Zespół oddechowy bliskiego wschodu (mers)
Etiologia i przyczyny

Zespół oddechowy Bliskiego Wschodu (MERS) wywoływany jest przez koronawirusa MERS-CoV, należącego do rodzaju betacoronavirus, który po raz pierwszy zidentyfikowano w Arabii Saudyjskiej w 2012 roku. Wirus ten wykorzystuje receptor DPP4 (CD26) do wnikania do komórek nabłonkowych płuc, nerek, wątroby i jelit, co prowadzi do ciężkiej choroby układu oddechowego i wielonarządowej dysfunkcji. MERS-CoV posiada mechanizmy hamujące odpowiedź interferonową gospodarza, m.in. poprzez białka ORF 4a i 4b, co sprzyja jego patogenności. Głównym rezerwuarem wirusa są wielbłądy dromadery, a transmisja na ludzi odbywa się przez bezpośredni lub pośredni kontakt z zakażonymi zwierzętami lub ich produktami (np. niepasteryzowane mleko). Współczynnik reprodukcji wirusa (R0) jest niski (<0,7), co ogranicza rozprzestrzenianie się w populacji, jednak transmisja międzyludzka występuje w warunkach bliskiego kontaktu, zwłaszcza w placówkach opieki zdrowotnej.

  1. Etiologia Zespołu Oddechowego Bliskiego Wschodu (MERS)
    1. Pochodzenie wirusa MERS-CoV
    2. Rola wielbłądów w transmisji MERS-CoV
    3. Mechanizm zakażenia i patogeneza MERS-CoV
    4. Transmisja międzyludzka MERS-CoV
    5. Czynniki ryzyka zakażenia MERS-CoV
    6. Epidemiologia MERS-CoV
  2. Konsekwencje kliniczne zakażenia MERS-CoV
  3. Podsumowanie etiologii MERS
    1. Kolejne rozdziały

Etiologia Zespołu Oddechowego Bliskiego Wschodu (MERS)

Zespół oddechowy bliskiego wschodu (MERS, z ang. Middle East Respiratory Syndrome) to ostra choroba zakaźna układu oddechowego wywołana przez koronawirusa MERS-CoV (Middle East Respiratory Syndrome Coronavirus), który został po raz pierwszy zidentyfikowany w Arabii Saudyjskiej w 2012 roku.12 MERS-CoV to nowy koronawirus, który nigdy wcześniej nie został zidentyfikowany u ludzi i różni się od innych koronawirusów (w tym od wirusa SARS-CoV), które zostały wykryte u ludzi lub zwierząt.3

MERS-CoV jest członkiem rodziny Coronaviridae, które są osłonkowymi, dodatnio-niciowymi, jednoniciowymi wirusami RNA.4 Jest to wirus z rodzaju betacoronavirus, który atakuje układ oddechowy.5 Genom MERS-CoV jest filogenetycznie klasyfikowany do dwóch kladów: A i B.6 MERS-CoV koduje 5 unikalnych białek dodatkowych, z których co najmniej dwa, 4A i 4B, modulują produkcję interferonu, gdy są wyrażane w izolacji.7

Pochodzenie wirusa MERS-CoV

Dokładne pochodzenie wirusa MERS-CoV nie jest w pełni poznane. Badania wskazują, że wirus MERS-CoV jest najściślej spokrewniony z koronawirusami nietoperzy Tylonycteris i Pipistrellus, odpowiednio HKU4 i HKU5, co sugeruje, że nietoperze mogły być ostatecznym źródłem wirusa.89 Analiza różnych genomów wirusa wskazuje, że pierwotnie mógł on pochodzić od nietoperzy, a następnie został przeniesiony na wielbłądy w odległej przeszłości.10

Hipoteza o pochodzeniu MERS-CoV od nietoperzy jest silna, biorąc pod uwagę wysokie pokrewieństwo genomowe między sekwencjami koronawirusów nietoperzy i MERS-CoV.11 Wirus został wyizolowany również od nietoperza, co potwierdza tę hipotezę.12 Jednakże fakt, że wirus zainfekował wielbłądy na znacznym obszarze geograficznym, stawia pytanie, dlaczego MERS nie został wykryty u pacjentów w Arabii Saudyjskiej przed 2012 rokiem.13

Rola wielbłądów w transmisji MERS-CoV

Wielbłądy dromadery (Camelus dromedarius) zostały zidentyfikowane jako pośredni gospodarze MERS-CoV, umożliwiający rozprzestrzenianie się wirusa na ludzi poprzez bezpośredni lub pośredni kontakt.1415 Badania wykazały, że ludzie zarażają się poprzez bezpośredni lub pośredni kontakt z zakażonymi wielbłądami dromaderami lub zakażonymi osobami w placówkach opieki zdrowotnej.16

Obecnie istnieją solidne dowody na to, że wielbłądy stanowią rezerwuar wirusa, a zakażenie u ludzi może być nabyte przez kontakt z wielbłądami i produktami pochodzącymi od wielbłądów:17

  • Bezpośredni kontakt fizyczny z zakażonymi wielbłądami
  • Spożycie niepasteryzowanego mleka wielbłądziego
  • Kontakt z mięsem lub innymi produktami pochodzącymi od zakażonych wielbłądów
  • Ekspozycja na zanieczyszczone produkty zwierzęce

1819

Przeciwciała przeciwko MERS-CoV wykryto u prawie wszystkich wielbłądów badanych na Półwyspie Arabskim i w kilku krajach afrykańskich.20 Pierwszym dowodem na transmisję z wielbłądów na ludzi było badanie w Arabii Saudyjskiej, w którym pełne sekwencje genomów MERS-CoV były identyczne w izolatach zarówno od człowieka z zakażeniem śmiertelnym, jak i od jego wielbłądów.21

Ważne jest jednak, że dokładne drogi transmisji wśród wielbłądów i od wielbłądów do ludzi nie są jeszcze w pełni wyjaśnione.22 Sposób transmisji jest prawdopodobnie wieloczynnikowy i może obejmować drogę kropelkową podczas bezpośredniego kontaktu z zakażonymi wielbłądami lub pośrednio poprzez środowisko.2324

Mechanizm zakażenia i patogeneza MERS-CoV

Patogeneza MERS rozpoczyna się od wniknięcia wirusa przez drogi oddechowe, gdzie białko kolca (S) oddziałuje z jego komórkowym receptorem DPP4 (dipeptydylopeptydaza 4).25 Wkrótce po odkryciu MERS-CoV zidentyfikowano receptor, który pośredniczy w wejściu do komórki – właśnie dipeptydylopeptydazę 4 (DPP4), dużą ektopeptydazę obecną na powierzchni wielu różnych typów komórek.26

DPP4, znany również jako CD26, jest glikoproteiną przezbłonową typu II o długości 766 aminokwasów, która pełni funkcję unikalnego receptora dla MERS-CoV.27 Jest głównie wyrażana w komórkach nabłonkowych płuc, wątroby, nerek, jelit, tymocytach i makrofagach pęcherzykowych.28 DPP4 przede wszystkim rozszczepia peptydy i hormony oraz wiąże się z deaminazą adenozyny w celu aktywacji limfocytów T.29

Proces wnikania MERS-CoV do komórki wygląda następująco:3031

  1. Trimeryczna forma białka kolca (S) MERS-CoV wiąże się z DPP4 i ułatwia wniknięcie wirusa do komórek gospodarza
  2. Po związaniu się z receptorem, wirus lub DPP4 może wiązać się z innymi czynnikami gospodarza, aby zainicjować proces internalizacji
  3. Wirus następnie wykorzystuje maszynerię komórkową gospodarza do replikacji

MERS-CoV posiada również mechanizmy unikania odpowiedzi immunologicznej gospodarza:32

  • Domena PLpro MERS-CoV może deubikwitynować IRF3, hamując w ten sposób syntezę interferonu
  • Białka strukturalne i dodatkowe M, ORF 4a, ORF 4b i ORF 5 wirusa MERS-CoV są silnymi antagonistami interferonu
  • Białko 4a, jedno z białek dodatkowych, blokuje indukcję interferonu i działa jako silny inhibitor interferonu typu 1, hamując rozpoznawanie dsRNA przez komórkowe RIG-I i MDA5

Transmisja międzyludzka MERS-CoV

MERS-CoV jest przenoszony nieefektywnie między ludźmi.33 Współczynnik reprodukcji (R0) dla MERS-CoV został oszacowany na mniej niż 0,7 i prawdopodobnie bliżej 0,5, znacznie poniżej wartości R0 równej 1, która oznacza potencjał epidemiczny.34 Oznacza to, że MERS-CoV nie wydaje się łatwo rozprzestrzeniać we wspólnotach.35

