Middle East Respiratory Syndrome

Zumla, Alimuddin; Hui, David S; Perlman, Stanley

The Middle East Respiratory Syndrome (MERS) is a newly recognized highly lethal respiratory disease caused by a novel single stranded, positive sense RNA betacoronavirus (MERS-CoV). Dromedary camels, host species for MERS-CoV are implicated in the direct or indirect transmission to humans, although the exact mode of transmission remains unknown. First isolated from a patient who died from a severe respiratory illness in June 2012 in Jeddah, Saudi Arabia, as of 16 February 2015, 983 laboratory-confirmed cases of MERS-CoV (360 deaths; 36.6% mortality) were reported to the WHO. Cases have been acquired in both the community and hospitals with limited human-to-human transmission reported in the community. Whilst the majority of MERS cases have occurred in Saudi Arabia and the United Arab Emirates, cases have been reported from Europe, USA and Asia in people who traveled from the Middle East or their contacts. Clinical features of MERS range from asymptomatic or mild disease to acute respiratory distress syndrome and multi-organ failure resulting in death, especially in individuals with underlying co-morbidities. There is no specific drug treatment for MERS and infection prevention and control measures are crucial to prevent spread of MERS-CoV in health care facilities. MERS-CoV continues to be an endemic,low level public health threat. However, the concern remains that the virus could mutate to exhibit increased interhuman transmissibility, increasing pandemic potential. Our seminar presents an overview of current knowledge and perspectives on the epidemiology, virology, mode of transmission, pathogen-host responses, clinical features, diagnosis and development of new drugs and vaccines.