 2015, ECDC. Stockholm (Sweden).
  • 16. Guery B., Poissy J., el Mansouf L.. Clinical features and viral diagnosis of two cases of infection with Middle East respiratory syndrome coronavirus: a report of nosocomial transmission. Lancet 381(9885): 2013 Jun;2265−2272. PMID: 23727167.Article
  • 17. Lloyd-Smith J.O., Schreiber S.J., Kopp P.E.. Superspreading and the effect of individual variation on disease emergence. Nature 438(7066): 2005 Nov;355−359. PMID: 16292310.Article
  • 18. Shen Z., Ning F., Zhou W.. Superspreading SARS events, Beijing, 2003. Emerg Infect Dis 10(2): 2004 Feb;256−260. PMID: 15030693.Article
  • 19. Stein R.A.. Super-spreaders in infectious diseases. Int J Infect Dis 15(8): 2011 Aug;e510−e513. PMID: 21737332.Article
  • 20. Saad M., Omrani A.S., Baig K.. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis 29:2014 Dec;301−306. PMID: 25303830.Article
  • 21. Chan J.F., Chan K.H., Choi G.K.. Differential cell line susceptibility to the emerging novel human betacoronavirus 2c EMC/2012: implications for disease pathogenesis and clinical manifestation. J Infect Dis 207(11): 2013 Jun;1743−1752. PMID: 23532101.Article
  • 22. World Health Organization . WHO guidelines for investigation of cases of human infection with Middle East Respiratory Syndrome Coronavirus(MERS-CoV). 2013, WHO. Geneva (Switzerland).
  • 23. Centers for Disease Control and Prevention (CDC) . Middle East respiratory syndrome—interim guidance for healthcare professionals. 2015, CDC. Atlanta (GA).
Figure 1
Epidemiologic curve of 178 confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea, 2015. Panel A (integrated curve) depicts the overall epidemiologic curve by date of symptom onset. Red color indicates the index patient, and three main clusters (Hospital C, Hospital H, and Hospital M and N) are depicted with yellow, green, and purple, respectively. Eight cases whose date of symptom onset is uncertain or who are still under investigation are excluded. Panel B shows the epidemic curve of each of the three main clusters. Stages of transmission are expressed by different patterns. An additional case in Hospital H whose stage of transmission is uncertain is excluded.
Figure 2
Incubation period of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in the Republic of Korea, 2015. Panel A shows the density estimation of incubation periods with gamma distribution. Panel B shows the empirical cumulative density estimation of incubation period.
Figure 3
Serial interval of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in the Republic of Korea, 2015. Panel A shows the density estimation of serial intervals using gamma distribution. Panel B shows the empirical cumulative density estimation of serial intervals.
Figure 4
Transmission map of 182 confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea. The numbers within the red circles are identifiers of notable patients who caused succeeding MERS-CoV infection. The site and the duration of exposure by these patients are indicated in colored boxes. Gray boxes depict the time periods that new cases occurred by date of symptom onset at each site. Black arrows represent how each spreader moved to the next site of transmission. The transmission route of Patient 119 is uncertain. Four cases still under investigation are excluded.
Figure 5
Evolutionary history of the Middle East respiratory syndrome coronavirus (MERS-CoV). A phylogenetic tree was constructed using RAxML. The scale bar shows evolutionary distance inferred by RAxML algorithm. The MERS-CoV in the Republic of Korea outbreak is indicated by a red cycle. Support for the ML phylogenetic trees was evaluated using 1,000 bootstrap replicates. Note numbers represent % bootstrap replicates >70%.
Table 1
Demographic and clinical features of 186 cases of laboratory-confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) infection, Republic of Korea, 2015.
Characteristics No. of patients
Sex, n (%)
 Male 111 (59.7)
 Female 75 (40.3)
Age (y), median (IQR) 55 (42–66)
 ≥65y, n (%) 55 (29.6)
Case classification, n (%)
 Healthcare personnel 25 (13.4)
 Patient 82 (44.1)
 Caregiver 61 (32.8)
 Others 18 (9.7)
Symptoms at presentation, n (%)
 Fever/chills 138 (74.2)
 Cough 33 (17.7)
 Dyspnea 10 (5.4)
 Myalgia 47 (25.3)
 Headache 16 (8.6)
 GI symptoms 24 (12.9)
 Sputum 14 (7.5)
 Sore throat 8 (4.3)
Comorbidities, n (%)
 Any 102 (54.8)
 Respiratory disease§ 23 (12.4)
 Diabetes mellitus 52 (28.0)
 Cardiac disease 42 (22.6)
 Chronic kidney disease 9 (4.8)
 Malignancy 43 (23.1)
Known setting of contact, n (%)
 Healthcare facility 178 (98.0)
 Household 1 (0.5)
 Ambulance 3 (1.5)
Time from symptom onset to laboratory confirmation in days, median (IQR) 5 (3–9)
Time from symptom onset to death in days, median (IQR) 15 (10–20)
Outcome as of July 13, 2015, n (%)
 Recovered 131 (70.4)
 Ongoing treatment in hospital 19 (10.2)
 Died 36 (19.4)

IQR = interquartile range.

Includes visitors, hospital security agents etc.

Any one or more among the following symptoms: nausea, vomiting, diarrhea, gastric discomfort, loss of appetite.

Any one or more among respiratory diseases, including chronic obstructive pulmonary disease and asthma, diabetes mellitus, cardiac disease, chronic kidney disease, and malignancy.

§ Includes chronic obstructive pulmonary disease and asthma.

Includes ischemic heart disease, arrhythmia and heart failure.

With exclusion of the index patient and three cases of which the precise setting of contact is unidentified.

Table 2
Characteristics of superspreaders of Middle East respiratory syndrome coronavirus infection outbreak in the Republic of Korea, 2015.
Patient number 1 14 15 16 76
Infected no. of patients 28 85 6 23 11
Age (y) 68 35 35 41 75
Sex Male Male Male Male Female
Body mass index 27 30 24 24 19
Underlying disease Hypertension, asthma No No Familial adenomatous polyposis Diabetes mellitus, multiple myeloma
Exposed duration (d) 10 9 10 11 2
Exposed setting GW (27 cases)
OPD (1 case)
ER (78 cases)
GW (4 cases)
Other (3 cases)
GW (6 cases) GW (22 cases)
Other (1 case)
ER (4 cases)
GW (3 cases)
Other (4 cases)
Number of close contacts 626 594 304 277 805
Personal protective equipment No Intermittent No No No
Pneumonia Present Present Present Present Present
Cough Frequent Frequent Rare Frequent Rare
Prognosis Survived Survived Survived Survived Expired
Aerosol-generating procedure No No No No No

ER = emergency room; GW = general ward; OPD = outpatient department.

Exposed duration is defined as the period from symptom onset to the date of proper isolation.

Pneumonia detected from chest radiograph at the moment of investigation.

Table 3
Risk factors associated with in-hospital mortality in 186 patients with laboratory-confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) infection, 2015.
Variable Univariate logistic regression
Multivariate logistic regression
OR 95%CI p OR 95%CI p
Sex, male 1.44 0.67–3.11 0.434 1.56 0.62–3.91 0.33
Age, ≥ 65 y 7.67 3.45–17.04 <0.0001 4.86 1.90–12.45 0.001
Case classification, patient 3.17 1.47–6.83 0.003 0.82 0.27–2.50 0.73
Respiratory disease, 6.27 2.48–15.83 <0.0001 4.90 1.64–14.65 0.004
Diabetes mellitus 2.91 1.436–6.20 0.006 1.37 0.55–3.45 0.49
Cardiac disease 4.43 2.02–9.70 <0.0001 2.21 0.86–5.67 0.09
Chronic kidney disease 5.84 1.48–23.0 0.012 2.30 0.44–11.94 0.32
Malignancy 2.63 1.20–5.76 0.015 1.92 0.75–4.86 0.16

Multivariate analysis adjusted by gender, age, and underlying diseases.

CI = confidence interval; OR = odds ratio.

Includes chronic obstructive pulmonary disease and asthma.

Includes ischemic heart disease, dysrhythmia, and heart failure.

