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Middle East respiratory syndrome coronavirus: five years later
1a Molecular Diagnostic Laboratory , Johns Hopkins Aramco Healthcare , Dhahran , Saudi Arabia.
Introduction:
In the past five years, there have been 1,936 laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in 27 countries, with a mortality rate of 35.6%. Most cases have arisen in the Middle East, particularly the Kingdom of Saudi Arabia, however there was a large hospital-associated outbreak in the Republic of Korea in 2015. Exposure to dromedary camels has been recognized by the World Health Organization (WHO) as a risk factor in primary cases, but the exact mechanisms of transmission are not clear. Rigorous application of nationally defined infection prevention and control measures has reduced the levels of healthcare facility-associated outbreaks. There is currently no approved specific therapy or vaccine available. Areas covered: This review presents an overview of MERS-CoV within the last five years, with a particular emphasis on the key areas of transmission, infection control and prevention, and therapies and vaccines. Expert commentary: MERS-CoV remains a significant threat to public health as transmission mechanisms are still not completely understood. There is the potential for mutations that could increase viral transmission and/or virulence, and zoonotic host range. The high mortality rate highlights the need to expedite well-designed randomized clinical trials for direct, effective therapies and vaccines.
Insights
Middle East Respiratory Syndrome coronavirus (MERS-CoV) remains a significant global health threat. Continued research into MERS-CoV transmission, prevention, and effective therapies is crucial due to its high mortality rate.
Area of Science:
- Infectious Diseases
- Public Health
- Virology
Background:
- Middle East Respiratory Syndrome coronavirus (MERS-CoV) has caused 1,936 confirmed cases across 27 countries in the last five years, with a concerning 35.6% mortality rate.
- While most cases originate in the Middle East, particularly Saudi Arabia, significant outbreaks like the one in the Republic of Korea in 2015 highlight its potential for wider spread.
- Dromedary camel exposure is a known risk factor for MERS-CoV, but precise transmission pathways require further elucidation.
Purpose of the Study:
- To provide a comprehensive overview of MERS-CoV epidemiology over the past five years.
- To emphasize critical aspects of MERS-CoV transmission dynamics.
- To review current infection control strategies, prevention measures, and the status of therapeutic and vaccine development.
Main Methods:
- Systematic review of MERS-CoV cases and outbreaks globally in the last five years.
- Analysis of reported risk factors, including animal exposure and healthcare-associated transmission.
- Assessment of existing literature on infection prevention and control (IPC) measures.
- Review of current therapeutic and vaccine research and development.
Main Results:
- A significant number of MERS-CoV cases and deaths have been documented globally, with a high overall mortality rate.
- Effective implementation of infection prevention and control measures has demonstrably reduced healthcare-associated outbreaks.
- No specific therapies or vaccines are currently approved, underscoring a critical gap in clinical management.
Conclusions:
- MERS-CoV continues to pose a substantial public health risk due to incompletely understood transmission mechanisms.
- The potential for viral mutations affecting transmissibility, virulence, and host range necessitates ongoing surveillance.
- The high mortality rate underscores the urgent need for well-designed clinical trials to develop effective therapies and vaccines.
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