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1、ThenewenglandjournalofmedicineeditorialsPerson-to-PersonSpreadoftheMERSCoronavirus—AnEvolvingPictureStanleyPerlman,M.D.,Ph.D.,andPaulB.McCray,Jr.,M.D.Approximately1yearago,anovelcoronavirus,(17of23)havingdiabetes.Inadditiontoshow-theMiddleEastrespira
2、torysyndromecoronavirusingthathuman-to-humantransmissionoc-(MERS-CoV),wasfirstidentifiedintheJournalascurredfrequently,therelativelylargenumberofthecausativeagentofalethalpneumoniainsev-patientsinfectedinthisoutbreakmadeitpossi-eralpatientsintheMiddl
3、eEast.1AsofJuly10,bletodefinecharacteristicsoftheinfection,2013,atotalof80caseshavebeenidentifiedinsuchastheincubationtime(5.2days)andthetheMiddleEast(SaudiArabia,Jordan,Qatar,andserialinterval(7.6days).AsseenintheSARStheUnitedArabEmirates),Europe(Un
4、itedKing-epidemic,therewasvariabilityinthenumbersdom,France,Italy,andGermany),andNorthofpatientsinfectedbyeachindexpatient,withAfrica(Tunisia),withacasefatalityrateof56%.1patienttransmittingvirusto7contacts;super-Sincethiscoronavirusisacloserelativeo
5、fthespreadingevents,inwhichafewpatientsinfect-virusthatcausedthesevereacuterespiratoryedlargenumbersofcontacts,werecriticalfac-syndrome(SARS),ashort-livedbutalarmingtorsinSARSreachingepidemicproportions.epidemicin2002–2003thatresultedinapproxi-Thestu
6、dybyAssirietal.showsthatMERS-CoVmately8000casesand800deaths,governmental,hasthepotentialtospreadwidelywithinhealthpublichealth,clinical,andlaboratoryauthoritiescaresettings,infectingprimarilyotherpatientsallmobilizedrapidlytorespondtothenewvirusbutal
7、sohealthcareworkersandfamilycon-outbreak.SoonaftertheidentificationofMERS-tacts,althoughtoalesserextent.PatientswithCoV,informationaboutitsgenomicsequenceanddiabetesorchronicrenalfailureappeartobeatorganization,speciestropism,andhost-cellre-especiall
8、yhighriskforsevereMERS-CoVinfec-ceptor(dipeptidylpeptidase4)waspublished.2,3tion,butwhetherthesecoexistingconditionsTheseinitialstudiesdidnotidentifythesourceofrepresenttrueriskfactorsorwhetherthesepa-thisnewlyidentifiedvirus,nordidtheyrevealtientsha