Figure & Data



    Citations to this article as recorded by  
    • CRISPR-Cas systems for diagnosing infectious diseases
      Anastasiya Kostyusheva, Sergey Brezgin, Yurii Babin, Irina Vasilyeva, Dieter Glebe, Dmitry Kostyushev, Vladimir Chulanov
      Methods.2022; 203: 431.     CrossRef
    • Prevention of Emerging Infections in Children
      Thanyawee Puthanakit, Suvaporn Anugulruengkitt, Watsamon Jantarabenjakul
      Pediatric Clinics of North America.2022; 69(1): 185.     CrossRef
    • Unresolved questions in the zoonotic transmission of MERS
      Malik Peiris, Stanley Perlman
      Current Opinion in Virology.2022; 52: 258.     CrossRef
    • New endemic and pandemic pathologies with interhuman airborne transmission through ear, nose and throat anatomical sites
      Francesco Di Gennaro, Nicola Petrosillo
      Acta Otorhinolaryngologica Italica.2022; 42(2 (Suppl.1): S5.     CrossRef
    • Associations of health-related quality of life with depression and stigma in MERS-CoV survivors during the recovery period
      So-Hyun Ahn, Jeong Lan Kim, So Hee Lee, Hye Yoon Park, Jung Jae Lee, Haewoo Lee
      Medicine.2022; 101(25): e29440.     CrossRef
    • Community Analysis of a Crisis Response Network
      Yushim Kim, Jihong Kim, Seong Soo Oh, Sang-Wook Kim, Minyoung Ku, Jaehyuk Cha
      Social Science Computer Review.2021; 39(3): 371.     CrossRef
    • Interorganizational Coordination and Collaboration During the 2015 MERS-CoV Response in South Korea
      Yushim Kim, Seong Soo Oh, Minyoung Ku, Jihyun Byeon
      Disaster Medicine and Public Health Preparedness.2021; 15(4): 409.     CrossRef
    • Strategies to prevent COVID-19 transmission in the emergency department of a regional base hospital in Korea: From index patient until pandemic declaration
      Jong-Hak Park, Seong-Geun Lee, Sejoong Ahn, Joo Yeong Kim, Juhyun Song, Sungwoo Moon, Hanjin Cho
      The American Journal of Emergency Medicine.2021; 46: 247.     CrossRef
    • Factors Associated With Viral Load Kinetics of Middle East Respiratory Syndrome Coronavirus During the 2015 Outbreak in South Korea
      Jeong-Sun Yang, Min-Gyu Yoo, Hye-Ja Lee, Han Byul Jang, Hee-Dong Jung, Jeong-Gu Nam, Joo-Yeon Lee, Youngmee Jee, Sung Soon Kim
      The Journal of Infectious Diseases.2021; 223(6): 1088.     CrossRef
    • Impact of Public Health Interventions on Seasonal Influenza Activity During the COVID-19 Outbreak in Korea
      Hyunju Lee, Heeyoung Lee, Kyoung-Ho Song, Eu Suk Kim, Jeong Su Park, Jongtak Jung, Soyeon Ahn, Eun Kyeong Jeong, Hyekyung Park, Hong Bin Kim
      Clinical Infectious Diseases.2021; 73(1): e132.     CrossRef
    • Antiviral activity against Middle East Respiratory Syndrome coronavirus by Montelukast, an anti-asthma drug
      Hanjie Jonathan Gan, Amaravadhi Harikishore, Jihye Lee, Sangeun Jeon, Sreekanth Rajan, Ming Wei Chen, Jun Long Neo, Seungtaek Kim, Ho Sup Yoon
      Antiviral Research.2021; 185: 104996.     CrossRef
    • Modelling of optimal vaccination strategies in response to a bioterrorism associated smallpox outbreak
      Valentina Costantino, Mohana Kunasekaran, Chandini Raina MacIntyre
      Human Vaccines & Immunotherapeutics.2021; 17(3): 738.     CrossRef
    • Chemokine Regulation During Epidemic Coronavirus Infection
      Shamik Majumdar, Philip M. Murphy
      Frontiers in Pharmacology.2021;[Epub]     CrossRef
    • Knowledge and Practices of Infection Prevention and Control towards COVID-19 among Healthcare Workers in Benghazi Medical Centre, Libya
      Naeima Houssein
      Khalij-Libya Journal of Dental and Medical Researc.2021; : 30.     CrossRef
    • Sputum Processing Method for Lateral Flow Immunochromatographic Assays to Detect Coronaviruses
      Aram Kang, Minjoo Yeom, Hyekwon Kim, Sun-Woo Yoon, Dae-Gwin Jeong, Hyong-Joon Moon, Kwang-Soo Lyoo, Woonsung Na, Daesub Song
      Immune Network.2021;[Epub]     CrossRef
    • Geographical Trend Analysis of COVID-19 Pandemic Onset in Africa
      Olumide David Onafeso, Tolulope Esther Onafeso, Glory Tomi Olumuyiwa-Oluwabiyi, Michael Olawole Faniyi, Adeyemi Oludapo Olusola, Adeolu Odutayo Dina, Adegbayi Mutiu Hassan, Sakinat Oluwabukonla Folorunso, Samuel Adelabu, Efosa Adagbasa
      Social Sciences & Humanities Open.2021; : 100137.     CrossRef
    • Impact of temporary closures of emergency departments during the COVID-19 outbreak on clinical outcomes for emergency patients in a metropolitan area
      Dong Eun Lee, Young Sun Ro, Hyun Wook Ryoo, Sungwoo Moon
      The American Journal of Emergency Medicine.2021; 47: 35.     CrossRef
    • Effectiveness of Intervention Strategies on MERS-CoV Transmission Dynamics in South Korea, 2015: Simulations on the Network Based on the Real-World Contact Data
      Yunhwan Kim, Hohyung Ryu, Sunmi Lee
      International Journal of Environmental Research an.2021; 18(7): 3530.     CrossRef
    • Modeling the transmission dynamics of middle eastern respiratory syndrome coronavirus with the impact of media coverage
      BiBi Fatima, Manar A. Alqudah, Gul Zaman, Fahd Jarad, Thabet Abdeljawad
      Results in Physics.2021; 24: 104053.     CrossRef
    • Lethal zoonotic coronavirus infections of humans – comparative phylogenetics, epidemiology, transmission, and clinical features of coronavirus disease 2019, The Middle East respiratory syndrome and severe acute respiratory syndrome
      David S. Hui, Alimuddin Zumla, Julian W. Tang
      Current Opinion in Pulmonary Medicine.2021; 27(3): 146.     CrossRef
    • Screening of FDA-Approved Drugs Using a MERS-CoV Clinical Isolate from South Korea Identifies Potential Therapeutic Options for COVID-19
      Meehyun Ko, So Young Chang, Soo Young Byun, Aleksandr Ianevski, Inhee Choi, Anne-Laure Pham Hung d’Alexandry d’Orengiani, Erlend Ravlo, Wei Wang, Magnar Bjørås, Denis E. Kainov, David Shum, Ji-Young Min, Marc P. Windisch
      Viruses.2021; 13(4): 651.     CrossRef
    • Factors Associated With Post-traumatic Growth Among Healthcare Workers Who Experienced the Outbreak of MERS Virus in South Korea: A Mixed-Method Study
      Hye Sun Hyun, Mi Ja Kim, Jin Hyung Lee
      Frontiers in Psychology.2021;[Epub]     CrossRef
    • Catch Me if You Can: Superspreading of COVID-19
      Seema S. Lakdawala, Vineet D. Menachery
      Trends in Microbiology.2021; 29(10): 919.     CrossRef
    • Middle East Respiratory Syndrome (MERS) Virus—Pathophysiological Axis and the Current Treatment Strategies
      Abdullah M Alnuqaydan, Abdulmajeed G Almutary, Arulmalar Sukamaran, Brian Tay Wei Yang, Xiao Ting Lee, Wei Xuan Lim, Yee Min Ng, Rania Ibrahim, Thiviya Darmarajan, Satheeshkumar Nanjappan, Jestin Chellian, Mayuren Candasamy, Thiagarajan Madheswaran, Ankur
      AAPS PharmSciTech.2021;[Epub]     CrossRef
    • Phenotypic and genetic characterization of MERS coronaviruses from Africa to understand their zoonotic potential
