Date: 03 July 2013
Contact: Dr Anthony Mounts firstname.lastname@example.org
This document was adapted from a protocol developed by the Consortium for the Standardization for Influenza Seroepidemiology (CONSISE), a global partnership aiming to develop influenza investigation protocols and standardize seroepidemiology to inform public health policy for pandemic, zoonotic and seasonal influenza. This international partnership was created out of a need, identified during the 2009 H1N1 pandemic, for better (standardized, validated) seroepidemiological data to estimate infection attack rates and severity of the pandemic virus and to inform policy decisions. More information on the CONSISE network can be found on their website: www.CONSISE.tghn.org.
This investigation will provide data to evaluate exposures and risk factors for human cases of Middle East Respiratory Syndrome Coronavirus (MERS-‐CoV) to determine those that are related to infection. This protocol outlines a case-‐control study and the epidemiological methods to guide data collection to assess risk factors for illness caused by MERS coronavirus (MERS-‐CoV) infection. Health care personnel and the evaluation of other contacts are addressed in a separate protocol.
Comments for the user’s consideration are provided in purple text throughout the document as the user may need to modify methods slightly because of the local context in which this study will be carried out.
1.0 Scientific Background and Rationnale
The novel Coronavirus now known as Middle East Respiratory Syndrome Coronavirus (MERS-‐CoV) was first detected in a patient living in Saudi Arabia in September of 2012. Since that time, sporadic cases, small clusters, and in large outbreaks have been reported in several countries. While the source of the virus is currently unknown, it is thought to originate in animals. Human-‐to-‐human transmission has also been documented on multiple occasions. Although finding the putative animal reservoir is an important step in controlling spread of the virus, a more immediate need is to understand the route and mode of transmission to humans, and the types of exposures that result in infection. Several possibilities exist, including direct contact with an infected animal, which could be either the reservoir species or an intermediate host species; contact with or consumption of unprocessed animal products; contact with the environment where an infected animal has recently been; or consumption of a food or beverage which has been contaminated by animal excreta. All of these have been implicated in other zoonotic infections. Learning the mode of transmission to humans will allow measures to be taken to interrupt transmission. This investigation will provide data to evaluate risk factors for infection by reviewing exposures of known cases and comparing them to rates of exposure in similar uninfected individuals in the general population.
Current information on the MERS-‐CoV and cases can be found on the WHO website: http://www.who.int/csr/disease/coronavirus_infections/en/index.html.
A separate protocol is available specifically for assessment of exposed Health Care Personnel and contacts of cases (see http://consise.tghn.org/articles/novel-‐coronavirus-‐MERS-‐CoV/).
The data collected from this study will be used to refine/update recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of MERS-‐CoV virus, help understand spread, severity, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and quarantine.
The primary objective of this study is to: • Identify modifiable non-‐human exposures that lead to human MERS-‐CoV infection
Complete Document: http://www.who.int/csr/disease/coronavirus_infections/MERSCoVCaseControlStudyPotentialRiskFactors_03Jul13.pdf