Middle East respiratory syndrome-related coronavirus

Middle East Respiratory Syndrome-Related Coronavirus

Middle East Respiratory Syndrome-Related Coronavirus (MERS-CoV) is a novel coronavirus that was first identified in Saudi Arabia in 2012. It is a zoonotic virus, meaning it is transmitted between animals and humans. MERS-CoV is part of the larger family of coronaviruses, which includes viruses that cause the common cold as well as more severe diseases such as Severe Acute Respiratory Syndrome (SARS) and COVID-19.

Virology

MERS-CoV is an enveloped, positive-sense, single-stranded RNA virus. It belongs to the genus Betacoronavirus, which also includes SARS-CoV and SARS-CoV-2. The virus has a characteristic crown-like appearance under the electron microscope, which is typical of coronaviruses.

The genome of MERS-CoV is approximately 30 kilobases in length and encodes several structural proteins, including the spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins. The spike protein is responsible for binding to the host cell receptor, dipeptidyl peptidase 4 (DPP4), which facilitates viral entry into the host cell.

Epidemiology

MERS-CoV was first identified in a patient in Saudi Arabia in 2012. Since then, cases have been reported in several countries, primarily in the Middle East, but also in Europe, Asia, and North America. The majority of cases have been linked to the Arabian Peninsula.

The virus is believed to have originated in bats and was transmitted to humans through dromedary camels, which are considered the primary animal reservoir for MERS-CoV. Human-to-human transmission can occur, particularly in healthcare settings, but it is not as easily transmissible as SARS-CoV or SARS-CoV-2.

Clinical Features

MERS-CoV infection can range from asymptomatic or mild respiratory symptoms to severe acute respiratory illness and death. Common symptoms include fever, cough, and shortness of breath. Severe cases can lead to pneumonia and kidney failure.

The case fatality rate for MERS-CoV is estimated to be around 35%, which is significantly higher than that of SARS or COVID-19. Certain populations, such as the elderly and those with underlying health conditions, are at higher risk of severe disease.

Diagnosis

Diagnosis of MERS-CoV infection is typically confirmed by reverse transcription polymerase chain reaction (RT-PCR) testing of respiratory specimens. Serological tests can also be used to detect antibodies to MERS-CoV, indicating past infection.

Prevention and Treatment

There is currently no specific antiviral treatment or vaccine for MERS-CoV. Management of the disease is primarily supportive, focusing on relieving symptoms and providing supportive care for complications.

Preventive measures include avoiding contact with camels, practicing good hand hygiene, and following infection control measures in healthcare settings. Research is ongoing to develop vaccines and antiviral therapies for MERS-CoV.

Also see

• Coronavirus
• Severe Acute Respiratory Syndrome
• COVID-19
• Zoonosis