      Ziqi Zhou, Kenrie P. Y. Hui, Ray T. Y. So, Huibin Lv, Ranawaka A. P. M. Perera, Daniel K. W. Chu, Esayas Gelaye, Harry Oyas, Obadiah Njagi, Takele Abayneh, Wilson Kuria, Elias Walelign, Rinah Wanglia, Ihab El Masry, Sophie Von Dobschuetz, Wantanee Kalprav
      Proceedings of the National Academy of Sciences.2021;[Epub]     CrossRef
    • Meta-analysis and comprehensive study of coronavirus outbreaks: SARS, MERS and COVID-19
      Engin Berber, Deepak Sumbria, Nurettin Çanakoğlu
      Journal of Infection and Public Health.2021; 14(8): 1051.     CrossRef
    • Risk assessment for the transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) on aircraft: a systematic review
      T. Berruga-Fernández, E. Robesyn, T. Korhonen, P. Penttinen, J. M. Jansa
      Epidemiology and Infection.2021;[Epub]     CrossRef
    • Transcriptomic Profiling of Dromedary Camels Immunised with a MERS Vaccine Candidate
      Sharif Hala, Paolo Ribeca, Haya A. Aljami, Suliman A. Alsagaby, Ibrahim Qasim, Sarah C. Gilbert, Naif Khalaf Alharbi
      Veterinary Sciences.2021; 8(8): 156.     CrossRef
    • Multiyear prospective cohort study to evaluate the risk potential of MERS-CoV infection among Malaysian Hajj pilgrims (MERCURIAL): a study protocol
      Jefree Johari, Robert D Hontz, Brian L Pike, Tupur Husain, Chee-Kheong Chong, Norhayati Rusli, Lokman-Hakim Sulaiman, Khebir Verasahib, Rozainanee Mohd Zain, Adzzie-Shazleen Azman, Chee Sieng Khor, Siti-Sarah Nor'e, Vunjia Tiong, Hai Yen Lee, Boon-Teong T
      BMJ Open.2021; 11(8): e050901.     CrossRef
    • Clustering and multiple-spreading events of nosocomial severe acute respiratory syndrome coronavirus 2 infection
      J. Jung, S.Y. Lim, J. Lee, S. Bae, Y.-J. Lim, M.J. Hong, S.H. Kwak, E.O. Kim, H. Sung, M.-N. Kim, J.-Y. Bae, M.-S. Park, S.-H. Kim
      Journal of Hospital Infection.2021; 117: 28.     CrossRef
    • Comparison of the Clinical Process and Outcomes in Patients after Coronavirus Infection 2019 Outbreak
      Sung-Jin Bae, Ho-Sub Chung, Myeong Namgung, Yoon-Hee Choi, Jin-Hong Min, Dong-Hoon Lee
      Medicina.2021; 57(10): 1086.     CrossRef
    • Effect of identified non-synonymous mutations in DPP4 receptor binding residues among highly exposed human population in Morocco to MERS-CoV through computational approach
      Anass Abbad, Latifa Anga, Abdellah Faouzi, Nadia Iounes, Jalal Nourlil, Ranjit Vijayan
      PLOS ONE.2021; 16(10): e0258750.     CrossRef
    • Clinical and biochemical indexes of 11 COVID‐19 patients and the genome sequence analysis of the tested SARS‐CoV‐2
      Zhikang Yu, Heming Wu, Qingyan Huang, Zhixiong Zhong
      Journal of Clinical Laboratory Analysis.2021;[Epub]     CrossRef
    • A Review of SARS-CoV2: Compared With SARS-CoV and MERS-CoV
      Huan Zhou, Junfa Yang, Chang Zhou, Bangjie Chen, Hui Fang, Shuo Chen, Xianzheng Zhang, Linding Wang, Lingling Zhang
      Frontiers in Medicine.2021;[Epub]     CrossRef
    • Middle East Respiratory Syndrome Coronavirus
      Jaffar A. Al-Tawfiq, Esam I. Azhar, Ziad A. Memish, Alimuddin Zumla
      Seminars in Respiratory and Critical Care Medicine.2021; 42(06): 828.     CrossRef
    • Comparative Analysis of Patients Visiting Department of Korean Internal Medicine in a Korean Medicine Hospital Before and During COVID-19 - From July 2018 to June 2021 at Wonkwang University Jeonju Korean Medicine Hospital -
      Ji-eun Lee, Yong-jeen Shin, Sun-ho Shin
      The Journal of Internal Korean Medicine.2021; 42(6): 1255.     CrossRef
    • Structure, Transmission, Diagnostic Symptoms, Host and Entry Mechanism of COVID-19: A Review
      Prashant Swapnil, Mukesh Meena, Tansukh Barupal, Yashwant Sompura, Deepa Hada
      Coronaviruses.2021; 2(5): 3.     CrossRef
    • Public health emergency response coordination: putting the plan into practice
      Yushim Kim, Minyoung Ku, Seong Soo Oh
      Journal of Risk Research.2020; 23(7-8): 928.     CrossRef
    • Polymorphisms in dipeptidyl peptidase 4 reduce host cell entry of Middle East respiratory syndrome coronavirus
      Hannah Kleine-Weber, Simon Schroeder, Nadine Krüger, Alexander Prokscha, Hassan Y. Naim, Marcel A. Müller, Christian Drosten, Stefan Pöhlmann, Markus Hoffmann
      Emerging Microbes & Infections.2020; 9(1): 155.     CrossRef
    • Ultra-Rapid Real-Time RT-PCR Method for Detecting Middle East Respiratory Syndrome Coronavirus Using a Mobile PCR Device, PCR1100
      Kazuya Shirato, Naganori Nao, Shutoku Matsuyama, Tsutomu Kageyama
      Japanese Journal of Infectious Diseases.2020; 73(3): 181.     CrossRef
    • Gold nanoparticle‐adjuvanted S protein induces a strong antigen‐specific IgG response against severe acute respiratory syndrome‐related coronavirus infection, but fails to induce protective antibodies and limit eosinophilic infiltration in lungs
      Hanako Sekimukai, Naoko Iwata‐Yoshikawa, Shuetsu Fukushi, Hideki Tani, Michiyo Kataoka, Tadaki Suzuki, Hideki Hasegawa, Kenichi Niikura, Katsuhiko Arai, Noriyo Nagata
      Microbiology and Immunology.2020; 64(1): 33.     CrossRef
    • Effect of isolation practice on the transmission of middle east respiratory syndrome coronavirus among hemodialysis patients
      Hayne Cho Park, Sang-Ho Lee, Juhee Kim, Do Hyoung Kim, AJin Cho, Hee Jung Jeon, Jieun Oh, Jung-Woo Noh, Da-Wun Jeong, Yang-Gyun Kim, Chang-Hee Lee, Kyung Don Yoo, Young-Ki Lee
      Medicine.2020; 99(3): e18782.     CrossRef
    • Coronavirus Infections in Children Including COVID-19
      Petra Zimmermann, Nigel Curtis
      Pediatric Infectious Disease Journal.2020; 39(5): 355.     CrossRef
    • Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 (COVID-19) pandemic: A global health emergency
      Thamina Acter, Nizam Uddin, Jagotamoy Das, Afroza Akhter, Tasrina Rabia Choudhury, Sunghwan Kim
      Science of The Total Environment.2020; 730: 138996.     CrossRef
    • Preparedness and Rapid Implementation of External Quality Assessment Helped Quickly Increase COVID-19 Testing Capacity in the Republic of Korea
      Heungsup Sung, Cheon-Kwon Yoo, Myung-Guk Han, Sang-Won Lee, Hyukmin Lee, Sail Chun, Wee Gyo Lee, Won-Ki Min
      Clinical Chemistry.2020; 66(7): 979.     CrossRef
    • COVID-19–We urgently need to start developing an exit strategy
      Eskild Petersen, Sean Wasserman, Shui-Shan Lee, Unyeong Go, Allison H. Holmes, Seif Al-Abri, Susan McLellan, Lucille Blumberg, Paul Tambyah
      International Journal of Infectious Diseases.2020; 96: 233.     CrossRef
    • Revised Triage and Surveillance Protocols for Temporary Emergency Department Closures in Tertiary Hospitals as a Response to COVID-19 Crisis in Daegu Metropolitan City
      Han Sol Chung, Dong Eun Lee, Jong Kun Kim, In Hwan Yeo, Changho Kim, Jungbae Park, Kang Suk Seo, Sin-Yul Park, Jung Ho Kim, Gyunmoo Kim, Suk Hee Lee, Jeon Jae Cheon, Yang Hun Kim
      Journal of Korean Medical Science.2020;[Epub]     CrossRef
    • Super-spreading events and contribution to transmission of MERS, SARS, and SARS-CoV-2 (COVID-19)
