Exploration of Superspreading Events in 2015 MERS-CoV Outbreak in Korea by Branching Process Models

Choe, Seoyun; Kim, Hee-Sung; Lee, Sunmi

South Korea has learned a valuable lesson from the Middle East respiratory syndrome (MERS) coronavirus outbreak in 2015. The 2015 MERS-CoV outbreak in Korea was the largest outbreak outside the Middle Eastern countries and was characterized as a nosocomial infection and a superspreading event. To assess the characteristics of a super spreading event, we specifically analyze the behaviors and epidemiological features of superspreaders. Furthermore, we employ a branching process model to understand a significantly high level of heterogeneity in generating secondary cases. The existing model of the branching process (Lloyd-Smith model) is used to incorporate individual heterogeneity into the model, and the key epidemiological components (the reproduction number and the dispersive parameter) are estimated through the empirical transmission tree of the MERS-CoV data. We also investigate the impact of control intervention strategies on the MERS-CoV dynamics of the Lloyd-Smith model. Our results highlight the roles of superspreaders in a high level of heterogeneity. This indicates that the conditions within hospitals as well as multiple hospital visits were the crucial factors for superspreading events of the 2015 MERS-CoV outbreak.