Taking stock of the first 133 MERS coronavirus cases globally – Is the epidemic changing?

Abstract

Since June 2012, 133 Middle East respiratory syndrome coronavirus (MERS-CoV) cases have been identified in nine countries. Two time periods in 2013 were compared to identify changes in the epidemiology. The case-fatality risk (CFR) is 45% and is decreasing. Men have a higher CFR (52%) and are over-represented among cases. Thirteen out of 14 known primary cases died. The sex-ratio is more balanced in the latter period. Nosocomial transmission was implied in 26% of the cases.

What are our pharmacotherapeutic options for MERS-CoV?

“…These two intervals were the initial period that included Al-Hasa outbreak, from March to May 2013 and the second period was from June to September 2013. The second period was associated with lower intensive care unit admission (63 vs 33%), a lower mortality rate and lower case fatality rate (58 vs 27%) [2]. These findings are likely related to the identification of a significant number of asymptomatic and mildly symptomatic cases.…”

“…The pattern of the diseases seems to be different when looking at two time intervals [2]. These two intervals were the initial period that included Al-Hasa outbreak, from March to May 2013 and the second period was from June to September 2013.…”

Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels, Qatar, April 2014

“…The haemodialysis unit was the most heavily affected, with nine confirmed cases, but transmission also occurred in the intensive care unit and the medical ward. Sequencing of viral isolates from this outbreak suggested multiple introductions to the facility rather than a single one [17] [30]. Strict infection control measures allowed the containment of outbreaks when implemented e.g.…”

“…Nosocomial transmission has been a hallmark of MERS-CoV [28] [29] and has resulted in an upsurge of cases during spring 2014 [30]. A large outbreak was previously documented in Al-Ahsa, Saudi Arabia in 2013.…”

Middle East respiratory syndrome coronavirus: epidemic potential or a storm in a teacup?

“…The critical question at that time was whether MERS-CoV was going to progress to cause a major pandemic as did SARS or was it just a ''storm in a teacup'' that it would die out, requiring only surveillance and reassurance? Subsequent surveillance performed by the KSA MoH indicates that MERS-CoV affects both sexes and, although only a few cases of MERS-CoV in children have been detected, it remains mainly a disease of adults across all age groups [24][25][26][27]. In KSA, we have subsequently identified milder or asymptomatic cases of MERS in HCWs, MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS | A.I.…”