      J.A. Al-Tawfiq, A.J. Rodriguez-Morales
      Journal of Hospital Infection.2020; 105(2): 111.     CrossRef
    • Hemodialysis with Cohort Isolation to Prevent Secondary Transmission during a COVID-19 Outbreak in Korea
      Jang-Hee Cho, Seok Hui Kang, Hayne Cho Park, Dong Ki Kim, Sang-Ho Lee, Jun Young Do, Jong Won Park, Seong Nam Kim, Myeong Seong Kim, Kyubok Jin, Gun Woo Kang, Sun-Hee Park, Yong-Lim Kim, Young-Ki Lee
      Journal of the American Society of Nephrology.2020; 31(7): 1398.     CrossRef
    • Challenge infection model for MERS-CoV based on naturally infected camels
      Naif Khalaf Alharbi, Osman H. Ibrahim, Ali Alhafufi, Samy Kasem, Ali Aldowerij, Raed Albrahim, Ali Abu-obaidah, Ali Alkarar, Faisal Altaib Bayoumi, Ali Mohammed Almansour, Musaad Aldubaib, Hail M. Al-Abdely, Hanan H. Balkhy, Ibrahim Qasim
      Virology Journal.2020;[Epub]     CrossRef
    • Beyond the fear: Nurses’ experiences caring for patients with Middle East respiratory syndrome: A phenomenological study
      Jin Young Lee, Jeong Hee Hong, Eun Young Park
      Journal of Clinical Nursing.2020; 29(17-18): 3349.     CrossRef
    • Studies on viral pneumonia related to novel coronavirus SARS‐CoV‐2, SARS‐CoV, and MERS‐CoV: a literature review
      Guo Liya, Wang Yuguang, Liu Jian, Yuan Huaiping, Han Xue, Huo Jianwei, Ma Jiaju, Lu Youran, Ming Chen, Jiao Yiqing
      APMIS.2020; 128(6): 423.     CrossRef
    • A comparative overview of COVID-19, MERS and SARS: Review article
      Jie Liu, Wanli Xie, Yanting Wang, Yue Xiong, Shiqiang Chen, Jingjing Han, Qingping Wu
      International Journal of Surgery.2020; 81: 1.     CrossRef
    • Small Particle Aerosol Exposure of African Green Monkeys to MERS-CoV as a Model for Highly Pathogenic Coronavirus Infection
      Allison Totura, Virginia Livingston, Ondraya Frick, David Dyer, Donald Nichols, Aysegul Nalca
      Emerging Infectious Diseases.2020; 26(12): 2835.     CrossRef
    • Spatial variability of Middle East respiratory syndrome coronavirus survival rates and mortality hazard in Saudi Arabia, 2012–2019
      Khalid Hussain Al-Ahmadi, Mohammed Hussain Alahmadi, Ali Saeed Al-Zahrani, Maged Gomaa Hemida
      PeerJ.2020; 8: e9783.     CrossRef
    • Exploring the experience of health professionals who cared for patients with coronavirus infection: Hospitalised isolation and self‐image
      Sujin Kim, Hyun A. Shin, Kieun Hong, Sue Kim
      Journal of Clinical Nursing.2020;[Epub]     CrossRef
    • An overview of Middle East respiratory syndrome coronavirus vaccines in preclinical studies
      Naru Zhang, Jian Shang, Chaoqun Li, Kehui Zhou, Lanying Du
      Expert Review of Vaccines.2020; 19(9): 817.     CrossRef
    • Exploration of Superspreading Events in 2015 MERS-CoV Outbreak in Korea by Branching Process Models
      Seoyun Choe, Hee-Sung Kim, Sunmi Lee
      International Journal of Environmental Research an.2020; 17(17): 6137.     CrossRef
    • Middle East Respiratory Syndrome (MERS) and novel coronavirus disease-2019 (COVID-19): From causes to preventions in Saudi Arabia
      Mohammad H. Alyami, Hamad S. Alyami, Ansaar Warraich
      Saudi Pharmaceutical Journal.2020; 28(11): 1481.     CrossRef
    • Prevalence of Diabetes Mellitus and Its Associated Unfavorable Outcomes in Patients With Acute Respiratory Syndromes Due to Coronaviruses Infection: A Systematic Review and Meta-Analysis
      Isabel Pinedo-Torres, Magaly Flores-Fernández, Marlon Yovera-Aldana, Claudia Gutierrez-Ortiz, Paolo Zegarra-Lizana, Claudio Intimayta-Escalante, Cristian Moran-Mariños, Carlos Alva-Diaz, Kevin Pacheco-Barrios
      Clinical Medicine Insights: Endocrinology and Diab.2020; 13: 117955142096249.     CrossRef
    • Les Coronavirus humains
      Michel Segondy
      Revue Francophone des Laboratoires.2020; 2020(526): 32.     CrossRef
    • An infectious cDNA clone of a growth attenuated Korean isolate of MERS coronavirus KNIH002 in clade B
      Minwoo Kim, Hee Cho, Seung-Hoon Lee, Woo-Jung Park, Jeong-Min Kim, Jae-Su Moon, Geon-Woo Kim, Wooseong Lee, Hae-Gwang Jung, Jeong-Sun Yang, Jang-Hoon Choi, Joo-Yeon Lee, Sung Soon Kim, Jong-Won Oh
      Emerging Microbes & Infections.2020; 9(1): 2714.     CrossRef
    • Acute Respiratory Infection in Human Dipeptidyl Peptidase 4-Transgenic Mice Infected with Middle East Respiratory Syndrome Coronavirus
      Naoko Iwata-Yoshikawa, Tadashi Okamura, Yukiko Shimizu, Osamu Kotani, Hironori Sato, Hanako Sekimukai, Shuetsu Fukushi, Tadaki Suzuki, Yuko Sato, Makoto Takeda, Masato Tashiro, Hideki Hasegawa, Noriyo Nagata, Tom Gallagher
      Journal of Virology.2019;[Epub]     CrossRef
    • Asymptomatic Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: Extent and implications for infection control: A systematic review
      Jaffar A. Al-Tawfiq, Philippe Gautret
      Travel Medicine and Infectious Disease.2019; 27: 27.     CrossRef
    • Sequential Emergence and Wide Spread of Neutralization Escape Middle East Respiratory Syndrome Coronavirus Mutants, South Korea, 2015
      Yeon-Sook Kim, Abdimadiyeva Aigerim, Uni Park, Yuri Kim, Ji-Young Rhee, Jae-Phil Choi, Wan Beom Park, Sang Won Park, Yeonjae Kim, Dong-Gyun Lim, Kyung-Soo Inn, Eung-Soo Hwang, Myung-Sik Choi, Hyoung-Shik Shin, Nam-Hyuk Cho
      Emerging Infectious Diseases.2019; 25(6): 1161.     CrossRef
    • Economic Impact of the 2015 MERS Outbreak on the Republic of Korea's Tourism-Related Industries
      Heesoo Joo, Brian A. Maskery, Andre D. Berro, Lisa D. Rotz, Yeon-Kyeng Lee, Clive M. Brown
      Health Security.2019; 17(2): 100.     CrossRef
    • MERS coronavirus outbreak: Implications for emerging viral infections
      Awad Al-Omari, Ali A. Rabaan, Samer Salih, Jaffar A. Al-Tawfiq, Ziad A. Memish
      Diagnostic Microbiology and Infectious Disease.2019; 93(3): 265.     CrossRef
    • The effects of past SARS experience and proximity on declines in numbers of travelers to the Republic of Korea during the 2015 MERS outbreak: A retrospective study
      Heesoo Joo, Ronald E. Henry, Yeon-Kyeng Lee, Andre D. Berro, Brian A. Maskery
      Travel Medicine and Infectious Disease.2019; 30: 54.     CrossRef
    • Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study
      Sarah H. Alfaraj, Jaffar A. Al-Tawfiq, Ayed Y. Assiri, Nojoom A. Alzahrani, Amal A. Alanazi, Ziad A. Memish
      Travel Medicine and Infectious Disease.2019; 29: 48.     CrossRef
    • Broad-spectrum coronavirus antiviral drug discovery
      Allison L. Totura, Sina Bavari
      Expert Opinion on Drug Discovery.2019; 14(4): 397.     CrossRef
    • Clinical and Laboratory Findings of Middle East Respiratory Syndrome Coronavirus Infection
      Se-Min Hwang, Baeg-Ju Na, Yoomi Jung, Hyun-Suk Lim, Jeong-Eun Seo, Shin-Ae Park, Young-Soo Cho, Eun-Hyang Song, Ji-Yeon Seo, Sung-Ryul Kim, Gang-Young Lee, Soon-Ja Kim, Young-Suk Park, Haesook Seo
      Japanese Journal of Infectious Diseases.2019; 72(3): 160.     CrossRef
