A pandemic risk assessment of middle east respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia

Eifan, Saleh A.; Nour, Islam; Hanif, Atif; Zamzam, Abdelrahman M.M.; AlJohani, Sameera Mohammed

The present study reported the highest R values (Table 2 ) ever observed for MERS-CoV, however other studies reported R of up to 0.73 (Kucharski and Edmunds, 2015) , 0.69 (Breban et al., 2013; Poletto et al., 2014) and 0.63 (Cauchemez et al., 2014) . The probable reasons for the surge of R value in the current study could be the absence of a vaccine or a treatment, besides the inefficient control measures in health care centers and hospitals as most of the observed cases were documented to be interand intra-hospital transmissions (Drosten et al., 2015; Oboho et al., 2015) . Furthermore, Cauchemez et al. (2014) mentioned that R 0 could range from 0.8 to 1.3 in the absence of the infection control measures. The results of current study are in agreement with the findings of Cauchemez et al. (2014) . A study in South Korea (Kucharski and Althaus, 2015) highlighted the risk of super-spreading events of MERS-CoV infection with relatively low basic reproductive number (R = 0.47) and should be considered as warning for future outbreak events in Saudi Arabia with the prediction of relatively higher R value. Therefore, future tracking of infections would add value to our understanding of viral transmissibility pattern as well as contracting the CIs around the R 0 value. Appropriate monitoring of cases as well as enhanced traceability procedures are important to reduce transmission rate, diminish any possible opportunity of viral adaptation to human-to-human transmission and to obtain reliable data for periodical update of the R value (Min et al., 2016) .