Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Abstract:
Middle
East respiratory syndrome (MERS) is a highly lethal respiratory disease caused by
a novel single-stranded, positive-sense RNA beta coronavirus (MERS-CoV). Dromedary
camels, hosts for MERS-CoV, are implicated in direct or indirect transmission to
human beings, although the exact mode of transmission is unknown. The virus was
first isolated from a patient who died from a severe respiratory illness in June,
2012, in Jeddah, Saudi Arabia. As of May 31, 2015, 1180 laboratory-confirmed cases
(483 deaths; 40% mortality) have been reported to WHO. MERS-CoV causes severe human
infections resulting in high mortality and has demonstrated the ability to transmit
between humans. So far, the observed human-to-human transmission has occurred mainly
in health care settings. WHO expects that additional cases of MERS-CoV infection
will be reported from the Middle East, and that cases will continue to be exported
to other countries by individuals who might acquire the infection after exposure
to animals or animal products (for example, following contact with dromedaries)
or human source (for example, in a health care setting). Both community-acquired
and hospital-acquired cases have been reported with little human-to-human transmission
reported in the community. Although most cases of MERS have occurred in Saudi Arabia
and the United Arab Emirates, cases have been reported in Europe, the USA, and Asia
in people who travelled from the Middle East or their contacts. Clinical features
of MERS range from asymptomatic or mild disease to acute respiratory distress syndrome
and multiorgan failure resulting in death, especially in individuals with underlying
comorbidities. No specific drug treatment exists for MERS and infection prevention
and control measures are crucial to prevent spread in health-care facilities. MERS-CoV
continues to be an endemic, low-level public health threat. However, the virus could
mutate to have increased interhuman transmissibility, increasing its pandemic potential.
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