Middle east respiratory syndrome (MERS): The emerging zoonoses

Abstract

Middle East Respiratory Syndrome (MERS), also known as camel flu, is a zoonotic viral respiratory infection caused by the MERS-coronavirus (MERS-CoV). Symptoms may range from mild to severe. The MERS-CoV was first identified in September, 2012 among individuals with severe acute respiratory illness in Kingdom of Saudi Arabia. All primary cases of MERS are epidemiologically linked to the Middle East. The disease is especially severe in elderly men with comorbidities. Between 2012 and 7 July, 2015, 1368 laboratory-confirmed cases of human infection with (MERS-CoV) have been reported to WHO, including at least 487 deaths. The MERS-CoV has entered the human population in the Arabian Peninsula on multiple occasions from direct or indirect contact with infected dromedary camels or camel related products (e.g., raw camel milk). Twenty six countries have been affected since, 2012 by this virus. As of today, there is no vaccine available for MERS-CoV and there are no specific drugs or treatment regimens available. Medical care is supportive and aimed at to help relieve symptoms and treat complications. Reverse transcription-PCR on respiratory or extra pulmonary specimens rapidly establishes diagnosis. Supportive treatment with extra corporeal membrane oxygenation and dialysis is often required in patients with organ failure. Anti-virals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid and lopinavir.