This study compared the phylogeography of MERS-CoV between hospital outbreak-associated cases and sporadic cases in Saudi Arabia. We collected complete genome sequences from human samples in Saudi Arabia and data on the multiple risk factors of human MERS-CoV in Saudi Arabia reported from 2012 to 2018. By matching each sequence to human cases, we identified isolates as hospital outbreak-associated cases or sporadic cases. We used Bayesian phylogenetic methods including temporal, discrete trait analysis and phylogeography to uncover transmission routes of MERS-CoV isolates between hospital outbreaks and sporadic cases. Of the 120 sequences collected between 19 June 2012 and 23 January 2017, there were 64 isolates from hospital outbreak-associated cases and 56 from sporadic cases. Overall, MERS-CoV is fast evolving at 7.43 × 10 −4 substitutions per site per year. Isolates from hospital outbreaks showed unusually fast evolutionary speed in a shorter time-frame than sporadic cases. Multiple introductions of different MERS-CoV strains occurred in three separate hospital outbreaks. MERS-CoV appears to be mutating in humans. The impact of mutations on viruses transmissibility in humans is unknown.
【저자키워드】 Epidemiology, nosocomial, MERS-CoV, phylogeography, phylogenetics, hospital outbreaks, 【초록키워드】 Mutation, Bayesian, hospital, Human, risk factor, virus, Saudi Arabia, Outbreaks, Transmissibility, outbreak, humans, transmission route, Analysis, genome sequence, strain, Phylogenetic, sequence, Substitution, Multiple, Complete, isolate, collected, occurred, reported, appear, 【제목키워드】 Saudi Arabia,