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Chapter 4 : Middle East Respiratory Syndrome (MERS)

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Middle East Respiratory Syndrome (MERS), Page 1 of 2

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Abstract:

The first patient identified with Middle East respiratory syndrome (MERS) was a 60-year-old male who presented in June of 2012 with fever, cough, and shortness of breath in Jeddah, Kingdom of Saudi Arabia (Saudi Arabia). The patient developed acute respiratory distress syndrome and subsequently died of respiratory and renal failure after being hospitalized for 11 days ( ). After tests for other more common respiratory viruses were negative, a novel coronavirus was identified, which was initially called HCoV-EMC (human coronavirus-Erasmus Medical Center, referring to where the virologic studies had been performed) and later became known as Middle East respiratory syndrome coronavirus (MERS-CoV) ( ). After information about this newly identified coronavirus was posted on the Program for Monitoring Emerging Diseases (ProMED) website by Dr. Ali Mohamed Zaki ( ), a second patient with MERS-CoV was identified. This patient was a 49-year-old male with a history of travel to Saudi Arabia who presented to a hospital in Qatar with bilateral pneumonia in September 2012 and was later transported to the United Kingdom for intensive care, where he was determined to have the same novel coronavirus ( ). Via genetic analysis, the cases from Saudi Arabia and Qatar were found to be 99.5% identical ( ). Later, two deceased patients who were part of a cluster of 13 cases of suspected pneumonia among health care personnel at a hospital in Jordan that had occurred in April 2012 were diagnosed retrospectively as having MERS-CoV infection ( ).

Citation: Rasmussen S, Watson A, Swerdlow D. 2016. Middle East Respiratory Syndrome (MERS), p 73-104. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0020-2016
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Figures

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Figure 1

Cases of Middle East respiratory syndrome coronavirus, 2012 to 2016, by month and year of onset (total = 1,638 cases), as reported by the World Health Organization (data as of 5 February 2016). The total case counts include 130 cases identified from Saudi Arabia Ministry of Health’s retrospective reviews, but these are not depicted in the epidemic curve due to unknown case onset dates.

Citation: Rasmussen S, Watson A, Swerdlow D. 2016. Middle East Respiratory Syndrome (MERS), p 73-104. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0020-2016
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Image of Figure 2
Figure 2

Global map of countries with confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV), 2012 to 2016, as reported by the World Health Organization (data as of 5 February 2016) (http://www.who.int/emergencies/mers-cov/en/).

Citation: Rasmussen S, Watson A, Swerdlow D. 2016. Middle East Respiratory Syndrome (MERS), p 73-104. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0020-2016
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Image of Figure 3
Figure 3

Depiction of components of the MERS-coronavirus including the membrane, envelope, and spike proteins that make up the viral membrane and nucleocapsid protein, which is associated with the viral RNA. Image source: CDC, Jennifer Oosthuizen.

Citation: Rasmussen S, Watson A, Swerdlow D. 2016. Middle East Respiratory Syndrome (MERS), p 73-104. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0020-2016
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Image of Figure 4
Figure 4

Middle East respiratory syndrome coronavirus as seen by electron microscopy. The spike proteins protrude from the viral membrane and give the virus a crown-like (corona) appearance. Image source: CDC’s Public Health Image Library (http://www.cdc.gov/coronavirus/mers/photos.html), Cynthia Goldsmith/Maureen Metcalfe/Azaibi Tamin.

Citation: Rasmussen S, Watson A, Swerdlow D. 2016. Middle East Respiratory Syndrome (MERS), p 73-104. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0020-2016
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