Imperial College London

Dr Tini Garske

Faculty of MedicineSchool of Public Health

Senior Lecturer



+44 (0)20 7594 3247t.garske




G24Norfolk PlaceSt Mary's Campus






BibTex format

author = {Cauchemez, S and Nouvellet, P and Cori, A and Jombart, T and Garske, T and Clapham, H and Moore, S and Mills, HL and Salje, H and Collins, C and Rodriquez-Barraquer, I and Riley, S and Truelove, S and Algarni, H and Alhakeem, R and AlHarbi, K and Turkistani, A and Aguas, RJ and Cummings, DA and Van, Kerkhove MD and Donnelly, CA and Lessler, J and Fraser, C and Al-Barrak, A and Ferguson, NM},
doi = {10.1073/pnas.1519235113},
journal = {Proceedings of the National Academy of Sciences of the United States of America},
pages = {9081--9086},
title = {Unraveling the drivers of MERS-CoV transmission.},
url = {},
volume = {113},
year = {2016}

RIS format (EndNote, RefMan)

AB - With more than 1,700 laboratory-confirmed infections, Middle East respiratory syndrome coronavirus (MERS-CoV) remains a significant threat for public health. However, the lack of detailed data on modes of transmission from the animal reservoir and between humans means that the drivers of MERS-CoV epidemics remain poorly characterized. Here, we develop a statistical framework to provide a comprehensive analysis of the transmission patterns underlying the 681 MERS-CoV cases detected in the Kingdom of Saudi Arabia (KSA) between January 2013 and July 2014. We assess how infections from the animal reservoir, the different levels of mixing, and heterogeneities in transmission have contributed to the buildup of MERS-CoV epidemics in KSA. We estimate that 12% [95% credible interval (CI): 9%, 15%] of cases were infected from the reservoir, the rest via human-to-human transmission in clusters (60%; CI: 57%, 63%), within (23%; CI: 20%, 27%), or between (5%; CI: 2%, 8%) regions. The reproduction number at the start of a cluster was 0.45 (CI: 0.33, 0.58) on average, but with large SD (0.53; CI: 0.35, 0.78). It was >1 in 12% (CI: 6%, 18%) of clusters but fell by approximately one-half (47% CI: 34%, 63%) its original value after 10 cases on average. The ongoing exposure of humans to MERS-CoV from the reservoir is of major concern, given the continued risk of substantial outbreaks in health care systems. The approach we present allows the study of infectious disease transmission when data linking cases to each other remain limited and uncertain.
AU - Cauchemez,S
AU - Nouvellet,P
AU - Cori,A
AU - Jombart,T
AU - Garske,T
AU - Clapham,H
AU - Moore,S
AU - Mills,HL
AU - Salje,H
AU - Collins,C
AU - Rodriquez-Barraquer,I
AU - Riley,S
AU - Truelove,S
AU - Algarni,H
AU - Alhakeem,R
AU - AlHarbi,K
AU - Turkistani,A
AU - Aguas,RJ
AU - Cummings,DA
AU - Van,Kerkhove MD
AU - Donnelly,CA
AU - Lessler,J
AU - Fraser,C
AU - Al-Barrak,A
AU - Ferguson,NM
DO - 10.1073/pnas.1519235113
EP - 9086
PY - 2016///
SN - 1091-6490
SP - 9081
TI - Unraveling the drivers of MERS-CoV transmission.
T2 - Proceedings of the National Academy of Sciences of the United States of America
UR -
UR -
VL - 113
ER -