Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 22, Number 1—January 2016
Research

Risk Factors for Primary Middle East Respiratory Syndrome Coronavirus Illness in Humans, Saudi Arabia, 2014

Basem M. Alraddadi, John T. Watson, Abdulatif Almarashi, Glen R. Abedi, Amal Turkistani, Musallam Sadran, Abeer Housa, Mohammad A. Almazroa, Naif Alraihan, Ayman Banjar, Eman Albalawi, Hanan Alhindi, Abdul Jamil Choudhry, Jonathan G. Meiman, Magdalena Paczkowski, Aaron Curns, Anthony W. Mounts, Daniel R. Feikin, Nina Marano, David L. Swerdlow, Susan I. Gerber, Rana Hajjeh, and Tariq A. MadaniComments to Author 
Author affiliations: King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia (B.M. Alraddadi); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (J.T. Watson, G.R. Abedi, J.G. Meiman, M. Paczkowski, A. Curns, A. Mounts, D.R. Feikin, N. Marano, D.L. Swerdlow, S.I. Gerber, R. Hajjeh); Ministry of Health, Jeddah (A. Almarashi, A. Turkistani, A. Housa, A. Banjar, T.A. Madani); Ministry of Health, Najran, Saudi Arabia (M. Sadran); Ministry of Health, Riyadh, Saudi Arabia (M.A. Almazroa, N. Alraihan, A.J. Choudhry); Ministry of Health, Alwajh, Saudi Arabia (E. Albalawi); Ministry of Health, Hail, Saudi Arabia (H. Alhindi); King Abdulaziz University, Jeddah (T.A. Madani)

Main Article

Table 2

Animal-related exposures, underlying health conditions, current tobacco use, and siwak use for Middle East respiratory syndrome coronavirus case-patients compared with matched controls. Saudi Arabia, March 16–November 13, 2014

Variable No. (%) with exposure*
Odds ratio (95% CI) p value
Case-patients, n = 30 Controls, n = 116
Animal-related exposures
Household members frequently visit farms with dromedaries†‡ 12/30 (40) 14/115 (12) 7.06 (2.23–26.46) <0.001
Household members visited a farm with dromedaries during exposure period‡ 9/30 (30) 14/115 (12) 3.95 (1.23–13.72) 0.018
Household members had direct contact with dromedaries during exposure period‡§ 12/30 (40) 17/114 (15) 5.03 (1.66–16.88) 0.004
Spouse 4/30 (13) 4/116 (3) 4.26 (0.86–23.41) 0.065
Other relatives‡ 7/30 (23) 7/116 (6) 4.59 (1.36–16.27) 0.012
Domestic help‡ 5/30 (17) 3/116 (3) 15.04 (1.96−369.59) 0.006
Dromedaries kept in/around home during exposure period‡§ 9/30 (30) 17/115 (15) 3.34 (1.04–10.98) 0.047
Goats kept in/around home during exposure period‡§ 1/30 (3) 22/115 (19) 0.08 (0.003–0.58) 0.011
Horses kept in/around home during exposure period§ 1/29 (3) 0/115 (0) 4.00 (0.44–∞) 0.200
Bats in/around house during exposure period§ 3/28 (11) 11/112 (10) 1.60 (0.24–9.23) 0.646
Sheep kept in/around home during exposure period§ 10/30 (33) 22/115 (19) 3.34 (0.97–12.19) 0.057
Sheep present at a slaughterhouse visited during exposure period‡§ 1/30 (3) 18/116 (16) 0.15 (<0.001–0.56) 0.040
Visited farm where livestock were kept during exposure period§ 10/29 (34) 32/116 (28) 1.67 (0.52–5.42) 0.393
Dromedary present on farm‡ 9/10 (90) 17/32 (53) 11.57 (2.67–∞) 0.013
Milked dromedaries while on farm‡ 5/10 (50) 7/31 (23) 10.36 (2.47–∞) 0.013
Visited other livestock venue (i.e., not farm, market, slaughterhouse, racetrack, or stable) during exposure period‡§ 7/29 (24) 12/111 (11) 3.33 (1.001–11.05) 0.040
Direct physical contact with dromedary during last 6 mo‡ 11/30 (37) 15/116 (13) 7.67 (2.10–36.08) 0.001
Any direct contact with a dromedary during exposure period‡§¶ 10/30 (33) 17/116 (15) 3.73 (1.24–11.80) 0.020
Any direct contact with a goat during exposure period§ 4/30 (13) 22/116 (19) 0.64 (0.17–2.02) 0.584
Any direct contact with a§ sheep during exposure period§¶ 10/30 (33) 38/116 (33) 1.03 (0.37–2.77) 1.000
Any direct contact with a horse during exposure period§¶ 1/30 (3) 0/116 (0) 4.00 (0.44–∞) 0.200
Any direct contact with cattle during exposure period§¶
4/30 (13)
4/116 (3)
6.00 (1.02–48.44)
0.043
Underlying health conditions and behaviors
Diabetes‡ 16/29 (55) 32/116 (28) 3.72 (1.45–10.25) 0.005
Emphysema, chronic bronchitis, or other chronic lung disease‡ 4/30 (13) 1/113 (1) 17.68 (4.22-∞) 0.003
Heart disease‡ 11/30 (37) 14/114 (12) 5.11 (1.81–15.46) 0.002
Current smoker‡ 11/30 (37) 22/116 (19) 3.14 (1.10–9.24) 0.030
Any underlying condition‡# 21/30 (70) 49/116 (42) 5.11 (1.70–18.67) 0.004
Any underlying condition, including current smoking‡ 27/30 (90) 64/116 (55) 7.55 (2.32–33.45) <0.001
Using siwak during exposure period‡§ 7/28 (25) 56/114 (49) 0.24 (0.06–0.77) 0.023

*Denominators vary on the basis of completeness of responses or reflect subsets.
†Dromedaries, dromedary camels.
‡Statistically significant (p<0.05).
§The exposure period of cases is defined as the 14 days before the date of the first symptom onset. For controls, the exposure period is the same as for the case to which they are matched.
¶Direct animal contact includes any of the following specific exposures: physical contact with animals or animal products (i.e., carcasses, body fluids, secretions, urine, excrement, or raw meat) in any setting (i.e., farm, livestock market, slaughterhouse, racetrack or stable, or other animal-related venues) or engaging in certain animal-related activities (i.e., feeding animals, cleaning their housing, slaughtering them, assisting with their birth, milking them, kissing or hugging them, or other related tasks).
#Diabetes, asthma, emphysema, chronic bronchitis, other chronic lung disease, kidney failure, chronic liver disease, heart disease, history of cancer treatment, blood disorder.

Main Article

Page created: December 18, 2015
Page updated: December 18, 2015
Page reviewed: December 18, 2015
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external