Transmisja wirusa MERS-CoV między ludźmi może jednak wystąpić w przypadku bliskiego kontaktu, takiego jak:3637

  • Opieka nad zakażonym pacjentem w gospodarstwie domowym
  • Kontakt w środowisku szpitalnym, gdy diagnoza MERS-CoV nie została jeszcze rozpoznana
  • Brak odpowiednich środków kontroli zakażeń

Wirus rozprzestrzenia się od zakażonej osoby do innych przez kaszel i wydzieliny dróg oddechowych.38 Większość przypadków transmisji z osoby na osobę wystąpiła u pracowników służby zdrowia opiekujących się zakażonymi osobami.39 Obecne dowody z badań kontaktów sugerują, że transmisja nie wykracza poza bliskie kontakty do społeczności.40

Główne skupiska zakażeń MERS-CoV między ludźmi:41

  • Pierwszy klaster zakażeń MERS-CoV miał miejsce w listopadzie 2012 roku, gdy rodzina zaraziła się wirusem w Rijadzie, Arabia Saudyjska
  • Drugi klaster został retrospektywnie zgłoszony w Jordanii w 2012 roku i był związany z najwcześniejszymi potwierdzonymi dwoma przypadkami śmiertelnymi

Ognisko MERS w Korei Południowej w 2015 roku, z dziesiątkami przypadków drugiego i trzeciego pokolenia, wzbudziło obawy, że MERS-CoV mógł się zaadaptować, aby umożliwić bardziej efektywne rozprzestrzenianie się wśród ludzi.42 Jednakże większość danych epidemiologicznych sugeruje, że pierwotne zakażenia MERS-CoV u ludzi wynikają głównie z wielokrotnych wprowadzeń MERS-CoV od wielbłądów dromaderów do człowieka, podczas gdy transmisja z człowieka na człowieka jest ograniczona.43

Czynniki ryzyka zakażenia MERS-CoV

Zidentyfikowano kilka niezależnych czynników ryzyka zwiększających podatność na zakażenie pierwotne MERS-CoV:44

  • Bezpośrednia ekspozycja na wielbłądy dromadery w ciągu dwóch tygodni przed wystąpieniem choroby
  • Bezpośredni kontakt fizyczny z wielbłądami dromaderami w ciągu ostatnich 6 miesięcy
  • Cukrzyca
  • Choroby serca

Być może najbardziej konsekwentnie opisywanym czynnikiem ryzyka dla choroby MERS jest obecność podstawowych chorób współistniejących, takich jak:45

  • Cukrzyca
  • Przewlekła choroba nerek
  • Otyłość
  • Nadciśnienie
  • Przewlekłe choroby serca
  • Choroby płuc, takie jak astma i przewlekła obturacyjna choroba płuc

Zakażenie MERS-CoV wydaje się powodować cięższą chorobę u osób starszych, osób z osłabionym układem odpornościowym oraz osób z chorobami przewlekłymi, takimi jak choroba nerek, nowotwory, przewlekła choroba płuc i cukrzyca.46 Większość osób, które rozwinęły ciężką chorobę i zmarły, miała inne problemy zdrowotne, które osłabiły ich układ odpornościowy.47

Epidemiologia MERS-CoV

Pierwszy przypadek MERS został zgłoszony w Arabii Saudyjskiej w 2012 roku, a następnie choroba rozprzestrzeniła się na inne kraje.48 Około 80% przypadków zachorowań u ludzi zostało zgłoszonych przez Arabię Saudyjską, w dużej mierze w wyniku bezpośredniego lub pośredniego kontaktu z zakażonymi wielbłądami dromaderami lub zakażonymi osobami w placówkach opieki zdrowotnej.49

Od 2012 roku WHO odnotowała łącznie 2428 potwierdzonych przypadków MERS-CoV na całym świecie, w tym 838 zgonów.50 Większość zakażeń zarejestrowano na Półwyspie Arabskim, szczególnie w Arabii Saudyjskiej (85 procent potwierdzonych przypadków).51

Wybuch epidemii w innych krajach jest również związany z osobami, które podróżowały do obszaru Bliskiego Wschodu.52 Wszystkie zgłoszone przypadki MERS w Stanach Zjednoczonych były związane z podróżami międzynarodowymi do krajów na Półwyspie Arabskim.53

Konsekwencje kliniczne zakażenia MERS-CoV

Zakażenie MERS-CoV powoduje szeroki zakres objawów klinicznych u ludzi.54 MERS-CoV zazwyczaj powoduje ciężką chorobę układu oddechowego, która często może prowadzić do śmierci.55 Jednakże niektóre osoby zarażone MERS-CoV miały łagodne objawy lub nie miały ich wcale.56

MERS-CoV zwykle powoduje ciężką dysfunkcję narządów pozapłucnych, a większość pacjentów prezentuje:57

  • Wstrząs
  • Ostre uszkodzenie nerek
  • Małopłytkowość

Dokładny mechanizm dysfunkcji nerek nie jest dobrze zrozumiany, jednak badania wykazały tropizm wirusowy dla komórek nerek ex vivo, sugerując, że MERS-CoV może indukować apoptozę w nerkach.58

Progresja od choroby płucnej do stanu ogólnoustrojowego ma złe rokowanie i może prowadzić do niewydolności wielonarządowej i śmierci.59 Poważne problemy mogą obejmować:60

  • Zapalenie płuc
  • Niewydolność oddechowa i konieczność stosowania respiratora
  • Niewydolność nerek i innych narządów
  • Uogólnione zakażenie i niskie ciśnienie krwi (wstrząs septyczny)

Około 30-40% osób z MERS umiera, co czyni go znacznie bardziej śmiertelnym niż SARS (10% śmiertelności) czy SARS-CoV-2.616263 Obecnie nie ma specyficznego leczenia MERS-CoV, ani zatwierdzonej szczepionki zapobiegającej zakażeniu.6465

Podsumowanie etiologii MERS

MERS jest wywoływany przez nowego koronawirusa (MERS-CoV), który najprawdopodobniej pierwotnie pochodzi od nietoperzy, a następnie został przeniesiony na wielbłądy dromadery, które służą jako główny rezerwuar i źródło zakażenia dla ludzi. Wirus wnika do komórek gospodarza poprzez interakcję białka S z receptorem DPP4, który jest obecny na powierzchni wielu typów komórek.

Transmisja wirusa następuje przede wszystkim przez bezpośredni lub pośredni kontakt z zakażonymi wielbłądami lub ich produktami, a także może dochodzić do transmisji międzyludzkiej w przypadku bliskiego kontaktu, szczególnie w środowisku opieki zdrowotnej. Czynniki ryzyka obejmują ekspozycję na wielbłądy oraz obecność chorób współistniejących, które osłabiają układ odpornościowy.

MERS stanowi poważne zagrożenie dla zdrowia publicznego ze względu na wysoką śmiertelność (30-40%) i brak specyficznego leczenia oraz zatwierdzonej szczepionki. Chociaż wirus nie wykazuje dużego potencjału epidemicznego (R0 < 1), nadal stanowi istotne ryzyko dla zdrowia publicznego, szczególnie w regionach, gdzie występują wielbłądy dromadery jako rezerwuar wirusa.

