Middle East respiratory syndrome coronavirus disease in children.

Memish, Ziad A; Al-Tawfiq, Jaffar A; Assiri, Abdullah; AlRabiah, Fahad A; Al Hajjar, Sami; Albarrak, Ali; Flemban, Hesham; Alhakeem, Rafat F; Makhdoom, Hatem Q; Alsubaie, Sarah; Al-Rabeeah, Abdullah A

BACKGROUND In the initial description of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, many affected patients were adults with underlying medical comorbidities. Data on the clinical presentation and outcome of pediatric cases are lacking. We report the clinical presentation and outcome of MERS-CoV infection in 11 pediatric patients. METHODS The clinical presentation, demographic and laboratory data of pediatric patients with MERS-CoV were analyzed. RESULTS A total of 11 pediatric cases that tested positive by screening and confirmatory polymerase chain reaction for MERS-CoV were reported from Saudi Arabia. Two patients were symptomatic and the other 9 cases were asymptomatic. The median age of patients was 13 (range 2-16) years. There were 8 females and 3 males (2.7:1 ratio). One symptomatic patient died and the other symptomatic patient recovered. The diagnosis of patients was based on positive nasopharyngeal swabs on 10 patients. CONCLUSIONS MERS-CoV disease is not limited to adults. Most cases of childhood MERS-CoV infection were asymptomatic and tested positive during contact investigation of older patients. Severe disease can occur in children with underlying conditions.