Author: Park, Donghyun; Huh, Hee Jae; Kim, Yeon Jeong; Son, Dae-Soon; Jeon, Hyo-Jeong; Im, Eu-Hyun; Kim, Jong-Won; Lee, Nam Yong; Kang, Eun-Suk; Kang, Cheol In; Chung, Doo Ryeon; Ahn, Jin-Hyun; Peck, Kyong Ran; Choi, Sun Shim; Kim, Yae-Jean; Ki, Chang-Seok; Park, Woong-Yang
Title: Analysis of intrapatient heterogeneity uncovers the microevolution of Middle East respiratory syndrome coronavirus Document date: 2016_11_23
ID: xgp2vx6o_1
Snippet: Middle East respiratory syndrome coronavirus (MERS-CoV) was first isolated from a patient in Saudi Arabia in 2012 and has been shown to cause severe acute respiratory illness, including fever, cough, and shortness of breath (Zaki et al. 2012) . As of March 1, 2016, 1638 laboratoryconfirmed cases (587 deaths; 36% case fatality rate [CFR] ) have been reported to the World Health Organization. A South Korean outbreak of MERS began in May 2015, and i.....
Document: Middle East respiratory syndrome coronavirus (MERS-CoV) was first isolated from a patient in Saudi Arabia in 2012 and has been shown to cause severe acute respiratory illness, including fever, cough, and shortness of breath (Zaki et al. 2012) . As of March 1, 2016, 1638 laboratoryconfirmed cases (587 deaths; 36% case fatality rate [CFR] ) have been reported to the World Health Organization. A South Korean outbreak of MERS began in May 2015, and its transmission continued until early July, resulting in 186 laboratory-confirmed cases with 38 deaths (20.4% CFR). In contrast to previous studies, which have suggested limited person-to-person transmissibility of MERS-CoV (Breban et al. 2013; Cotten et al. 2013b ), many secondary and tertiary cases of transmission occurred during the South Korean outbreak. Importantly, more than half of the tertiary cases were transmitted from one particular super-spreader, called Patient 14 in this study. This unusual transmission pattern raised questions related to transmissibility as well as the potential adaptations of MERS-CoV to the human host. To address these questions, several researchers have investigated MERS-CoV sequences. However, all previous studies on the South Korean outbreak have focused only on the consensus sequences of MERS-CoVs Kim et al. 2016a,b; Park et al. 2016; Seong et al. 2016) .
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