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Middle East respiratory syndrome coronavirus (MERS-CoV) | Communicable Diseases Agency
    https://www.cda.gov.sg/public/diseases/middle-east-respiratory-syndrome-coronavirus-
    Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a novel coronavirus which causes acute respiratory illness in infected patients. […] MERS-CoV was first reported by the World Health Organization (WHO) on 22 September 2012. […] MERS-CoV is present in infected dromedary camels and can be transmitted to humans through contact with infected animals or consumption or exposure to contaminated animal products. […] Human-to-human transmission is possible, and limited transmission has occurred among close contacts of confirmed cases in household and healthcare settings. […] There is no curative treatment for MERS.
  • #2
    https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)
    Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by Middle East respiratory syndrome coronavirus (MERSCoV) that was first identified in Saudi Arabia in 2012. […] MERS-CoV is a zoonotic virus, meaning it is transmitted between animals and people. MERS-CoV has been identified and linked to human infections in dromedary camels in several Member States in the Middle East, Africa and South Asia. […] Zoonotic transmission: MERS-CoV is a zoonotic virus, which means that is transmitted between animals and people. Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels, although the exact route of transmission remains unclear. […] Approximately 80% of human cases have been reported by Saudi Arabia, largely as a result of direct or indirect contact with infected dromedary camels or infected individuals in health care facilities.
  • #3 Centre for Health Protection – Middle East Respiratory Syndrome
    https://www.chp.gov.hk/en/healthtopics/content/24/26528.html
    Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus that was first identified in Saudi Arabia in 2012. […] Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a beta coronavirus which has not been identified in humans before and is different from other coronaviruses (including SARS-coronavirus) that have been found in humans or animals. […] Scientific studies support that dromedary camels serve as a major reservoir host for MER-CoV and an animal source of infection in humans.
  • #4 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    In 2012, a zoonotic coronavirus was identified as the causative agent of Middle East Respiratory Syndrome (MERS), called MERS Coronavirus (MERS-CoV). […] Further studies showed that it was related to several bat CoV, including HKU4 and HKU5 and it was named the Middle East Respiratory Syndrome-CoV (MERS-CoV). […] MERS-CoV is a member of the family Coronaviridae, which are enveloped, positive-sense, single stranded RNA viruses. […] MERS-CoV encodes for 5 unique accessory proteins, with at least two, 4A and 4B, that modulate interferon production when expressed in isolation. […] Soon after the discovery of MERS-CoV, the receptor that mediates cell entry was identified as dipeptidyl peptidase four (DPP4), a large ectopeptidase present at the surface of many different cell types. […] While there has been extensive recombination of MERS-CoV in camels and genetic changes in the virus have been noted since 2012, there is no evidence that the virus has mutated to enhance binding to DPP4.
  • #5 MERS | Causes, Symptoms & Treatment | Britannica
    https://www.britannica.com/science/MERS
    MERS, acute viral respiratory illness that is characterized primarily by cough, fever, and shortness of breath and is sometimes associated with severe and potentially fatal complications such as pneumonia and kidney failure. […] MERS is caused by a coronavirus known as MERS-CoV, which attacks the respiratory system. […] Cases of MERS in the Middle East that lacked evidence for human-to-human transmission indicated the involvement of a nonhuman source for the disease. […] Bats are a suspected natural reservoir of coronaviruses, and genomic analyses showed that MERS-CoV is closely related to coronaviruses derived from bats. […] By contrast, studies have indicated that infection with the virus may be widespread among camels in the Middle East and Africa. The high likelihood for direct or indirect human contact with camels in those regions suggested that camels were a probable source of human infection.
  • #6 Factsheet about Middle East respiratory syndrome coronavirus (MERS-CoV)
    https://www.ecdc.europa.eu/en/middle-east-respiratory-syndrome-coronavirus/factsheet
    MERS-CoV is a newly identified coronavirus that has recently emerged in the Middle East. […] There is growing evidence that the dromedary camel is a host species for the virus and that this species might play an important role in the direct or indirect transmission to humans. […] MERS-CoV genomes are phylogenetically classified into two clades: clades A and B. […] The hypothesis that dromedary camels are hosts of MERS CoV has been proven by the viral RNA detection in different specimens collected from these animals in Qatar, Saudi Arabia, Oman and Egypt and the isolation of the virus from nasal and faecal samples. […] The continued detection of new MERS-CoV cases, the low estimated basic reproduction number of the infection (R0), and the detection of multiple distinct MERS-CoV genotypes suggest the existence of a persistent possible zoonotic source.
  • #7 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    In 2012, a zoonotic coronavirus was identified as the causative agent of Middle East Respiratory Syndrome (MERS), called MERS Coronavirus (MERS-CoV). […] Further studies showed that it was related to several bat CoV, including HKU4 and HKU5 and it was named the Middle East Respiratory Syndrome-CoV (MERS-CoV). […] MERS-CoV is a member of the family Coronaviridae, which are enveloped, positive-sense, single stranded RNA viruses. […] MERS-CoV encodes for 5 unique accessory proteins, with at least two, 4A and 4B, that modulate interferon production when expressed in isolation. […] Soon after the discovery of MERS-CoV, the receptor that mediates cell entry was identified as dipeptidyl peptidase four (DPP4), a large ectopeptidase present at the surface of many different cell types. […] While there has been extensive recombination of MERS-CoV in camels and genetic changes in the virus have been noted since 2012, there is no evidence that the virus has mutated to enhance binding to DPP4.
  • #8 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is most closely related to the Tylonycteris and Pipistrellus bat CoVs HKU4 and HKU5, respectively, suggesting that bats could have been the ultimate source for the virus. […] This suggests that MERS-CoV has infected camels for an extended amount of time and raises the question as to why MERS was not detected in patients in Saudi Arabia before 2012. […] While camels are clearly the primary zoonotic intermediate for MERS-CoV infection, the route of transmission into the human population is not entirely clear and is likely multi-factorial. […] In order to do develop therapeutics and vaccines, new small animal models that more closely resemble lethal human disease will be required.
  • #9 MERS-related coronavirus – Wikipedia
    https://en.wikipedia.org/wiki/MERS-related_coronavirus
    Middle East respiratory syndromerelated coronavirus (MERS-CoV, Betacoronavirus cameli) or EMC/2012 (HCoV-EMC/2012), is the virus that causes Middle East respiratory syndrome (MERS). It is a species of coronavirus which infects humans, bats, and camels. The infecting virus is an enveloped, positive-sense, single-stranded RNA virus which enters its host cell by binding to the DPP4 receptor. […] MERS-CoV is one of several viruses identified by the World Health Organization (WHO) as a likely cause of a future epidemic. They list it for urgent research and development. […] The virus appears to have originated in bats. The virus itself has been isolated from a bat. […] It is believed that the virus originated in bats, one candidate being the Egyptian tomb bat. […] According to the 27 March 2014 MERS-CoV summary update, recent studies support that camels serve as the primary source of the MERS-CoV infecting humans, while bats may be the ultimate reservoir of the virus. Evidence includes the frequency with which the virus has been found in camels to which human cases have been exposed, seriological data which shows widespread transmission in camels, and the similarity of the camel CoV to the human CoV.
  • #10
    https://www.who.int/health-topics/middle-east-respiratory-syndrome-coronavirus-mers
    Middle East respiratory syndrome coronavirus (MERS-CoV) is a virus transferred to humans from infected dromedary camels. It is a zoonotic virus, meaning it is transmitted between animals and people, and it is contractable through direct or indirect contact with infected animals. […] The origins of the virus are not fully understood but according to the analysis of different virus genomes it is believed that it may have originated in bats and later transmitted to camels at some point in the distant past. […] MERS-CoV is considered an emerging zoonotic virus with dromedary camels serving as the animal reservoir.
  • #11 Middle East Respiratory Syndrome Coronavirus (MERS-CoV): State of the Science
    https://www.mdpi.com/2076-2607/8/7/991
    The bat origin of MERS-CoV was a strong hypothesis considering the high genome relatedness between sequences of bat coronaviruses and MERS-CoV. […] Until now, dromedary camels have likely been the main zoonotic source for human infections. […] MERS-CoV antibodies have already been detected in nearly all dromedary camels examined in the Arabian Peninsula and several African countries. […] Some human infections with MERS-CoV were linked to exposure to camels. […] The first evidence was a study in KSA in which the full genome sequences of MERS-CoV were identical in isolates from both a human case with a fatal infection and his camels. […] The first cluster of MERS-CoV infections was in November 2012 when a family contracted the virus in Riyadh, KSA. […] The second cluster was retroactively reported in Jordan in 2012 and was related to the earliest confirmed two fatal cases.
  • #12 MERS-related coronavirus – Wikipedia
    https://en.wikipedia.org/wiki/MERS-related_coronavirus