    • Risk of transmission via medical employees and importance of routine infection-prevention policy in a nosocomial outbreak of Middle East respiratory syndrome (MERS): a descriptive analysis from a tertiary care hospital in South Korea
      Hyun Kyun Ki, Sang Kuk Han, Jun Seong Son, Sang O Park
      BMC Pulmonary Medicine.2019;[Epub]     CrossRef
    • The Middle East Respiratory Syndrome (MERS)
      Esam I. Azhar, David S.C. Hui, Ziad A. Memish, Christian Drosten, Alimuddin Zumla
      Infectious Disease Clinics of North America.2019; 33(4): 891.     CrossRef
    • TMPRSS2 Contributes to Virus Spread and Immunopathology in the Airways of Murine Models after Coronavirus Infection
      Naoko Iwata-Yoshikawa, Tadashi Okamura, Yukiko Shimizu, Hideki Hasegawa, Makoto Takeda, Noriyo Nagata, Tom Gallagher
      Journal of Virology.2019;[Epub]     CrossRef
    • A Comparative Analysis of Factors Influencing Two Outbreaks of Middle Eastern Respiratory Syndrome (MERS) in Saudi Arabia and South Korea
      Marnie Willman, Darwyn Kobasa, Jason Kindrachuk
      Viruses.2019; 11(12): 1119.     CrossRef
    • Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017
      Sibylle Bernard-Stoecklin, Birgit Nikolay, Abdullah Assiri, Abdul Aziz Bin Saeed, Peter Karim Ben Embarek, Hassan El Bushra, Moran Ki, Mamunur Rahman Malik, Arnaud Fontanet, Simon Cauchemez, Maria D. Van Kerkhove
      Scientific Reports.2019;[Epub]     CrossRef
    • MERS-CoV infection in South Korea and strategies for possible future outbreak: narrative review
      Chulwoo Park
      Journal of Global Health Reports.2019;[Epub]     CrossRef
    • MERS transmission and risk factors: a systematic review
      Ji-Eun Park, Soyoung Jung, Aeran Kim, Ji-Eun Park
      BMC Public Health.2018;[Epub]     CrossRef
    • Agent-Based Modeling for Super-Spreading Events: A Case Study of MERS-CoV Transmission Dynamics in the Republic of Korea
      Yunhwan Kim, Hohyung Ryu, Sunmi Lee
      International Journal of Environmental Research an.2018; 15(11): 2369.     CrossRef
    • Factors associated with recovery delay in a sample of patients diagnosed by MERS-CoV rRT-PCR: A Saudi Arabian multicenter retrospective study
      Anwar E. Ahmed, Hamdan Al-Jahdali, Mody Alaqeel, Salma S. Siddiq, Hanan A. Alsaab, Ezzeldin A. Sakr, Hamed A. Alyahya, Munzir M. Alandonisi, Alaa T. Subedar, Yosra Z. Ali, Hazza Al Otaibi, Nouf M. Aloudah, Salim Baharoon, Sameera Al Johani, Mohammed G. Al
      Influenza and Other Respiratory Viruses.2018; 12(5): 656.     CrossRef
    • Twitter and Middle East respiratory syndrome, South Korea, 2015: A multi-lingual study
      Isaac Chun-Hai Fung, Jing Zeng, Chung-Hong Chan, Hai Liang, Jingjing Yin, Zhaochong Liu, Zion Tsz Ho Tse, King-Wa Fu
      Infection, Disease & Health.2018; 23(1): 10.     CrossRef
    • Evaluation of Antibody-Dependent Enhancement of SARS-CoV Infection in Rhesus Macaques Immunized with an Inactivated SARS-CoV Vaccine
      Fan Luo, Fan-Lu Liao, Hui Wang, Hong-Bin Tang, Zhan-Qiu Yang, Wei Hou
      Virologica Sinica.2018; 33(2): 201.     CrossRef
    • Correlation between Pneumonia Severity and Pulmonary Complications in Middle East Respiratory Syndrome
      Wan Beom Park, Kang Il Jun, Gayeon Kim, Jae-Phil Choi, Ji-Young Rhee, Shinhyea Cheon, Chang Hyun Lee, Jun-Sun Park, Yeonjae Kim, Joon-Sung Joh, Bum Sik Chin, Pyeong Gyun Choe, Ji Hwan Bang, Sang-Won Park, Nam Joong Kim, Dong-Gyun Lim, Yeon-Sook Kim, Myoun
      Journal of Korean Medical Science.2018;[Epub]     CrossRef
    • Urban Rodent Surveillance, Climatic Association, and Genomic Characterization of Seoul Virus Collected at U.S. Army Garrison, Seoul, Republic of Korea, 2006–2010
      Se Hun Gu, Won-Keun Kim, Terry A. Klein, Seung-Ho Lee, Heung-Chul Kim, Jin Sun No, Sung-Tae Chong, Jin-Won Song
      The American Journal of Tropical Medicine and Hygi.2018; 99(2): 470.     CrossRef
    • MERS, SARS and other coronaviruses as causes of pneumonia
      Yudong Yin, Richard G. Wunderink
      Respirology.2018; 23(2): 130.     CrossRef
    • A Middle East respiratory syndrome screening clinic for health care personnel during the 2015 Middle East respiratory syndrome outbreak in South Korea: A single-center experience
      Ji Yeon Lee, Gayeon Kim, Dong-Gyun Lim, Hyeon-Gun Jee, Yunyoung Jang, Joon-Sung Joh, Ina Jeong, Yeonjae Kim, Eunhee Kim, Bum Sik Chin
      American Journal of Infection Control.2018; 46(4): 436.     CrossRef
    • Surveys and Proposals of the Infectious Disease Home Isolation through Middle East Respiratory Syndrome (MERS) Transmission
      Song Yi An, Woong Jung, Chang Min Lee, Sung Hyuk Park, Hyun Kyung Park, Myung Chun Kim
      Korean Journal of Healthcare-Associated Infection .2018; 23(2): 72.     CrossRef
    • Working experiences of nurses during the Middle East respiratory syndrome outbreak
      Hee Sun Kang, Ye Dong Son, Sun-Mi Chae, Colleen Corte
      International Journal of Nursing Practice.2018; 24(5): e12664.     CrossRef
    • Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission
      David S Hui, Esam I Azhar, Yae-Jean Kim, Ziad A Memish, Myoung-don Oh, Alimuddin Zumla
      The Lancet Infectious Diseases.2018; 18(8): e217.     CrossRef
    • Human Neutralizing Monoclonal Antibody Inhibition of Middle East Respiratory Syndrome Coronavirus Replication in the Common Marmoset
      Zhe Chen, Linlin Bao, Cong Chen, Tingting Zou, Ying Xue, Fengdi Li, Qi Lv, Songzhi Gu, Xiaopan Gao, Sheng Cui, Jianmin Wang, Chuan Qin, Qi Jin
      The Journal of Infectious Diseases.2017; 215(12): 1807.     CrossRef
    • Pneumonia in the tropics: Report from the Task Force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine
      Mohd Basri Mat Nor, Guy A. Richards, Steve McGloughlin, Pravin R. Amin
      Journal of Critical Care.2017; 42: 360.     CrossRef
    • Evaluation and Clinical Validation of Two Field–Deployable Reverse Transcription-Insulated Isothermal PCR Assays for the Detection of the Middle East Respiratory Syndrome–Coronavirus
      Yun Young Go, Yeon-Sook Kim, Shinhye Cheon, Sangwoo Nam, Keun Bon Ku, Meehyein Kim, Nam Hyuk Cho, Hyun Park, Pei-Yu Alison Lee, Yu-Chun Lin, Yun-Long Tsai, Hwa-Tang Thomas Wang, Udeni B.R. Balasuriya
      The Journal of Molecular Diagnostics.2017; 19(6): 817.     CrossRef
    • Identified Transmission Dynamics of Middle East Respiratory Syndrome Coronavirus Infection During an Outbreak: Implications of an Overcrowded Emergency Department
      Thamer H. Alenazi, Hussain Al Arbash, Aiman El-Saed, Majid M. Alshamrani, Henry Baffoe-Bonnie, Yaseen M. Arabi, Sameera M. Al Johani, Ra’ed Hijazi, Adel Alothman, Hanan H. Balkhy
      Clinical Infectious Diseases.2017; 65(4): 675.     CrossRef
    • The Role of Infection Control Nurse During Emerging Infectious Disease Epidemic: Focusing on the Middle East Respiratory Syndrome
      Kyeong Sook Cha, Myoung Jin Shin, Ji Young Lee, Hee Kyung Chun
      Korean Journal of Healthcare-Associated Infection .2017; 22(1): 31.     CrossRef
