Middle East Respiratory Syndrome: Its Occurrence, Aetiology, Epidemiology, Associated Clinicopathological Findings, Diagnosis, Prevention and Control in Humans and Animals: An Overview
Middle East respiratory syndrome (MERS) is a serious zoonotic disease. It is characterized by severe infection of the lower respiratory pathway in humans. Dromedary camels are considered to be the likeliest source of the very pathogenic aetiologic agent, Middle East respiratory syndrome coronavirus (MERS-CoV). Although, the first case of MERS-CoV was initially identified in Kingdom of Saudi Arabia (KSA) in September 2012, most of the reported cases have been detected in Arabian Peninsula but worthy of note is that travel-associated MERS cases have been reported around the world especially in Europe, Asia, Africa and North-America. This virus is very endemic in camel populations of East Africa and the Arabian Peninsula but worryingly, the zoonotic transmission of MERS-CoV are now well reported. It is diagnosed in camels using IgG immunofluorescence assay, protein microarray and virus neutralisation assay Diagnosis in humans is based on chest radiographs and computed tomographic scans but confirmatory diagnosis of suspected MERS patients could be done by taking a intratracheal aspirate for detection test of MERS-CoV RNA positive real-time reverse transcriptase polymerase chain reaction assays. The major control measures of MERS-CoV spread include strict regulation of camel movement, regular herd screening and culling of infected camels.
Ali M, El-Shesheny R, Kandeil A, Shehata M, Elsokary B, Gomaa M, ... Oludayo FF (2017). Cross-sectional surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels and other mammals in Egypt, August 2015 to January 2016. Eurosurveillance 22(11).
Alraddadi BM, Watson JT, Almarashi A, Abedi GR, Turkistani, A., Sadran M, Housa A, Swerdlow DL (2016). Risk factors for primary Middle East Respiratory Syndrome coronavirus illness in humans, Saudi Arabia, 2014. Emerging Infectious Diseases 22(1):49-55.
Al-Tawfiq JA, Memish ZA (2016). Drivers of MERS-CoV transmission: what do we know? Expert Review of Respiratory Medicine 10(3):331-338.
Annan A, Baldwin HJ, Corman VM, Klose SM, Owusu M, Nkrumah EE (2013). Human betacoronavirus 2c EMC/2012-related viruses in bats, Ghana and Europe. Emerging Infectious Diseases 19(3):456-459.
Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A, … Raiy B (2014). Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection. Annals of Internal Medicine 160(6):389-397.
Arabi YM, Harthi, A, Hussein J, Bouchama A, Johani S. Hajeer AH, … Balkhy H (2015). Severe neurologic syndrome associated with Middle East respiratory syndrome corona virus (MERS-CoV). Infection 43(4):495-501.
Arabi YM, Balkhy HH, Hayden FG, Bouchama A, Luke T, Baillie JK, … Fowler RA (2017). Middle East Respiratory Syndrome: special report. The New England Journal of Medicine 376(6):584-594.
Azhar EI, El-Kafrawy SA, Farraj SA, Hassan AM, Al-Saeed M, Hashem AM, Madani TA (2014). Evidence for camel to human transmission of MERS coronavirus. The New England Journal of Medicine 370(26):2499-2505.
Bin SY, Heo JY, Song MS, Lee J, Kim EH, Park SJ, … Choi, YK (2016). Environmental contamination and viral shedding in MERS patients during MERS-CoV outbreak in South Korea. Clinical Infectious Diseases 62(6):755-760.
Cotton M, Watson SJ, Kellam P, Al-Rabeeah AA, Makhdoom HQ, Assiri A (2013). Transmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive genomic study. Lancet 382(9909):1993-2002.
De Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L (2013). Middle East Respiratory Syndrome Coronavirus (MERS-CoV): announcement of the Coronavirus study group. Journal of Virology 87(14):7790-7792.
de Wit E, Rasmussen AL, Falzarano D, Bushmaker T, Feldmann F, Brining DL, … Munster VJ (2013). Middle East Respiratory Syndrome Coronavirus (MERSCoV) causes transient lower respiratory tract infection in rhesus macaques. PNAS 110(41):16598-16603.
Haagmans BL, Al Dhahiry SH, Reusken CB, Raj VS, Galiano M, Myers R, … Koopmans MP (2014). Middle East Respiratory Syndrome Coronavirus in dromedary camels: an outbreak investigation. The Lancet Infectious Diseases 14(2):140-145.
Haagmans BL, van den Brand JM, Provacia LB, Raj VS, Stittelaar KJ, Getu S, … Osterhaus AD (2015). Asymptomatic middle east respiratory syndrome coronavirus infection in rabbits. Journal of Virology 89(11):6131-6135.
Haagmans BL, van den Brand JM, Provacia LB, Raj VS, Stittelaar KJ, Getu S, ... Fouchier RA (2015). Asymptomatic Middle East respiratory syndrome coronavirus infection in rabbits. Journal of Virology 89(11):6131-6135.
Hilgenfeld R., Peiris M (2013). From SARS to MERS: 10 years of research on highly pathogenic human coronaviruses. Antiviral Research 100(1):286-295.
Ithete NL, Stoffberg S, Corman VM, Cottontail VM, Richards LR, Schoeman MC (2013). Close relative of human Middle East respiratory syndrome coronavirus in bat, South Africa. Emerging Infectious Disease 19(10):1697-1699.
Al‐Tawfiq JA, Hinedi K, Abbasi S, Babike M, Sunji A, Eltigani M (2017). Hematologic, hepatic, and renal function changes in hospitalized patients with Middle East Respiratory Syndrome coronavirus. International Journal of Laboratory Haematology 39(3):272-278.