    Middle East respiratory syndromerelated coronavirus (MERS-CoV, Betacoronavirus cameli) or EMC/2012 (HCoV-EMC/2012), is the virus that causes Middle East respiratory syndrome (MERS). It is a species of coronavirus which infects humans, bats, and camels. The infecting virus is an enveloped, positive-sense, single-stranded RNA virus which enters its host cell by binding to the DPP4 receptor. […] MERS-CoV is one of several viruses identified by the World Health Organization (WHO) as a likely cause of a future epidemic. They list it for urgent research and development. […] The virus appears to have originated in bats. The virus itself has been isolated from a bat. […] It is believed that the virus originated in bats, one candidate being the Egyptian tomb bat. […] According to the 27 March 2014 MERS-CoV summary update, recent studies support that camels serve as the primary source of the MERS-CoV infecting humans, while bats may be the ultimate reservoir of the virus. Evidence includes the frequency with which the virus has been found in camels to which human cases have been exposed, seriological data which shows widespread transmission in camels, and the similarity of the camel CoV to the human CoV.
  • #13 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is most closely related to the Tylonycteris and Pipistrellus bat CoVs HKU4 and HKU5, respectively, suggesting that bats could have been the ultimate source for the virus. […] This suggests that MERS-CoV has infected camels for an extended amount of time and raises the question as to why MERS was not detected in patients in Saudi Arabia before 2012. […] While camels are clearly the primary zoonotic intermediate for MERS-CoV infection, the route of transmission into the human population is not entirely clear and is likely multi-factorial. […] In order to do develop therapeutics and vaccines, new small animal models that more closely resemble lethal human disease will be required.
  • #14
    https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)
    Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by Middle East respiratory syndrome coronavirus (MERSCoV) that was first identified in Saudi Arabia in 2012. […] MERS-CoV is a zoonotic virus, meaning it is transmitted between animals and people. MERS-CoV has been identified and linked to human infections in dromedary camels in several Member States in the Middle East, Africa and South Asia. […] Zoonotic transmission: MERS-CoV is a zoonotic virus, which means that is transmitted between animals and people. Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels, although the exact route of transmission remains unclear. […] Approximately 80% of human cases have been reported by Saudi Arabia, largely as a result of direct or indirect contact with infected dromedary camels or infected individuals in health care facilities.
  • #15 The Middle East Respiratory Syndrome (MERS)
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7127753/
    The Middle East respiratory syndrome (MERS) is a novel lethal zoonotic disease of humans caused by the MERS coronavirus (MERS-CoV). […] Humans are thought to acquire MERS-CoV though contact with camels or camel products. […] MERS carries a 35% mortality rate. There is no specific treatment for MERS. Person-to-person spread causes hospital and household outbreaks of MERS-CoV. […] The exact mode of transmission of MERS-CoV to humans is not yet accurately defined. Epidemiologic, genetic, and phenotypic studies indicate that dromedary camels appear to be the main intermediary reservoirs of MERS-CoV. […] The primary source of human MERS-CoV infections remains unknown. […] Several independent risk factors for increased susceptibility to acquiring primary MERS-CoV infections have been identified: direct dromedary exposure in the fortnight before illness onset, direct physical contact with dromedary camels during the previous 6 months, diabetes mellitus, and heart disease.
  • #16
    https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)
    Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by Middle East respiratory syndrome coronavirus (MERSCoV) that was first identified in Saudi Arabia in 2012. […] MERS-CoV is a zoonotic virus, meaning it is transmitted between animals and people. MERS-CoV has been identified and linked to human infections in dromedary camels in several Member States in the Middle East, Africa and South Asia. […] Zoonotic transmission: MERS-CoV is a zoonotic virus, which means that is transmitted between animals and people. Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels, although the exact route of transmission remains unclear. […] Approximately 80% of human cases have been reported by Saudi Arabia, largely as a result of direct or indirect contact with infected dromedary camels or infected individuals in health care facilities.
  • #17 Middle East respiratory syndrome (MERS) – including symptoms, treatment and prevention | SA Health
    https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/middle+east+respiratory+syndrome/middle+east+respiratory+syndrome+mers+-+including+symptoms+treatment+and+prevention
    Middle East respiratory syndrome (MERS) was first recognised in Saudi Arabia in 2012. It is caused by infection with Middle East respiratory syndrome coronavirus (MERS-CoV). […] There is strong evidence to suggest that camels serve as a reservoir for the virus and that infection in humans can be acquired from contact with camels and camel products. MERS-CoV does not appear to be present in Australian camels. […] MERS-CoV mainly causes a respiratory infection, which can range from mild illness, to severe pneumonia. Older persons and those with diabetes or immunosuppression are at higher risk of severe illness. […] There is no specific treatment for MERS. […] There is no vaccine available to prevent MERS.
  • #18 Middle East respiratory syndrome coronavirus (MERS-CoV) | Communicable Diseases Agency
    https://www.cda.gov.sg/public/diseases/middle-east-respiratory-syndrome-coronavirus-
    Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a novel coronavirus which causes acute respiratory illness in infected patients. […] MERS-CoV was first reported by the World Health Organization (WHO) on 22 September 2012. […] MERS-CoV is present in infected dromedary camels and can be transmitted to humans through contact with infected animals or consumption or exposure to contaminated animal products. […] Human-to-human transmission is possible, and limited transmission has occurred among close contacts of confirmed cases in household and healthcare settings. […] There is no curative treatment for MERS.
  • #19 HIE Multimedia – Middle East Respiratory Syndrome (MERS)
    https://adamcertificationdemo.adam.com/content.aspx?productid=117&isarticlelink=false&pid=60&gid=000723
    Middle East Respiratory Syndrome (MERS) is caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). […] MERS was first reported in Saudi Arabia in 2012 and then spread to many countries. […] The MERS virus comes from MERS-CoV virus mainly spreads from animals to humans. The virus has been found in camels, and exposure to camels is a risk factor for MERS. […] Some people infected with MERS-CoV had mild symptoms or no symptoms at all. […] About 3 to 4 out of every 10 people with MERS have died.
  • #20 Middle East Respiratory Syndrome Coronavirus (MERS-CoV): State of the Science
    https://www.mdpi.com/2076-2607/8/7/991
    The bat origin of MERS-CoV was a strong hypothesis considering the high genome relatedness between sequences of bat coronaviruses and MERS-CoV. […] Until now, dromedary camels have likely been the main zoonotic source for human infections. […] MERS-CoV antibodies have already been detected in nearly all dromedary camels examined in the Arabian Peninsula and several African countries. […] Some human infections with MERS-CoV were linked to exposure to camels. […] The first evidence was a study in KSA in which the full genome sequences of MERS-CoV were identical in isolates from both a human case with a fatal infection and his camels. […] The first cluster of MERS-CoV infections was in November 2012 when a family contracted the virus in Riyadh, KSA. […] The second cluster was retroactively reported in Jordan in 2012 and was related to the earliest confirmed two fatal cases.
  • #21 Middle East Respiratory Syndrome Coronavirus (MERS-CoV): State of the Science
    https://www.mdpi.com/2076-2607/8/7/991
    The bat origin of MERS-CoV was a strong hypothesis considering the high genome relatedness between sequences of bat coronaviruses and MERS-CoV. […] Until now, dromedary camels have likely been the main zoonotic source for human infections. […] MERS-CoV antibodies have already been detected in nearly all dromedary camels examined in the Arabian Peninsula and several African countries. […] Some human infections with MERS-CoV were linked to exposure to camels. […] The first evidence was a study in KSA in which the full genome sequences of MERS-CoV were identical in isolates from both a human case with a fatal infection and his camels. […] The first cluster of MERS-CoV infections was in November 2012 when a family contracted the virus in Riyadh, KSA. […] The second cluster was retroactively reported in Jordan in 2012 and was related to the earliest confirmed two fatal cases.
  • #22 Factsheet about Middle East respiratory syndrome coronavirus (MERS-CoV)
    https://www.ecdc.europa.eu/en/middle-east-respiratory-syndrome-coronavirus/factsheet
    By August 2014, the evidence is accumulating that the dromedary camel is a host species for MERS-CoV and that camels play an important role in the transmission to humans. […] The exact routes of transmission among camels and from camels to humans are still not clear. […] Although previous studies on the presence of MERS-CoV antibodies in abattoir workers in Saudi Arabia and in Egypt suggested that the virus is not easily transmitted from camels to humans, evidence on the role of dromedary camels as a potential reservoir of MERS-CoV and the direct transmission of the virus from infected camels to humans are accumulating. […] The transmission of the virus from person to person has been documented in several human clusters in healthcare facilities, households and workplace, both in the Middle East and in Europe. […] Current evidence from contact tracing suggests that transmission did not extend beyond close contacts into the community.
