[Source: Journal of Infectious Diseases, full page: (LINK). Extract.]

Advancing Priority Research on the Middle East Respiratory Syndrome Coronavirus

David F. Hui 1, Alimuddin Zumla 2

1 Department of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, and NIHR Biomedical Research Centre, University College London Hospitals, London, United Kingdom; 2 Division of Respiratory Medicine and Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong

Correspondence to: Professor Alimuddin Zumla, Professor of Infectious Diseases and International Health, University College London,UCL Royal Free Campus, Division of Infection and Immunity, Centre for Clinical Microbiology, Royal Free Hospital, 2nd floor, Rowland Hill Street, London NW3 2P, United Kingdom. Tel: +44‐7901 638375, Email: a.zumla@ucl.ac.uk or a.i.zumla@gmail.com

? The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e‐mail: journals.permissions@oup.com

J Infect Dis. (2013) - doi: 10.1093/infdis/jit591 - First published online: November 11, 2013

Over a year since its first discovery, a new human disease, the Middle East Respiratory Syndrome (MERS), continues to be of major international concern due to its high fatality rate and lack of knowledge on its primary source and mode of transmission. It is caused by a novel coronavirus MERS‐CoV, initially named 2cEMC/2012 (HCoV‐EMC) (1) and subsequently renamed as MERSCoV(2) after international consensus (3). It presents as a spectrum of respiratory diseases and is associated with a high case fatality rate in persons with co‐morbid medical conditions. (4,5), The first MERS case report was from Jeddah, Kingdom of Saudi Arabia (KSA) in September 2012 when MERS‐CoV was isolated from a Saudi Arabian patient who died from a severe respiratory illness and multi‐organ failure (2). As of October 30th 2013, there have been 145 laboratory‐confirmed cases of MERS with 62 deaths (42% case fatality rate), reported from 9 countries to the World Health Organization (WHO) (6,7).All cases were linked directly or indirectly to one of four countries in the Middle East: KSA, Qatar, Jordan, and the United Arab Emirates (UAE). Five countries outside the Middle East, The United Kingdom, France, Italy, Germany and Tunisia, have reported patients who were either transferred for care or returned from a visit to the Middle East and subsequently became ill. Four of these countries, Italy, France, Tunisia and the United Kingdom, have had secondary cases linked to the initial imported case (6, 7). The majority of MERS‐CoV cases to date (121out of145 cases) have been reported from KSA, occurring as family (8) or hospital (5) clusters, sporadic community cases, or detected with mild disease or asymptomatic infection on screening of health care workers who were in contact with MERS cases (9). Human‐to‐human transmission of MERS‐CoV has been well documented in KSA (5,10), England(11), France(12), Tunisia and Italy (6,12). The clusters detected so far are mostly small and there have been no reports of sustained transmission of MERS‐CoV within the community.


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