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

Abstract

The Middle East respiratory syndrome (MERS) is a new killer respiratory disease caused by the MERS coronavirus (CoV) first reported from the Kingdom of Saudi Arabia (KSA) in September 2012, after identification of a novel betacoronavirus from a Saudi Arabian patient who died from a severe respiratory illness [1, 2]. Retrospective study of stored samples later showed that, earlier in April 2012, a cluster of severe respiratory illness occurred in a public health hospital in Zarqa, Jordan, where eight healthcare workers (HCWs) were among the 11 people affected, with two deaths attributed to MERS-CoV [3]. The appearance of any new fatal infectious disease, and uncertainty about its origin and mode of transmission, invariably threatens global health security and its detection in western countries rapidly focuses political and scientific attention. Unfortunately, at the same time, it evokes unnecessary and unwarranted fierce scientific competition and discourse, as was illustrated by the HIV, severe acute respiratory syndrome (SARS) and avian influenza epidemics [4–8]. Disappointingly, the events surrounding the MERS-CoV have been no different [6]. MERS-CoV was first isolated, sequenced and patented by Erasmus Medical Centre (EMC) researchers in Rotterdam, the Netherlands, and initially it was named after their centre as HCoV-EMC [2]. Subsequently, international consensus led to renaming it as MERS-CoV [9]. Since the first KSA case report in September 2012, the KSA Ministry of Health (MoH) has recommended mandatory testing for MERS-CoV in all cases of respiratory illness requiring intensive care admission. 6 months after MERS-CoV was discovered, at the end of March 2013, there were only 17 MERS-CoV cases reported globally, nine of which were from KSA [10], four of these from one family case cluster [11]. This small number of MERS-CoV …