  • #23 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is most closely related to the Tylonycteris and Pipistrellus bat CoVs HKU4 and HKU5, respectively, suggesting that bats could have been the ultimate source for the virus. […] This suggests that MERS-CoV has infected camels for an extended amount of time and raises the question as to why MERS was not detected in patients in Saudi Arabia before 2012. […] While camels are clearly the primary zoonotic intermediate for MERS-CoV infection, the route of transmission into the human population is not entirely clear and is likely multi-factorial. […] In order to do develop therapeutics and vaccines, new small animal models that more closely resemble lethal human disease will be required.
  • #24 MERS-CoV: Symptoms, causes, risk factors, and treatment
    https://www.medicalnewstoday.com/articles/262538
    Middle East respiratory syndrome (MERS) is caused by a coronavirus. First identified in Saudi Arabia in 2012, the virus still causes local outbreaks today. […] MERS is caused by the Middle East respiratory syndrome coronavirus (MERS-CoV). Most people who develop the syndrome have severe respiratory symptoms. […] Research suggests that MERS-CoV originated in bats. It then likely spread from infected dromedary camels to humans. […] According to the World Health Organization (WHO), most cases of MERS in humans have been transmitted by people in healthcare environments. However, evidence suggests that dromedary camels could also be a source of infection in humans. […] The virus does not seem to pass easily from person to person unless there is close contact, as in a healthcare setting. […] Researchers do not yet know how exactly camels are involved in transmitting this virus. They have identified MERS-CoV in camels in several countries in the Middle East, Africa, and South Asia.
  • #25 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is transmitted inefficiently among humans. […] The R0 factor for MERS-CoV has been estimated to be less than 0.7 and likely closer to 0.5, significantly lower than an R0 of 1, a mark of epidemic potential. […] Perhaps the most consistently described risk factor for MERS disease is the presence of underlying co-morbidities such as diabetes, chronic renal disease, obesity, hypertension, chronic cardiac diseases and lung disease such as asthma and chronic obstructive pulmonary disease. […] MERS pathogenesis begins with entry of virus via the respiratory tract where the spike (S) protein interacts with its cellular receptor DPP4. […] Lack of patient autopsy or surgical pathology samples from the Middle East or the Korean outbreak has limited studies of MERS-CoV pathogenesis. […] MERS-CoV infection causes a wide range of clinical manifestations in humans.
  • #26 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    In 2012, a zoonotic coronavirus was identified as the causative agent of Middle East Respiratory Syndrome (MERS), called MERS Coronavirus (MERS-CoV). […] Further studies showed that it was related to several bat CoV, including HKU4 and HKU5 and it was named the Middle East Respiratory Syndrome-CoV (MERS-CoV). […] MERS-CoV is a member of the family Coronaviridae, which are enveloped, positive-sense, single stranded RNA viruses. […] MERS-CoV encodes for 5 unique accessory proteins, with at least two, 4A and 4B, that modulate interferon production when expressed in isolation. […] Soon after the discovery of MERS-CoV, the receptor that mediates cell entry was identified as dipeptidyl peptidase four (DPP4), a large ectopeptidase present at the surface of many different cell types. […] While there has been extensive recombination of MERS-CoV in camels and genetic changes in the virus have been noted since 2012, there is no evidence that the virus has mutated to enhance binding to DPP4.
  • #27 Middle East respiratory syndrome coronavirus (MERS-CoV) internalization does not rely on DPP4 cytoplasmic tail signaling | npj Viruses
    https://www.nature.com/articles/s44298-024-00080-y
    The entry process of MERS-CoV is primarily mediated by the membrane-bound receptor DPP4, also known as CD26, which belongs to the family of peptidases. […] DPP4 primarily cleaves peptides and hormones and binds to adenosine deaminase to activate T-cells. […] In addition to its regular physiological function, DPP4 acts as the primary entry receptor for MERS-CoV. […] The trimeric form of the MERS-CoV spike protein binds to DPP4 and facilitates viral entry into host cells. […] The DPP4 lacks a conserved endocytic motif in the cytoplasmic tail. […] MERS-CoV uses DPP4 as the primary receptor, and upon binding to the receptor, the virus or DPP4 may bind to other host factor(s) to initiate the internalization process like HCV and HIV.
  • #28 Middle East respiratory syndrome coronavirus (MERS-CoV) internalization does not rely on DPP4 cytoplasmic tail signaling | npj Viruses
    https://www.nature.com/articles/s44298-024-00080-y
    Middle East respiratory syndrome coronavirus (MERS-CoV) infects respiratory epithelial cells in humans and camels by binding to dipeptidyl peptidase 4 (DPP4) as its entry receptor. […] MERS-CoV is known to bind to the ectodomain of DPP4 to gain entry into the host cell. […] The presence and distribution of the MERS-CoV receptor in the respiratory tract correlate with virus transmission, implying that frequent spillovers from this species to humans may occur in the near future. […] MERS-CoV uses dipeptidyl peptidase 4 (DPP4) as an entry receptor, which belongs to the serine peptidase family and is predominantly expressed in epithelial cells of the lungs, liver, kidney, intestine, thymocytes, and alveolar macrophages. […] The distribution of DPP4 in host cells plays a vital role in the transmission of MERS-CoV between camels and humans, as well as the severity of the infection.
  • #29 Middle East respiratory syndrome coronavirus (MERS-CoV) internalization does not rely on DPP4 cytoplasmic tail signaling | npj Viruses
    https://www.nature.com/articles/s44298-024-00080-y
    The entry process of MERS-CoV is primarily mediated by the membrane-bound receptor DPP4, also known as CD26, which belongs to the family of peptidases. […] DPP4 primarily cleaves peptides and hormones and binds to adenosine deaminase to activate T-cells. […] In addition to its regular physiological function, DPP4 acts as the primary entry receptor for MERS-CoV. […] The trimeric form of the MERS-CoV spike protein binds to DPP4 and facilitates viral entry into host cells. […] The DPP4 lacks a conserved endocytic motif in the cytoplasmic tail. […] MERS-CoV uses DPP4 as the primary receptor, and upon binding to the receptor, the virus or DPP4 may bind to other host factor(s) to initiate the internalization process like HCV and HIV.
  • #30 Middle East respiratory syndrome coronavirus (MERS-CoV) internalization does not rely on DPP4 cytoplasmic tail signaling | npj Viruses
    https://www.nature.com/articles/s44298-024-00080-y
    The entry process of MERS-CoV is primarily mediated by the membrane-bound receptor DPP4, also known as CD26, which belongs to the family of peptidases. […] DPP4 primarily cleaves peptides and hormones and binds to adenosine deaminase to activate T-cells. […] In addition to its regular physiological function, DPP4 acts as the primary entry receptor for MERS-CoV. […] The trimeric form of the MERS-CoV spike protein binds to DPP4 and facilitates viral entry into host cells. […] The DPP4 lacks a conserved endocytic motif in the cytoplasmic tail. […] MERS-CoV uses DPP4 as the primary receptor, and upon binding to the receptor, the virus or DPP4 may bind to other host factor(s) to initiate the internalization process like HCV and HIV.
  • #31 Middle East respiratory syndrome coronavirus: transmission, virology and therapeutic targeting to aid in outbreak control | Experimental & Molecular Medicine
    https://www.nature.com/articles/emm201576
    MERS-CoV enters the host through its S protein, a type I transmembrane glycoprotein with 1353 amino acids (aa) that exists on the virion surface as a trimer. […] DPP4 is mainly expressed on epithelial cells and controls the activity of hormones and chemokines. […] DPP4, a 766-aa-long type-II transmembrane glycoprotein, acts as a unique receptor for MERS-CoV. […] Processing of the viral polyproteins is necessary for the discharge of mature proteins as they guide the replication and transcription of the MERS-CoV genome. […] MERS-CoV PLpro is able to deubiquitinate IRF3, thereby inhibiting the synthesis of IFN. […] The MERS-CoV PLpro domain spans residues 14841800 in the pp1a protein. […] The structural and accessory proteins M, ORF 4a, ORF 4b, and ORF 5 of Middle East respiratory syndrome coronavirus (MERS-CoV) are potent interferon antagonists. […] Protein 4a, one of the accessory proteins, blocks IFN induction and works as a strong inhibitor of type 1 IFN by inhibiting dsRNA recognition by cellular RIG-I and MDA5.
  • #32 Middle East respiratory syndrome coronavirus: transmission, virology and therapeutic targeting to aid in outbreak control | Experimental & Molecular Medicine
    https://www.nature.com/articles/emm201576
    MERS-CoV enters the host through its S protein, a type I transmembrane glycoprotein with 1353 amino acids (aa) that exists on the virion surface as a trimer. […] DPP4 is mainly expressed on epithelial cells and controls the activity of hormones and chemokines. […] DPP4, a 766-aa-long type-II transmembrane glycoprotein, acts as a unique receptor for MERS-CoV. […] Processing of the viral polyproteins is necessary for the discharge of mature proteins as they guide the replication and transcription of the MERS-CoV genome. […] MERS-CoV PLpro is able to deubiquitinate IRF3, thereby inhibiting the synthesis of IFN. […] The MERS-CoV PLpro domain spans residues 14841800 in the pp1a protein. […] The structural and accessory proteins M, ORF 4a, ORF 4b, and ORF 5 of Middle East respiratory syndrome coronavirus (MERS-CoV) are potent interferon antagonists. […] Protein 4a, one of the accessory proteins, blocks IFN induction and works as a strong inhibitor of type 1 IFN by inhibiting dsRNA recognition by cellular RIG-I and MDA5.
  • #33 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is transmitted inefficiently among humans. […] The R0 factor for MERS-CoV has been estimated to be less than 0.7 and likely closer to 0.5, significantly lower than an R0 of 1, a mark of epidemic potential. […] Perhaps the most consistently described risk factor for MERS disease is the presence of underlying co-morbidities such as diabetes, chronic renal disease, obesity, hypertension, chronic cardiac diseases and lung disease such as asthma and chronic obstructive pulmonary disease. […] MERS pathogenesis begins with entry of virus via the respiratory tract where the spike (S) protein interacts with its cellular receptor DPP4. […] Lack of patient autopsy or surgical pathology samples from the Middle East or the Korean outbreak has limited studies of MERS-CoV pathogenesis. […] MERS-CoV infection causes a wide range of clinical manifestations in humans.