Kim SH, Chang SY, Sung M, Park JH, Bin KH, Lee, H, Min JY (2016). Extensive viable Middle East respiratory syndrome (MERS) coronavirus contamination in air and surrounding environment in MERS isolation wards. Clinical Infectious Disease 63(3):363-369.
Korea Center for Disease Control and Prevention (2016). Corrigendum to “Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015” [Volume 6, Issue 4, August 2015, 269-278]. Osong Public Health and Research Perspective 2017:138.
Lee H, Ki CS, Sung H, Kim S, Seong MW, Yong D, Kim JS, Kim JH (2016). Guidelines for the laboratory diagnosis of Middle East respiratory syndrome coronavirus in Korea. Infectious and Chemotherapy 48(1):61-69.
Memish ZA, Al-Tawfiq JA, Assiri A, AlRabiah FA, Al Hajjar S, Albarrak A, … Alsubaie S (2014). Middle East respiratory syndrome coronavirus disease is rare in children. World Journal of Clinical Pediatrics 5(4):391.
Memish ZA, Zumla AI, Al-Hakeem RF, Al-Rabeeah AA, Stephens GM (2013). Family cluster of Middle East respiratory syndrome coronavirus infections. The New England Journal of Medicine 368:2487-2494.
Memish ZA, Mishra N, Olival KJ, Fagbo SF, Kapoor V, Epstein JH (2013). Middle East respiratory syndrome coronavirus in bats, Saudi Arabia. Emerging Infectious Diseases 19(11):1819-1823.
Mohd HA, Al-Tawfiq JA, Memish ZA (2016). Middle East respiratory syndrome coronavirus (MERS-CoV) origin and animal reservoir. Virology Journal 13(1):87.
Muller MA, Meyer B, Corman VM, Al-Masri M, Turkestani A, Ritz D, … Memish ZA (2015). Presence of Middle East respiratory syndrome coronavirus antibodies in Saudi Arabia: a nationwide, cross-sectional, serological study. The Lancet Infectious Diseases 15(5):559-564.
Ng DL, Al Hosani F, Keating MK, Gerber SI, Jones TL, Metcalfe MG, … Zaki SR (2016). Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in the United Arab Emirates, April 2014. The American Journal of Pathology 186(3):652-658.
Oboho IK, Tomczyk SM, Al-Asmari AM, Banjar AA, Al-Mugti H, Aloraini MS (2015) MERSCoV outbreak in Jeddah - a link to health care facilities. The New England Journal of Medicine 372(9):846-854.
Omrani AS, Al-Tawfiq JA, Memish ZA (2015). Middle East respiratory syndrome coronavirus (MERS-CoV): animal to human interaction. Pathogens and Global Health 109 (8):354-362.
Park GE, Kang CI, Ko JH, Cho SY, Ha YE, Kim YJ, Chung DR (2017). Differential cell count and crp level in blood as predictors for Middle East respiratory syndrome coronavirus infection in acute febrile patients during nosocomial outbreak. Journal of Korean Medical Science 32(1):151-154.
Park SH, Kim WJ, Yoo J, Cho J (2016). Epidemiologic parameters of the Middle East respiratory syndrome outbreak in Korea, 2015. Infection and Chemotherapy 48(2):108-117.
Payne DC, Iblan I, Alqasrawi S, Al Nsour M, Rha B, Tohme RA, … Al Abdallat MM (2014). Jordan MERS-CoV investigation team. Stillbirth during infection with Middle East respiratory syndrome coronavirus. Journal of Infectious Disease 209(12):870-1872.
Perera RA, Wang P, Gomaa MR, El-Shesheny R, Kandeil A, Bagato O, … Kayali G (2013). Seroepidemiology for MERS coronavirus using microneutralisation and pseudoparticle virus neutralisation assays reveal a high prevalence of antibody in dromedary camels in Egypt, June 2013. Eurosurveillance 18(36):20574.
van Boheemen, S, de Graaf, M. Lauber C, Bestebroer TM, Raj VS, Zaki AM, … Fouchier, RAM (2012). Genomic characterization of a newly discovered coronavirus associated with acute respiratory distress syndrome in humans. MBio 3(6):e00473-12.
Van Doremalen N, Munster VJ (2015). Animal models of Middle East respiratory syndrome coronavirus infection. Antiviral Research 122:28-38.
World Health Organization (2015). Middle East respiratory syndrome coronavirus (MERS-CoV). Retrieved 2018 August 8 from http://www.who.int/ emergencies/mers-cov/en/.
Younan M, Bornstein S, Gluecks IV (2016). MERS and the dromedary camel trade between Africa and the Middle East. Tropical Animal Health and Production 48(6):1277-1282.
Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM (2012). Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. The New England Journal of Medicine 367(19):1814-1820.
Copyright (c) 2019 Notulae Scientia Biologicae
This work is licensed under a Creative Commons Attribution 4.0 International License.
Distribution - Permissions - Copyright
Papers published in Notulae Scientia Biologicae are Open-Access, distributed under the terms and conditions of the Creative Commons Attribution License.
© Articles by the authors; licensee SHST, Cluj-Napoca, Romania. The journal allow the author(s) to hold the copyright/to retain publishing rights without restriction.
Open Access Journal - the journal offers free, immediate, and unrestricted access to peer-reviewed research and scholarly work, due SHST supports to increase the visibility, accessibility and reputation of the researchers, regardless of geography and their budgets. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author.