    • Clinical and Epidemiologic Characteristics of Spreaders of Middle East Respiratory Syndrome Coronavirus during the 2015 Outbreak in Korea
      Chang Kyung Kang, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang Won Park, Hong Bin Kim, Nam Joong Kim, Sung-il Cho, Jong-koo Lee, Myoung-don Oh
      Journal of Korean Medical Science.2017; 32(5): 744.     CrossRef
    • Establishment and Application of a Universal Coronavirus Screening Method Using MALDI-TOF Mass Spectrometry
      Leshan Xiu, Chi Zhang, Zhiqiang Wu, Junping Peng
      Frontiers in Microbiology.2017;[Epub]     CrossRef
    • Health Care Provider Knowledge and Attitudes Regarding Reporting Diseases and Events to Public Health Authorities in Tennessee
      Mary-Margaret A. Fill, Rendi Murphree, April C. Pettit
      Journal of Public Health Management and Practice.2017; 23(6): 581.     CrossRef
    • The experience of endotracheal intubation in Middle East respiratory syndrome patients -A case report-
      Mi-Young Kwon, Gunn Hee Kim, Byunguk Kim, Min Seok Koo
      Anesthesia and Pain Medicine.2017; 12(2): 191.     CrossRef
    • Clinical spectrum of the Middle East respiratory syndrome coronavirus (MERS-CoV)
      Mikiko Senga, Yaseen M. Arabi, Robert A. Fowler
      Journal of Infection and Public Health.2017; 10(2): 191.     CrossRef
    • High fatality rates and associated factors in two hospital outbreaks of MERS in Daejeon, the Republic of Korea
      Hae-Sung Nam, Jung Wan Park, Moran Ki, Mi-Yeon Yeon, Jin Kim, Seung Woo Kim
      International Journal of Infectious Diseases.2017; 58: 37.     CrossRef
    • Middle East respiratory syndrome clinical practice guideline for hemodialysis facilities
      Hayne Cho Park, Young-Ki Lee, Sang-Ho Lee, Kyung Don Yoo, Hee Jung Jeon, Dong-Ryeol Ryu, Seong Nam Kim, Seung Hwan Sohn, Rho Won Chun, Kyu Bok Choi
      Kidney Research and Clinical Practice.2017; 36(2): 111.     CrossRef
    • Recombinant Receptor-Binding Domains of Multiple Middle East Respiratory Syndrome Coronaviruses (MERS-CoVs) Induce Cross-Neutralizing Antibodies against Divergent Human and Camel MERS-CoVs and Antibody Escape Mutants
      Wanbo Tai, Yufei Wang, Craig A. Fett, Guangyu Zhao, Fang Li, Stanley Perlman, Shibo Jiang, Yusen Zhou, Lanying Du, Terence S. Dermody
      Journal of Virology.2017;[Epub]     CrossRef
    • Middle East respiratory syndrome coronavirus vaccines: current status and novel approaches
      Nisreen MA Okba, V Stalin Raj, Bart L Haagmans
      Current Opinion in Virology.2017; 23: 49.     CrossRef
    • MERS-CoV Antibody Responses 1 Year after Symptom Onset, South Korea, 2015
      Pyoeng Gyun Choe, R.A.P.M. Perera, Wan Beom Park, Kyoung-Ho Song, Ji Hwan Bang, Eu Suk Kim, Hong Bin Kim, Long Wei Ronald Ko, Sang Won Park, Nam-Joong Kim, Eric H.Y. Lau, Leo L.M. Poon, Malik Peiris, Myoung-don Oh
      Emerging Infectious Diseases.2017; 23(7): 1079.     CrossRef
    • Hospital Outbreaks of Middle East Respiratory Syndrome, Daejeon, South Korea, 2015
      Jung Wan Park, Keon Joo Lee, Kang Hyoung Lee, Sang Hyup Lee, Jung Rae Cho, Jin Won Mo, Soo Young Choi, Geun Yong Kwon, Ji-Yeon Shin, Jee Young Hong, Jin Kim, Mi-Yeon Yeon, Jong Seok Oh, Hae-Sung Nam
      Emerging Infectious Diseases.2017; 23(6): 898.     CrossRef
    • The clinical and virological features of the first imported case causing MERS-CoV outbreak in South Korea, 2015
      Ji Yeon Lee, You-Jin Kim, Eun Hee Chung, Dae-Won Kim, Ina Jeong, Yeonjae Kim, Mi-ran Yun, Sung Soon Kim, Gayeon Kim, Joon-Sung Joh
      BMC Infectious Diseases.2017;[Epub]     CrossRef
    • An Opportunistic Pathogen Afforded Ample Opportunities: Middle East Respiratory Syndrome Coronavirus
      Ian Mackay, Katherine Arden
      Viruses.2017; 9(12): 369.     CrossRef
    • Transgene expression in the genome of Middle East respiratory syndrome coronavirus based on a novel reverse genetics system utilizing Red-mediated recombination cloning
      Doreen Muth, Benjamin Meyer, Daniela Niemeyer, Simon Schroeder, Nikolaus Osterrieder, Marcel Alexander Müller, Christian Drosten
      Journal of General Virology .2017; 98(10): 2461.     CrossRef
    • Estimating and modelling the transmissibility of Middle East Respiratory Syndrome CoronaVirus during the 2015 outbreak in the Republic of Korea
      Xu-Sheng Zhang, Richard Pebody, Andre Charlett, Daniela de Angelis, Paul Birrell, Hunseok Kang, Marc Baguelin, Yoon Hong Choi
      Influenza and Other Respiratory Viruses.2017; 11(5): 434.     CrossRef
    • Epidemic and Emerging Coronaviruses (Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome)
      David S. Hui
      Clinics in Chest Medicine.2017; 38(1): 71.     CrossRef
    • Structural Insights into the Interaction of Coronavirus Papain-Like Proteases and Interferon-Stimulated Gene Product 15 from Different Species
      Courtney M. Daczkowski, John V. Dzimianski, Jozlyn R. Clasman, Octavia Goodwin, Andrew D. Mesecar, Scott D. Pegan
      Journal of Molecular Biology.2017; 429(11): 1661.     CrossRef
    • Vaccines against Middle East respiratory syndrome coronavirus for humans and camels
      Naif Khalaf Alharbi
      Reviews in Medical Virology.2017; 27(2): e1917.     CrossRef
    • Retrospective, epidemiological cluster analysis of the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic using open source data
      Epidemiology and Infection.2017; 145(15): 3106.     CrossRef
    • Cryo-EM structures of MERS-CoV and SARS-CoV spike glycoproteins reveal the dynamic receptor binding domains
      Yuan Yuan, Duanfang Cao, Yanfang Zhang, Jun Ma, Jianxun Qi, Qihui Wang, Guangwen Lu, Ying Wu, Jinghua Yan, Yi Shi, Xinzheng Zhang, George F. Gao
      Nature Communications.2017;[Epub]     CrossRef
    • Differential Cell Count and CRP Level in Blood as Predictors for Middle East Respiratory Syndrome Coronavirus Infection in Acute Febrile Patients during Nosocomial Outbreak
      Ga Eun Park, Cheol-In Kang, Jae-Hoon Ko, Sun Young Cho, Young Eun Ha, Yae-Jean Kim, Kyong Ran Peck, Jae-Hoon Song, Doo Ryeon Chung
      Journal of Korean Medical Science.2017; 32(1): 151.     CrossRef
    • Effects of operational decisions on the diffusion of epidemic disease: A system dynamics modeling of the MERS-CoV outbreak in South Korea
      Nina Shin, Taewoo Kwag, Sangwook Park, Yon Hui Kim
      Journal of Theoretical Biology.2017; 421: 39.     CrossRef
    • Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment
      Dae Hyun Um, Jang Sub Kim, Hae Woo Lee, So Hee Lee
      Journal of Korean Neuropsychiatric Association.2017; 56(1): 28.     CrossRef
    • Factors determining human-to-human transmissibility of zoonotic pathogens via contact
      Mathilde Richard, Sascha Knauf, Philip Lawrence, Alison E Mather, Vincent J Munster, Marcel A Müller, Derek Smith, Thijs Kuiken
      Current Opinion in Virology.2017; 22: 7.     CrossRef