  • #34 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is transmitted inefficiently among humans. […] The R0 factor for MERS-CoV has been estimated to be less than 0.7 and likely closer to 0.5, significantly lower than an R0 of 1, a mark of epidemic potential. […] Perhaps the most consistently described risk factor for MERS disease is the presence of underlying co-morbidities such as diabetes, chronic renal disease, obesity, hypertension, chronic cardiac diseases and lung disease such as asthma and chronic obstructive pulmonary disease. […] MERS pathogenesis begins with entry of virus via the respiratory tract where the spike (S) protein interacts with its cellular receptor DPP4. […] Lack of patient autopsy or surgical pathology samples from the Middle East or the Korean outbreak has limited studies of MERS-CoV pathogenesis. […] MERS-CoV infection causes a wide range of clinical manifestations in humans.
  • #35 MERS – Epidemiology
    https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/middle-east-respiratory-syndrome-mers/
    Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by a coronavirus known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS typically causes a severe respiratory illness that is often fatal. […] MERS-CoV is not the same as the SARS-associated coronaviruses SARS-CoV, which causes severe acute respiratory syndrome (SARS), or SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19). […] MERS-CoV does NOT appear to spread readily in communities. […] While the exact mode of transmission is not clear, MERS-CoV is felt to be spread by close contact by respiratory droplets from an infected person to another person. […] Some people with MERS might become infected after having contact with infected camels. […] MERS is diagnosed based on the patients history, epidemiological data, symptoms and signs, imaging findings, and laboratory data. […] Currently, there is no specific antiviral treatment for MERS. […] The current mortality rate from MERS is about 30-40%.
  • #36 The Middle East Respiratory Syndrome (MERS)
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7127753/
    MERS-CoV does not transmit easily from person-to-person unless there is close contact, such as occurs when providing care to a patient in the household or nosocomial setting when the diagnosis of MERS-CoV has not yet been recognized and there are lapses in instituting infection control measures. […] MERS-CoV infection appears to cause more severe disease in older people, people with weakened immune systems, and those with chronic diseases, such as renal disease, cancer, chronic lung disease, and diabetes. […] Currently there are no specific treatments to treat MERS-CoV. […] MERS-CoV remains an important public health risk and possible consequences of further international spread could be serious in view of the patterns of nosocomial transmission within health care facilities.
  • #37 MERS – Epidemiology
    https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/middle-east-respiratory-syndrome-mers/
    Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by a coronavirus known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS typically causes a severe respiratory illness that is often fatal. […] MERS-CoV is not the same as the SARS-associated coronaviruses SARS-CoV, which causes severe acute respiratory syndrome (SARS), or SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19). […] MERS-CoV does NOT appear to spread readily in communities. […] While the exact mode of transmission is not clear, MERS-CoV is felt to be spread by close contact by respiratory droplets from an infected person to another person. […] Some people with MERS might become infected after having contact with infected camels. […] MERS is diagnosed based on the patients history, epidemiological data, symptoms and signs, imaging findings, and laboratory data. […] Currently, there is no specific antiviral treatment for MERS. […] The current mortality rate from MERS is about 30-40%.
  • #38 Coronaviruses and Acute Respiratory Syndromes (MERS and SARS) – Infections – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/infections/respiratory-viruses/coronaviruses-and-acute-respiratory-syndromes-mers-and-sars
    Middle East respiratory syndrome (MERS) is a coronavirus infection that causes severe flu-like symptoms. […] The virus that causes Middle East respiratory syndrome (MERS) is a coronavirus. […] MERS-CoV was identified in 2012 as the cause of Middle East respiratory syndrome (MERS). […] In several countries in the Middle East, dromedary camels are suspected of being the primary source of infection for people, but how the virus spreads from camels to people is unknown. […] The infection has been fatal in about one third of infected people. […] The MERS virus is spread through close contact with people who have MERS or through airborne droplets that were coughed or sneezed out by an infected person. […] Most cases of person-to-person spread have occurred in health care workers caring for infected people.
  • #39 Coronaviruses and Acute Respiratory Syndromes (MERS and SARS) – Infections – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/infections/respiratory-viruses/coronaviruses-and-acute-respiratory-syndromes-mers-and-sars
    Middle East respiratory syndrome (MERS) is a coronavirus infection that causes severe flu-like symptoms. […] The virus that causes Middle East respiratory syndrome (MERS) is a coronavirus. […] MERS-CoV was identified in 2012 as the cause of Middle East respiratory syndrome (MERS). […] In several countries in the Middle East, dromedary camels are suspected of being the primary source of infection for people, but how the virus spreads from camels to people is unknown. […] The infection has been fatal in about one third of infected people. […] The MERS virus is spread through close contact with people who have MERS or through airborne droplets that were coughed or sneezed out by an infected person. […] Most cases of person-to-person spread have occurred in health care workers caring for infected people.
  • #40 Factsheet about Middle East respiratory syndrome coronavirus (MERS-CoV)
    https://www.ecdc.europa.eu/en/middle-east-respiratory-syndrome-coronavirus/factsheet
    By August 2014, the evidence is accumulating that the dromedary camel is a host species for MERS-CoV and that camels play an important role in the transmission to humans. […] The exact routes of transmission among camels and from camels to humans are still not clear. […] Although previous studies on the presence of MERS-CoV antibodies in abattoir workers in Saudi Arabia and in Egypt suggested that the virus is not easily transmitted from camels to humans, evidence on the role of dromedary camels as a potential reservoir of MERS-CoV and the direct transmission of the virus from infected camels to humans are accumulating. […] The transmission of the virus from person to person has been documented in several human clusters in healthcare facilities, households and workplace, both in the Middle East and in Europe. […] Current evidence from contact tracing suggests that transmission did not extend beyond close contacts into the community.
  • #41 Middle East Respiratory Syndrome Coronavirus (MERS-CoV): State of the Science
    https://www.mdpi.com/2076-2607/8/7/991
    The bat origin of MERS-CoV was a strong hypothesis considering the high genome relatedness between sequences of bat coronaviruses and MERS-CoV. […] Until now, dromedary camels have likely been the main zoonotic source for human infections. […] MERS-CoV antibodies have already been detected in nearly all dromedary camels examined in the Arabian Peninsula and several African countries. […] Some human infections with MERS-CoV were linked to exposure to camels. […] The first evidence was a study in KSA in which the full genome sequences of MERS-CoV were identical in isolates from both a human case with a fatal infection and his camels. […] The first cluster of MERS-CoV infections was in November 2012 when a family contracted the virus in Riyadh, KSA. […] The second cluster was retroactively reported in Jordan in 2012 and was related to the earliest confirmed two fatal cases.
  • #42 Current understanding of middle east respiratory syndrome coronavirus infection in human and animal models – Wang – Journal of Thoracic Disease
    https://jtd.amegroups.org/article/view/20125/html
    However, the 2015 MERS outbreak in South Korea with dozens of secondary- and tertiary-generation cases raised the concern that MERS-CoV may have adapted to allow a more efficient spread in humans. […] MERS-CoV is the etiological agent responsible for the ongoing MERS pandemic in Middle East region. […] No specific vaccine and drug have so far been licensed for human use.
  • #43 Current understanding of middle east respiratory syndrome coronavirus infection in human and animal models – Wang – Journal of Thoracic Disease
    https://jtd.amegroups.org/article/view/20125/html
    Middle East respiratory syndrome (MERS) is a highly lethal respiratory disease caused by a novel betacoronavirus (MERS coronavirus, MERS-CoV). […] MERS-CoV as the most recent novel coronavirus emerged in human can cause severe, life-threatening disease and is a potential threat to global public health and economy. […] The evolutionary origins of MERS-CoV are still uncertain. […] Several MERS-CoV viruses have also been isolated from these camels indicating that they could be an intermediate host for MERS-CoV. […] Current evidence indicates that bats are likely to be the original source, and dromedary camels are considered to be a possible intermediate host for MERS-CoV. […] Previous studies indicated that MERS-CoV infection are primarily due to repeated introductions of MERS-CoV from dromedary camels to human, while human to human transmission is limited.
  • #44 The Middle East Respiratory Syndrome (MERS)
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7127753/
