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Overview of the Middle East Respiratory Syndrome (MERS) coronavirus
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Masoud Mardani *   , Zahra Abtahian , Kasra Mardani |
| Professor of Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran , masoud_mardani@ymail.com |
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Abstract: (10209 Views) |
| The Middle East Respiratory Syndrome (MERS) is a novel viral respiratory illness first reported on September 2012 in Jeddah, Saudi Arabia. The etiology of the disease is a novel coronavirus, which belongs to the genus, betacoronavirus. At this stage the origin of this virus is unclear but genetic studies suggest that bat coronaviruses are the nearest relatives. However, it is unlikely that the virus is transmitting directly from bats to humans. Since, human-to-human transmissibility of the virus appears to be rare, many researchers suspect that another animal reservoir for the virus exists and following that they have found antibodies specific to bat coronaviruses in dromedary camels. In general, MERS-CoV is thought to be an animal virus that has sporadically resulted in human infections with subsequent limited transmission between humans. Globally from September 2012 till August 30th 2013 WHO has been informed of a total 130 laboratory-confirmed cases of infection with MERS-CoV including 58% deaths, with Saudi Arabia reporting approximately 80% of cases. Countries where cases acquired infection from an unknown source or through person-to-person transmission are: Jordan, Kingdom of Saudi Arabia, Qatar and the United Arab Emirates. Countries where cases are imported associated with travel or contact with a returned infected travelers are: Germany, France, Tunisia, Italy and The United Kingdom. Exclusively, cases are all linked to a point of origin in the Arabian Peninsula, in particular, the Kingdom of Saudi Arabia. The original source(s), route(s), of transmission to humans and the mode(s) of human-to-human transmission have not been determined yet. However, there is growing evidence that like many other respiratory viruses the fine droplets created when people cough or sneeze, they will spread the infection. The incubation period of illness is generally less than one week, but ranges between 2-14 days. MERS-CoV has seen to cause a spectrum of disease from asymptomatic infection to mild illness to life threatening infection leading to death. Common symptoms are acute, serious respiratory illness with fever, cough, and shortness of breath and breathing difficulties. Most patients have had pneumonia. Many have also had gastrointestinal symptoms, including diarrhea. Some patients have had kidney failure. In people with immune deficiencies, the disease may have an atypical presentation. The majority of patients have had at least one comorbid condition, including diabetes, heart disease, hypertension and pulmonary disease. There are several highly sensitive, confirmatory real-time RT-PCR assays for rapid identification of MERS-CoV from patient-derived samples. Respiratory samples including upper respiratory tract viral swabs, nasopharyngeal aspirates, sputum, bronchoalveolar lavage fluid, lung biopsies and post-mortem tissues are suitable for testing for MERS-CoV. Lower respiratory tract specimens should be collected if possible. There is no specific treatment for MERS-CoV infection and patients should be evaluated and treated case by case, which may include using antivirals, antibiotics for preventing secondary bacterial infection or using immunomodulators. Considering our proximity to countries where MERS-CoV is circulating and likelihood of virus entry into our country with pilgrims. Our purpose is to review the symptoms, characteristics, diagnostic approach and management of a patient with suspected infection with MERS-CoV. |
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| Keywords: MERS, Coronavirus, Respiratory viral infection |
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Full-Text [PDF 857 kb]
(3038 Downloads)
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Type of Study: Original |
Subject:
Medicine
Received: 2017 | Accepted: 2017 | Published: 2017
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