    • The Role of Infection Control Nurse During Emerging Infectious Disease Epidemic: Focusing on the Middle East Respiratory Syndrome
      Kyeong Sook Cha, Myoung Jin Shin, Ji Young Lee, Hee Kyung Chun
      Korean Journal of Healthcare-Associated Infection .2017; 22(1): 31.     CrossRef
    • Longitudinal study of Middle East Respiratory Syndrome coronavirus infection in dromedary camel herds in Saudi Arabia, 2014–2015
      Maged Gomaa Hemida, Abdulmohsen Alnaeem, Daniel KW Chu, Ranawaka APM Perera, Samuel MS Chan, Faisal Almathen, Emily Yau, Brian CY Ng, Richard J Webby, Leo LM Poon, Malik Peiris
      Emerging Microbes & Infections.2017; 6(1): 1.     CrossRef
    • Epidemiologic Parameters of the Middle East Respiratory Syndrome Outbreak in Korea, 2015
      Sun Hee Park, Woo Joo Kim, Jin-Hong Yoo, Jung-Hyun Choi
      Infection & Chemotherapy.2016; 48(2): 108.     CrossRef
    • The global spread of Middle East respiratory syndrome: an analysis fusing traditional epidemiological tracing and molecular phylodynamics
      Jae Min, Eleonora Cella, Massimo Ciccozzi, Antonello Pelosi, Marco Salemi, Mattia Prosperi
      Global Health Research and Policy.2016;[Epub]     CrossRef
    • SARS and MERS: recent insights into emerging coronaviruses
      Emmie de Wit, Neeltje van Doremalen, Darryl Falzarano, Vincent J. Munster
      Nature Reviews Microbiology.2016; 14(8): 523.     CrossRef
    • Estimates of the risk of large or long-lasting outbreaks of Middle East respiratory syndrome after importations outside the Arabian Peninsula
      Damon J.A. Toth, Windy D. Tanner, Karim Khader, Adi V. Gundlapalli
      Epidemics.2016; 16: 27.     CrossRef
    • Drivers of MERS-CoV transmission: what do we know?
      Jaffar A. Al-Tawfiq, Ziad A. Memish
      Expert Review of Respiratory Medicine.2016; 10(3): 331.     CrossRef
    • MERS-CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study
      Sun Young Cho, Ji-Man Kang, Young Eun Ha, Ga Eun Park, Ji Yeon Lee, Jae-Hoon Ko, Ji Yong Lee, Jong Min Kim, Cheol-In Kang, Ik Joon Jo, Jae Geum Ryu, Jong Rim Choi, Seonwoo Kim, Hee Jae Huh, Chang-Seok Ki, Eun-Suk Kang, Kyong Ran Peck, Hun-Jong Dhong, Jae-
      The Lancet.2016; 388(10048): 994.     CrossRef
    • Viral Load Kinetics of MERS Coronavirus Infection
      Myoung-don Oh, Wan Beom Park, Pyoeng Gyun Choe, Su-Jin Choi, Jong-Il Kim, Jeesoo Chae, Sung Sup Park, Eui-Chong Kim, Hong Sang Oh, Eun Jung Kim, Eun Young Nam, Sun Hee Na, Dong Ki Kim, Sang-Min Lee, Kyoung-Ho Song, Ji Hwan Bang, Eu Suk Kim, Hong Bin Kim,
      New England Journal of Medicine.2016; 375(13): 1303.     CrossRef
    • Reply to Oh
      Hye Won Jeong, Young Ki Choi
      Clinical Infectious Diseases.2016; 62(12): 1615.2.     CrossRef
    • Extensive Viable Middle East Respiratory Syndrome (MERS) Coronavirus Contamination in Air and Surrounding Environment in MERS Isolation Wards
      Sung-Han Kim, So Young Chang, Minki Sung, Ji Hoon Park, Hong Bin Kim, Heeyoung Lee, Jae-Phil Choi, Won Suk Choi, Ji-Young Min
      Clinical Infectious Diseases.2016; 63(3): 363.     CrossRef
    • Spread of Mutant Middle East Respiratory Syndrome Coronavirus with Reduced Affinity to Human CD26 during the South Korean Outbreak
      Yuri Kim, Shinhye Cheon, Chan-Ki Min, Kyung Mok Sohn, Ying Jin Kang, Young-Je Cha, Ju-Il Kang, Seong Kyu Han, Na-Young Ha, Gwanghun Kim, Abdimadiyeva Aigerim, Hyun Mu Shin, Myung-Sik Choi, Sanguk Kim, Hyun-Soo Cho, Yeon-Sook Kim, Nam-Hyuk Cho, Michael J.
      mBio.2016;[Epub]     CrossRef
    • Super-spreading events of MERS-CoV infection
      David S Hui
      The Lancet.2016; 388(10048): 942.     CrossRef
    • Feasibility of Using Convalescent Plasma Immunotherapy for MERS-CoV Infection, Saudi Arabia
      Yaseen M. Arabi, Ali H. Hajeer, Thomas Luke, Kanakatte Raviprakash, Hanan Balkhy, Sameera Johani, Abdulaziz Al-Dawood, Saad Al-Qahtani, Awad Al-Omari, Fahad Al-Hameed, Frederick G. Hayden, Robert Fowler, Abderrezak Bouchama, Nahoko Shindo, Khalid Al-Khair
      Emerging Infectious Diseases.2016; 22(9): 1554.     CrossRef
    • Comparison of incubation period distribution of human infections with MERS-CoV in South Korea and Saudi Arabia
      Victor Virlogeux, Vicky J. Fang, Minah Park, Joseph T. Wu, Benjamin J. Cowling
      Scientific Reports.2016;[Epub]     CrossRef
    • Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity
      Chan-Ki Min, Shinhye Cheon, Na-Young Ha, Kyung Mok Sohn, Yuri Kim, Abdimadiyeva Aigerim, Hyun Mu Shin, Ji-Yeob Choi, Kyung-Soo Inn, Jin-Hwan Kim, Jae Young Moon, Myung-Sik Choi, Nam-Hyuk Cho, Yeon-Sook Kim
      Scientific Reports.2016;[Epub]     CrossRef
    • Coronaviruses and the human airway: a universal system for virus-host interaction studies
      Hulda R. Jonsdottir, Ronald Dijkman
      Virology Journal.2016;[Epub]     CrossRef
    • Environmental Contamination and Viral Shedding in MERS Patients
      Myoung-don Oh
      Clinical Infectious Diseases.2016; 62(12): 1615.1.     CrossRef
    • Outbreaks of Middle East Respiratory Syndrome in Two Hospitals Initiated by a Single Patient in Daejeon, South Korea
      Sun Hee Park, Yeon-Sook Kim, Younghee Jung, Soo young Choi, Nam-Hyuk Cho, Hye Won Jeong, Jung Yeon Heo, Ji Hyun Yoon, Jacob Lee, Shinhye Cheon, Kyung Mok Sohn
      Infection & Chemotherapy.2016; 48(2): 99.     CrossRef
    • Outbreak of Middle East Respiratory Syndrome at Tertiary Care Hospital, Jeddah, Saudi Arabia, 2014
      Deborah L. Hastings, Jerome I. Tokars, Inas Zakaria A.M. Abdel Aziz, Khulud Z. Alkhaldi, Areej T. Bensadek, Basem M. Alraddadi, Hani Jokhdar, John A. Jernigan, Mohammed A. Garout, Sara M. Tomczyk, Ikwo K. Oboho, Andrew I. Geller, Nimalan Arinaminpathy, Da
      Emerging Infectious Diseases.2016; 22(5): 794.     CrossRef
    • The Characteristics of Middle Eastern Respiratory Syndrome Coronavirus Transmission Dynamics in South Korea
      Yunhwan Kim, Sunmi Lee, Chaeshin Chu, Seoyun Choe, Saeme Hong, Youngseo Shin
      Osong Public Health and Research Perspectives.2016; 7(1): 49.     CrossRef
    • Clinical Progression and Cytokine Profiles of Middle East Respiratory Syndrome Coronavirus Infection
      Eu Suk Kim, Pyoeng Gyun Choe, Wan Beom Park, Hong Sang Oh, Eun Jung Kim, Eun Young Nam, Sun Hee Na, Moonsuk Kim, Kyoung-Ho Song, Ji Hwan Bang, Sang Won Park, Hong Bin Kim, Nam Joong Kim, Myoung-don Oh
      Journal of Korean Medical Science.2016; 31(11): 1717.     CrossRef
    • Isolation of Middle East Respiratory Syndrome Coronavirus from a Patient of the 2015 Korean Outbreak
      Wan Beom Park, Nak-Jung Kwon, Pyoeng Gyun Choe, Su-Jin Choi, Hong Sang Oh, Sang Min Lee, Hyonyong Chong, Jong-Il Kim, Kyoung-Ho Song, Ji Hwan Bang, Eu Suk Kim, Hong-Bin Kim, Sang Won Park, Nam Joong Kim, Myoung-don Oh
      Journal of Korean Medical Science.2016; 31(2): 315.     CrossRef
    • Middle East Respiratory Syndrome Coronavirus Transmission in Extended Family, Saudi Arabia, 2014
      M. Allison Arwady, Basem 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