    The Middle East respiratory syndrome (MERS) is a novel lethal zoonotic disease of humans caused by the MERS coronavirus (MERS-CoV). […] Humans are thought to acquire MERS-CoV though contact with camels or camel products. […] MERS carries a 35% mortality rate. There is no specific treatment for MERS. Person-to-person spread causes hospital and household outbreaks of MERS-CoV. […] The exact mode of transmission of MERS-CoV to humans is not yet accurately defined. Epidemiologic, genetic, and phenotypic studies indicate that dromedary camels appear to be the main intermediary reservoirs of MERS-CoV. […] The primary source of human MERS-CoV infections remains unknown. […] Several independent risk factors for increased susceptibility to acquiring primary MERS-CoV infections have been identified: direct dromedary exposure in the fortnight before illness onset, direct physical contact with dromedary camels during the previous 6 months, diabetes mellitus, and heart disease.
  • #45 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is transmitted inefficiently among humans. […] The R0 factor for MERS-CoV has been estimated to be less than 0.7 and likely closer to 0.5, significantly lower than an R0 of 1, a mark of epidemic potential. […] Perhaps the most consistently described risk factor for MERS disease is the presence of underlying co-morbidities such as diabetes, chronic renal disease, obesity, hypertension, chronic cardiac diseases and lung disease such as asthma and chronic obstructive pulmonary disease. […] MERS pathogenesis begins with entry of virus via the respiratory tract where the spike (S) protein interacts with its cellular receptor DPP4. […] Lack of patient autopsy or surgical pathology samples from the Middle East or the Korean outbreak has limited studies of MERS-CoV pathogenesis. […] MERS-CoV infection causes a wide range of clinical manifestations in humans.
  • #46 The Middle East Respiratory Syndrome (MERS)
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7127753/
    MERS-CoV does not transmit easily from person-to-person unless there is close contact, such as occurs when providing care to a patient in the household or nosocomial setting when the diagnosis of MERS-CoV has not yet been recognized and there are lapses in instituting infection control measures. […] MERS-CoV infection appears to cause more severe disease in older people, people with weakened immune systems, and those with chronic diseases, such as renal disease, cancer, chronic lung disease, and diabetes. […] Currently there are no specific treatments to treat MERS-CoV. […] MERS-CoV remains an important public health risk and possible consequences of further international spread could be serious in view of the patterns of nosocomial transmission within health care facilities.
  • #47 Middle East Respiratory Syndrome (MERS) Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/special-topic/middle-east-respiratory-syndrome-mers
    Middle East Respiratory Syndrome (MERS) is a severe respiratory illness that mainly involves the upper respiratory tract. It causes fever, coughing, and shortness of breath. About 35% of people who have gotten this illness have died. Some people only have mild symptoms. […] MERS is caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Coronaviruses are a family of viruses that can cause mild to severe respiratory infections. […] The MERS virus comes from MERS-CoV virus mainly spreads from animals to humans. The virus has been found in camels, and exposure to camels is a risk factor for MERS. […] About 3 to 4 out of every 10 people with MERS have died. Most of those who developed severe illness and died had other health problems that weakened their immune system.
  • #48 Middle East respiratory syndrome coronavirus (MERS-CoV) | Communicable Diseases Agency
    https://www.cda.gov.sg/public/diseases/middle-east-respiratory-syndrome-coronavirus-
    Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a novel coronavirus which causes acute respiratory illness in infected patients. […] MERS-CoV was first reported by the World Health Organization (WHO) on 22 September 2012. […] MERS-CoV is present in infected dromedary camels and can be transmitted to humans through contact with infected animals or consumption or exposure to contaminated animal products. […] Human-to-human transmission is possible, and limited transmission has occurred among close contacts of confirmed cases in household and healthcare settings. […] There is no curative treatment for MERS.
  • #49
    https://www.who.int/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)
    Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by Middle East respiratory syndrome coronavirus (MERSCoV) that was first identified in Saudi Arabia in 2012. […] MERS-CoV is a zoonotic virus, meaning it is transmitted between animals and people. MERS-CoV has been identified and linked to human infections in dromedary camels in several Member States in the Middle East, Africa and South Asia. […] Zoonotic transmission: MERS-CoV is a zoonotic virus, which means that is transmitted between animals and people. Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels, although the exact route of transmission remains unclear. […] Approximately 80% of human cases have been reported by Saudi Arabia, largely as a result of direct or indirect contact with infected dromedary camels or infected individuals in health care facilities.
  • #50 Middle-East respiratory syndrome coronavirus
    https://www.bag.admin.ch/bag/en/home/krankheiten/krankheiten-im-ueberblick/mers.html
    Middle-East respiratory syndrome coronavirus (MERS-CoV) is a new coronavirus that causes acute pneumonia. It was discovered in 2012 in a patient in the Middle East. […] MERS-CoV belongs to Coronaviridae, a large family of viruses responsible for a broad range of disease in humans and animals. […] MERS-CoV is genetically distinct from the coronavirus that caused the 2003 SARS pandemic. […] The dromedary (and products such as unpasteurised milk derived from it) seems to play a key role in the transmission of the virus from animals to humans. […] Infection often occurs in hospital (nosocomial infection) or in the family. […] In Saudi Arabia the disease has been fatal in around 35 percent of infected patients. […] At present there is neither a vaccination nor other specific treatment. […] Since 2012 the WHO has recorded a total of 2,428 confirmed cases of MERS-CoV worldwide, including 838 fatalities. […] Most infections have been recorded on the Arabian Peninsula, particularly Saudi Arabia (85 percent of the confirmed cases).
  • #51 Middle-East respiratory syndrome coronavirus
    https://www.bag.admin.ch/bag/en/home/krankheiten/krankheiten-im-ueberblick/mers.html
    Middle-East respiratory syndrome coronavirus (MERS-CoV) is a new coronavirus that causes acute pneumonia. It was discovered in 2012 in a patient in the Middle East. […] MERS-CoV belongs to Coronaviridae, a large family of viruses responsible for a broad range of disease in humans and animals. […] MERS-CoV is genetically distinct from the coronavirus that caused the 2003 SARS pandemic. […] The dromedary (and products such as unpasteurised milk derived from it) seems to play a key role in the transmission of the virus from animals to humans. […] Infection often occurs in hospital (nosocomial infection) or in the family. […] In Saudi Arabia the disease has been fatal in around 35 percent of infected patients. […] At present there is neither a vaccination nor other specific treatment. […] Since 2012 the WHO has recorded a total of 2,428 confirmed cases of MERS-CoV worldwide, including 838 fatalities. […] Most infections have been recorded on the Arabian Peninsula, particularly Saudi Arabia (85 percent of the confirmed cases).
  • #52 What Is Middle East Respiratory Syndrome? An Overview
    https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/middle-east-respiratory-syndrome
    Middle East respiratory syndrome (MERS) is a respiratory viral infection that is rare in the United States. MERS is caused by the MERS-coronavirus (MERS-CoV). The virus can be transmitted between animals, such as camels, and humans. […] MERS-CoV was first reported in the Arabian Peninsula in 2012. About 80% of human cases have since occurred in Saudi Arabia. […] Most cases are still associated with countries in or around the Arabian Peninsula. Outbreaks in other countries are also associated with people who have traveled to the area. […] MERS-CoV can spread from animals to people due to close contact and improperly prepared camel meat and milk. The virus can then be transmitted between people via droplets expelled during talking or coughing. […] MERS is caused by the MERS-coronavirus (MERS-CoV).
  • #53 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) | Wisconsin Department of Health Services
    https://www.dhs.wisconsin.gov/disease/mers.htm
    Middle East Respiratory Syndrome (MERS) is a serious respiratory disease caused by Middle East Respiratory Syndrome coronavirus (MERS-CoV). MERS-CoV was first reported in Saudi Arabia in 2012. […] MERS-CoV is part of the coronavirus family. […] MERS-CoV has spread from infected people to others through close contact, such as caring for or living with an infected person. […] All reported cases of MERS in the United States have been linked to international travel to countries in the Arabian Peninsula. […] Only a few cases of MERS have ever been reported in the United States.
  • #54 Middle East respiratory syndrome (MERS): Emergence of a pathogenic human Coronavirus
    https://pmc.ncbi.nlm.nih.gov/articles/PMC5353356/
    MERS-CoV is transmitted inefficiently among humans. […] The R0 factor for MERS-CoV has been estimated to be less than 0.7 and likely closer to 0.5, significantly lower than an R0 of 1, a mark of epidemic potential. […] Perhaps the most consistently described risk factor for MERS disease is the presence of underlying co-morbidities such as diabetes, chronic renal disease, obesity, hypertension, chronic cardiac diseases and lung disease such as asthma and chronic obstructive pulmonary disease. […] MERS pathogenesis begins with entry of virus via the respiratory tract where the spike (S) protein interacts with its cellular receptor DPP4. […] Lack of patient autopsy or surgical pathology samples from the Middle East or the Korean outbreak has limited studies of MERS-CoV pathogenesis. […] MERS-CoV infection causes a wide range of clinical manifestations in humans.
  • #55 Middle Eastern Respiratory Syndrome (MERS) | American Lung Association
    https://www.lung.org/lung-health-diseases/lung-disease-lookup/middle-eastern-respiratory-syndrome-mers
