![]() ![]() MERS-CoV is a large single-strand positive-sense RNA virus ( figure 1 MERS-CoV, like SARS-CoV and SARS-CoV-2, can cause highly lethal disease in humans. Other human coronaviruses generally cause mild respiratory infections (eg, HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1). MERS-CoV, SARS-CoV, and SARS-CoV-2, are members of the Coronaviridae family of the order Nidovirales. This Seminar reviews current knowledge and provides an update on MERS-CoV epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features, management, infection control, and development of new therapeutics and vaccines, and also highlights unanswered questions and priorities for research, improved management, and prevention. ![]() Outside China, there have been 8774 cases reported from 64 countries with 128 deaths. 13 This outbreak is rapidly evolving and as of Mathere have been 88 948 laboratory confirmed cases of COVID-19, with 3043 deaths (3♴% mortality). ![]() SARS-CoV-2 (initially named 2019-nCoV) was detected in December 2019 after sequencing of clinical samples from a cluster of patients in Wuhan, China who developed pneumonia of unknown cause. 11, 12 This outbreak was associated with substantial morbidity and mortality, as well as having substantial economic, social, and health security effects. 2, 10 Several outbreaks of human-to-human MERS-CoV transmission have occurred, the largest outside the Middle East occurring in South Korea in 2015. Unlike SARS-CoV, which was contained within a year of emerging, MERS-CoV continues to circulate and cause human disease with intermittent sporadic cases, community clusters, and nosocomial outbreaks in the Middle East with considerable risk of spreading globally. 7 MERS-CoV is considered a zoonotic pathogen, with MERS-CoV-infected dromedary camels being the animal source of infection to humans. 6 A retrospective study then linked MERS-CoV to a hospital outbreak in April, 2012, in Jordan. MERS-CoV was first identified as causing human disease when it was isolated from a lung sample of an adult patient who was admitted at a hospital in Jeddah, Saudi Arabia, with severe pneumonia and died of multiorgan failure. 1, 5 The SARS epidemic ended abruptly in July, 2003, 1 and no human cases of SARS have been detected over the past 15 years. SARS-CoV was first identified in humans in Guangdong, China, in November, 2002 and subsequently spread rapidly worldwide to 29 countries, resulting in 8098 human SARS cases with 774 deaths (9♶% mortality). 3 All three causative coronaviruses, respectively, SARS-CoV, MERS-CoV, and SARS-related coronavirus-2 (SARS-CoV-2) have focused the attention of global public health authorities and are listed in the WHO Blueprint list for priority pathogens 4 because of their pandemic potential, threat to global health security, and the absence of any effective treatments. This Seminar provides an update on the current knowledge and perspectives on MERS epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features, management, infection control, development of new therapeutics and vaccines, and highlights unanswered questions and priorities for research, improved management, and prevention.ĭuring the past 17 years three lethal zoonotic diseases of humans caused by novel coronaviruses, severe acute repiratory syndrome (SARS) in November, 2002, 1 Middle East respiratory syndrome (MERS) in April, 2012, 2 and more recently coronavirus disease (COVID-19) in December, 2019. MERS-CoV remains a high-threat pathogen identified by WHO as a priority pathogen because it causes severe disease that has a high mortality rate, epidemic potential, and no medical countermeasures. Large outbreaks of human-to-human transmission have occurred, the largest in Riyadh and Jeddah in 2014 and in South Korea in 2015. Between April 2012 and December 2019, 2499 laboratory-confirmed cases of MERS-CoV infection, including 858 deaths (34♳% mortality) were reported from 27 countries to WHO, the majority of which were reported by Saudi Arabia (2106 cases, 780 deaths). Intermittent sporadic cases, community clusters, and nosocomial outbreaks of MERS-CoV continue to occur. The Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonotic pathogen that was first identified in humans in Saudi Arabia and Jordan in 2012. ![]()
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