      Emerging Infectious Diseases.2016; 22(8): 1395.     CrossRef
    • Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia
      Hanan H. Balkhy, Thamer H. Alenazi, Majid M. Alshamrani, Henry Baffoe-Bonnie, Yaseen Arabi, Raed Hijazi, Hail M. Al-Abdely, Aiman El-Saed, Sameera Al Johani, Abdullah M. Assiri, Abdulaziz bin Saeed
      Infection Control & Hospital Epidemiology.2016; 37(10): 1147.     CrossRef
    • A Comparative Study of Clinical Presentation and Risk Factors for Adverse Outcome in Patients Hospitalised with Acute Respiratory Disease Due to MERS Coronavirus or Other Causes
      Musa A. Garbati, Shamsudeen F. Fagbo, Vicky J. Fang, Leila Skakni, Mercy Joseph, Tariq A. Wani, Benjamin J. Cowling, Malik Peiris, Ahmed Hakawi, Renee W.Y. Chan
      PLOS ONE.2016; 11(11): e0165978.     CrossRef
    • Exportations of Symptomatic Cases of MERS-CoV Infection to Countries outside the Middle East
      Cristina Carias, Justin J. O’Hagan, Amy Jewett, Manoj Gambhir, Nicole J. Cohen, Yoni Haber, Nicki Pesik, David L. Swerdlow
      Emerging Infectious Diseases.2016; 22(4): 723.     CrossRef
    • Persistence of Antibodies against Middle East Respiratory Syndrome Coronavirus
      Daniel C. Payne, Ibrahim Iblan, Brian Rha, Sultan Alqasrawi, Aktham Haddadin, Mohannad Al Nsour, Tarek Alsanouri, Sami Sheikh Ali, Jennifer Harcourt, Congrong Miao, Azaibi Tamin, Susan I. Gerber, Lia M. Haynes, Mohammad Mousa Al Abdallat
      Emerging Infectious Diseases.2016; 22(10): 1824.     CrossRef
    • The spectrum of respiratory pathogens among returning Hajj pilgrims: myths and reality
      Phillipe Gautret, Samir Benkouiten, Jaffar A. Al-Tawfiq, Ziad A. Memish
      International Journal of Infectious Diseases.2016; 47: 83.     CrossRef
    • The Korean Middle East Respiratory Syndrome Coronavirus Outbreak and Our Responsibility to the Global Scientific Community
      Myoung-don Oh
      Infection & Chemotherapy.2016; 48(2): 145.     CrossRef
    • Risk factors for severity and mortality in patients with MERS-CoV: Analysis of publicly available data from Saudi Arabia
      Gouri Rani Banik, Amani Salem Alqahtani, Robert Booy, Harunor Rashid
      Virologica Sinica.2016; 31(1): 81.     CrossRef
    • Syndromic Surveillance System for Korea–US Joint Biosurveillance Portal: Design and Lessons Learned
      Chulwoo Rhee, Howard Burkom, Chang-gyo Yoon, Miles Stewart, Yevgeniy Elbert, Aaron Katz, Sangwoo Tak
      Health Security.2016; 14(3): 152.     CrossRef
    • Viral RNA in Blood as Indicator of Severe Outcome in Middle East Respiratory Syndrome Coronavirus Infection
      So Yeon Kim, Sun Jae Park, Sook Young Cho, Ran-hui Cha, Hyeon-Gun Jee, Gayeon Kim, Hyoung-Shik Shin, Yeonjae Kim, Yu Mi Jung, Jeong-Sun Yang, Sung Soon Kim, Sung Im Cho, Man Jin Kim, Jee-Soo Lee, Seung Jun Lee, Soo Hyun Seo, Sung Sup Park, Moon-Woo Seong
      Emerging Infectious Diseases.2016; 22(10): 1813.     CrossRef
    • Transmissibility of Middle East Respiratory Syndrome by the Airborne Route
      Myoung-don Oh
      Clinical Infectious Diseases.2016; 63(8): 1143.     CrossRef
    • Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea
      Won Suk Choi, Cheol-In Kang, Yonjae Kim, Jae-Phil Choi, Joon Sung Joh, Hyoung-Shik Shin, Gayeon Kim, Kyong Ran Peck, Doo Ryeon Chung, Hye Ok Kim, Sook Hee Song, Yang Ree Kim, Kyung Mok Sohn, Younghee Jung, Ji Hwan Bang, Nam Joong Kim, Kkot Sil Lee, Hye Wo
      Infection & Chemotherapy.2016; 48(2): 118.     CrossRef
    • Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia
      Hamzah A. Mohd, Ziad A. Memish, Sarah H. Alfaraj, Donna McClish, Talal Altuwaijri, Marzouqah S. Alanazi, Saleh A. Aloqiel, Ahmed M. Alenzi, Fahad Bafaqeeh, Amal M. Mohamed, Kamel Aldosari, Sameeh Ghazal
      Travel Medicine and Infectious Disease.2016; 14(5): 464.     CrossRef
    • Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity
      C.-J. Kim, W.S. Choi, Y. Jung, S. Kiem, H.Y. Seol, H.J. Woo, Y.H. Choi, J.S. Son, K.-H. Kim, Y.-S. Kim, E.S. Kim, S.H. Park, J.H. Yoon, S.-M. Choi, H. Lee, W.S. Oh, S.-Y. Choi, N.-J. Kim, J.-P. Choi, S.Y. Park, J. Kim, S.J. Jeong, K.S. Lee, H.C. Jang, J.Y
      Clinical Microbiology and Infection.2016; 22(10): 880.     CrossRef
    • Clinical determinants of the severity of Middle East respiratory syndrome (MERS): a systematic review and meta-analysis
      Ryota Matsuyama, Hiroshi Nishiura, Satoshi Kutsuna, Kayoko Hayakawa, Norio Ohmagari
      BMC Public Health.2016;[Epub]     CrossRef
    • Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients
      Ghaleb A. Almekhlafi, Mohammed M. Albarrak, Yasser Mandourah, Sahar Hassan, Abid Alwan, Abdullah Abudayah, Sultan Altayyar, Mohamed Mustafa, Tareef Aldaghestani, Adnan Alghamedi, Ali Talag, Muhammad K. Malik, Ali S. Omrani, Yasser Sakr
      Critical Care.2016;[Epub]     CrossRef
    • Passive Transfer of A Germline-like Neutralizing Human Monoclonal Antibody Protects Transgenic Mice Against Lethal Middle East Respiratory Syndrome Coronavirus Infection
      Anurodh Shankar Agrawal, Tianlei Ying, Xinrong Tao, Tania Garron, Abdullah Algaissi, Yanping Wang, Lili Wang, Bi-Hung Peng, Shibo Jiang, Dimiter S. Dimitrov, Chien-Te K. Tseng
      Scientific Reports.2016;[Epub]     CrossRef
    • Middle East Respiratory Syndrome (MERS)
      Sonja A. Rasmussen, Amelia K. Watson, David L. Swerdlow, W. Michael Scheld, James M. Hughes, Richard J. Whitley
      Microbiology Spectrum.2016;[Epub]     CrossRef
    • Prevalence of Diabetes in the 2009 Influenza A (H1N1) and the Middle East Respiratory Syndrome Coronavirus: A Systematic Review and Meta-Analysis
      Alaa Badawi, Seung Gwan Ryoo
      Journal of Public Health Research.2016; 5(3): jphr.2016.733.     CrossRef
    • Middle East Respiratory Syndrome Coronavirus Infection in Children
      Hyunju Lee, Mi Seon Han
      Pediatric Infection and Vaccine.2015; 22(3): 143.     CrossRef
    • Middle East Respiratory Syndrome Outbreak in Korea, 2015
      Eun Hwa Choi
      Pediatric Infection and Vaccine.2015; 22(3): 131.     CrossRef
    • Two Epidemics and Global Health Security Agenda
      Hae-Wol Cho, Chaeshin Chu
      Osong Public Health and Research Perspectives.2015; 6(6): S1.     CrossRef
    • Global Health Security: The Lessons from the West African Ebola Virus Disease Epidemic and MERS Outbreak in the Republic of Korea
      GHSA Preparation Task Force Team
      Osong Public Health and Research Perspectives.2015; 6(6): S25.     CrossRef
    • Clinical imaging research of the first Middle East respiratory syndrome in China
      Bowen Lan, Puxuan Lu, Yujing Zeng, Xin Li, Xiaxing Ou, Jingjing Li, Hongjun Li
      Radiology of Infectious Diseases.2015; 2(4): 173.     CrossRef
    • REMOVED: Editorial
      Hae-Wol Cho
      Osong Public Health and Research Perspectives.2015; 6(4): 219.     CrossRef

    Related articles

    PHRP : Osong Public Health and Research Perspectives