    Middle Eastern Respiratory Syndrome, or MERS, is a viral illness that causes severe lung infection. […] MERS is caused by a virus in the coronavirus family, and the syndrome is also called MERS-Coronavirus (MERS-CoV). […] MERS is passed primarily to people from infected camels. […] Most cases have been found in Saudi Arabia, where the virus originated. Outbreaks in other countries have been traced back to infected individuals returning from travel to the Middle East. […] Around one-third of patients diagnosed with MERS have died, according to the CDC.
  • #56 Middle East Respiratory Syndrome (MERS)
    https://adamcertificationdemo.adam.com/content.aspx?productid=144&isarticlelink=false&pid=60&gid=000723
    Middle East Respiratory Syndrome (MERS) is a severe respiratory illness that mainly involves the upper respiratory tract. It causes fever, coughing, and shortness of breath. About 35% of people who have gotten this illness have died. Some people only have mild symptoms. […] MERS is caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Coronaviruses are a family of viruses that can cause mild to severe respiratory infections. MERS was first reported in Saudi Arabia in 2012 and then spread to many countries. Most cases were spread from people who traveled to the Middle Eastern countries. […] Some people infected with MERS-CoV had mild symptoms or no symptoms at all. Some people with MERS have developed pneumonia and kidney failure. About 3 to 4 out of every 10 people with MERS have died. Most of those who developed severe illness and died had other health problems that weakened their immune system.
  • #57
    https://link.springer.com/article/10.1007/s11547-020-01311-x
    In 2012, a new coronavirus (MERS-CoV) was recognized to cause the Middle East respiratory syndrome (MERS) that presented with more than 30% mortality (858 reported deaths) and spread to 27 countries. […] MERS and SARS have been associated with acute kidney injury (AKI), possibly caused by virus tropism for the kidneys and secondary damage due to systemic inflammation and hypotension. […] MERS-CoV infection usually causes severe extra-pulmonary organ dysfunction, and most patients present with shock, acute kidney injury, and thrombocytopenia. […] The exact mechanism of renal dysfunction is not well understood; however, studies have shown viral tropism for kidney cells ex vivo, suggesting MERS-CoV could induce apoptosis in the kidney. […] A systematic review on pregnancy-related complications from SARS, MERS, and COVID-19 showed an increased prevalence of preterm birth and miscarriage, along with fetal distress and necessity for ICU treatment. […] The progression from pulmonary disease to a systemic condition has a poor outcome and can result in multi-organ failure and death.
  • #58
    https://link.springer.com/article/10.1007/s11547-020-01311-x
    In 2012, a new coronavirus (MERS-CoV) was recognized to cause the Middle East respiratory syndrome (MERS) that presented with more than 30% mortality (858 reported deaths) and spread to 27 countries. […] MERS and SARS have been associated with acute kidney injury (AKI), possibly caused by virus tropism for the kidneys and secondary damage due to systemic inflammation and hypotension. […] MERS-CoV infection usually causes severe extra-pulmonary organ dysfunction, and most patients present with shock, acute kidney injury, and thrombocytopenia. […] The exact mechanism of renal dysfunction is not well understood; however, studies have shown viral tropism for kidney cells ex vivo, suggesting MERS-CoV could induce apoptosis in the kidney. […] A systematic review on pregnancy-related complications from SARS, MERS, and COVID-19 showed an increased prevalence of preterm birth and miscarriage, along with fetal distress and necessity for ICU treatment. […] The progression from pulmonary disease to a systemic condition has a poor outcome and can result in multi-organ failure and death.
  • #59
    https://link.springer.com/article/10.1007/s11547-020-01311-x
    In 2012, a new coronavirus (MERS-CoV) was recognized to cause the Middle East respiratory syndrome (MERS) that presented with more than 30% mortality (858 reported deaths) and spread to 27 countries. […] MERS and SARS have been associated with acute kidney injury (AKI), possibly caused by virus tropism for the kidneys and secondary damage due to systemic inflammation and hypotension. […] MERS-CoV infection usually causes severe extra-pulmonary organ dysfunction, and most patients present with shock, acute kidney injury, and thrombocytopenia. […] The exact mechanism of renal dysfunction is not well understood; however, studies have shown viral tropism for kidney cells ex vivo, suggesting MERS-CoV could induce apoptosis in the kidney. […] A systematic review on pregnancy-related complications from SARS, MERS, and COVID-19 showed an increased prevalence of preterm birth and miscarriage, along with fetal distress and necessity for ICU treatment. […] The progression from pulmonary disease to a systemic condition has a poor outcome and can result in multi-organ failure and death.
  • #60 Middle East Respiratory Syndrome (MERS)
    https://encyclopedia.nm.org/134,252
    Middle East respiratory syndrome (MERS) is caused by a common type of virus called coronavirus. […] The coronavirus (MERS-CoV) that causes MERS is related to the one that causes COVID-19. […] The virus causing MERS is related to the one that causes COVID-19. […] In some cases, MERS can cause severe problems. These include pneumonia, respiratory failure, failure of the kidneys and other organs, and septic shock. […] Currently there is no cure for MERS. But sometimes experimental treatments are offered. Treatment is mostly aimed at helping support your body while it fights the disease.
  • #61 MERS – Epidemiology
    https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/middle-east-respiratory-syndrome-mers/
    Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by a coronavirus known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS typically causes a severe respiratory illness that is often fatal. […] MERS-CoV is not the same as the SARS-associated coronaviruses SARS-CoV, which causes severe acute respiratory syndrome (SARS), or SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19). […] MERS-CoV does NOT appear to spread readily in communities. […] While the exact mode of transmission is not clear, MERS-CoV is felt to be spread by close contact by respiratory droplets from an infected person to another person. […] Some people with MERS might become infected after having contact with infected camels. […] MERS is diagnosed based on the patients history, epidemiological data, symptoms and signs, imaging findings, and laboratory data. […] Currently, there is no specific antiviral treatment for MERS. […] The current mortality rate from MERS is about 30-40%.
  • #62 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – ISID
    https://isid.org/guide/pathogens/mers-cov/
    MERS-CoV is an emerging new coronavirus, with less human to human transmission (with an estimated R0 of less than 0.7) but carrying a higher mortality than SARS. […] Some of the key similarities between SARS and MERS are: they are both caused by novel coronaviruses; they are zoonotic in nature; their original source is thought to be bats; they are both transmitted preferentially in HCFs; they both have no approved therapeutic agents or preventative vaccines; and both are controlled in HCFs with strict application of infection control practices. […] The major difference to date has been the higher reported mortality of MERS-CoV affected patients when compared to SARS (35% vs. 10%) and the slower spread of cases on a national and global level. […] MERS is a new and formidable epidemic that is challenging infection control programs. […] To contain this novel coronavirus, there is no room for error or relaxation of the highest standards of all features of infection control.
  • #63 Middle East Respiratory Syndrome Coronavirus (MERS-CoV): State of the Science
    https://www.mdpi.com/2076-2607/8/7/991
    MERS Coronavirus continues to circulate and infect human species constituting a significant threat with a fatality rate higher than SARS-COV-2. […] Dromedary camels serve as a major reservoir of the virus with silent spillover human infections. […] Although dromedary camels are well-known to be the main reservoir of the virus, the origin of the virus and how it was introduced into camels, whether direct or indirect transmission from bats, is not very well understood.
  • #64 The Middle East Respiratory Syndrome (MERS)
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7127753/
    MERS-CoV does not transmit easily from person-to-person unless there is close contact, such as occurs when providing care to a patient in the household or nosocomial setting when the diagnosis of MERS-CoV has not yet been recognized and there are lapses in instituting infection control measures. […] MERS-CoV infection appears to cause more severe disease in older people, people with weakened immune systems, and those with chronic diseases, such as renal disease, cancer, chronic lung disease, and diabetes. […] Currently there are no specific treatments to treat MERS-CoV. […] MERS-CoV remains an important public health risk and possible consequences of further international spread could be serious in view of the patterns of nosocomial transmission within health care facilities.
  • #65 Middle East respiratory syndrome (MERS) – including symptoms, treatment and prevention | SA Health
    https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/middle+east+respiratory+syndrome/middle+east+respiratory+syndrome+mers+-+including+symptoms+treatment+and+prevention
    Middle East respiratory syndrome (MERS) was first recognised in Saudi Arabia in 2012. It is caused by infection with Middle East respiratory syndrome coronavirus (MERS-CoV). […] There is strong evidence to suggest that camels serve as a reservoir for the virus and that infection in humans can be acquired from contact with camels and camel products. MERS-CoV does not appear to be present in Australian camels. […] MERS-CoV mainly causes a respiratory infection, which can range from mild illness, to severe pneumonia. Older persons and those with diabetes or immunosuppression are at higher risk of severe illness. […] There is no specific treatment for MERS. […] There is no vaccine available to prevent MERS.

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