中東呼吸道症候群冠狀病毒的演化和認知差距

科學會議回顧 - 中東呼吸道症候群冠狀病毒的演化和認知差距 - 世衛組織東地中海區域辦事處WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps

http://afludiary.blogspot.tw/2015/05/emro-scientific-meeting-reviews-mers.html

我們正在迅速接觸，三年前在沙烏地阿拉伯首次被發現的新冠狀病毒現在被稱為中東呼吸道症候群冠狀病毒，但這種病毒是如何傳播到人類？仍有許多未知？We are rapidly approaching three years since the novel coronavirus now known as MERS-CoV was first discovered in Saudi Arabia, and yet there is still much we don’t know about how the virus is transmitted to, and among, humans.

相當多確診病例數都與院內感染有關，駱駝已被證明為帶源者，推測帶中東呼吸道症候群冠狀病毒源的駱駝在媒介傳播病毒到人類扮演部分的角色，但大多確診病例的感染源仍然不明。

A fair number of cases have been linked to hospital spread, and camels have been shown to carry the virus and are presumed to play some part in introduction of the virus to humans, but for most cases the source of infection remains unknown.

許多確診病例在缺乏明顯存在的所謂流行病學接觸史的聯結（無確診病例的接觸史），可能透過接觸過輕微症狀（或無症狀）病毒帶源者所引起病毒傳染散播的問題。從有限已知確診病例的疫情調查我們發現，約20％確診病例可能透過接觸過輕微症狀或無症狀病毒帶源者而被感染（無確診病例的接觸史）。

The lack of obvious epidemiological links between many cases raises the question of transmission of the virus from mildly symptomatic (or asymptomatic) carriers of the virus.  We know from limited testing of contacts of known cases that some percentage (roughly 20%)  can be infected and show little or no outward signs of illness.

這些輕微症狀或無症狀病毒帶源者是否能夠傳染散播病毒仍未知？但我們已經看到了一些暗示，它可能是某個因素（參閱研究：可能從被無症狀中東呼吸道症候群冠狀病毒帶源者傳染的病例http://afludiary.blogspot.com/2013/08/study-possible-transmission-from.html）。

Whether these people can transmit the virus onward isn’t known, but we’ve seen some hints that it may be a factor (see Study: Possible Transmission From Asymptomatic MERS-CoV Case).

也無法解釋的是，從最新的中東呼吸道症候群冠狀病毒快速風險評估，在下面的圖表顯示主要感染病例數是高齡層，和男性占極大多數的嚴重年齡層感染病例數統計數據傾斜。20歲以下的病例數占極少數也是一個謎（20歲以下年齡層占大約40％埃及人口）。Also unexplained are the heavily skewed demographics of infection (predominately older, and male)  shown in the following graphic from the most recent ECDC Rapid Risk Assessment on MERS.  The minor representation of patients under the age of 20 (which comprise roughly 40% of Egypt’s population) is also a mystery.