Case report: Detection of the Middle East respiratory syndrome corona virus (MERS-CoV) in nasal secretions of a dead human

Mahallawi, Waleed H.

This is the first report confirming the presence of the MERS-CoV in an infected human cadaver (three days following the death). This report should be considered seriously in terms of taking full precautions in dealing with human remains infected with the MERS-CoV, as they might be a source of infection. How the MERS-CoV transmits is unfortunately a mystery, but it is presumed to involve the direct interaction with the mucus secretion (saliva) of diseased camels or via the intake of milk or perhaps the uncooked meat. Nevertheless, it is not yet confirmed whether there is another transitional host for the MERS-CoV transmission to humans or not. 12 A secondary infection could occur by droplets, and the virus could possibly spread either via air or fomites. 13 For the diagnosis of a MERS-CoV infection, routine nasopharyngeal and oropharyngeal swabs must be taken together. Both swabs must be combined and placed immediately into the same sterile tubes containing 2e3 ml of a viral transport media. Two genes of the MERS-CoV must be recognized as appropriate markers for the diagnostic testdthe upstream E protein gene (upE) and the open reading frame (ORF) 1A. Positive controls for the upE screening and the ORF 1A confirmation assays also should be added. 14 The test result is considered positive if both assays gave positive results, as occurred in the processed patient samples in this report.