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To guide risk assessment, expected numbers of cases and generations were estimated, assuming a case importation of Middle East respiratory syndrome (MERS). Our analysis of 36 importation events yielded the risk of observing secondary transmission events at 22.7% (95% confidence interval: 19.3–25.1). The risks of observing generations 2, 3 and 4 were estimated at 10.5%, 6.1% and 3.9%, respectively. Countries at risk should be ready for highly variable outcomes following an importation of MERS.


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Nishiura H, Miyamatsu Y, Chowell G, Saitoh M. Assessing the risk of observing multiple generations of Middle East respiratory syndrome (MERS) cases given an imported case. Euro Surveill. 2015;20(27):pii=21181. Article DOI:

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