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MERS CoV

Coronaviruses are a large, diverse group of viruses that affect many animal species. A few of these viruses cause a wide range of respiratory illness in humans, typically with common cold symptoms. A novel coronavirus was identified in 2012, which has been named Middle East respiratory syndrome coronavirus (MERS-CoV). Genetic sequence data indicate that this novel coronavirus is a beta-coronavirus similar to bat coronaviruses and unrelated to any other coronavirus described in humans, including the coronavirus that caused severe acute respiratory syndrome (SARS).

The first patient was a 60 year old man from Saudi Arabia, who was hospitalized in June 2012 and subsequently died.  The second patient was a 49 year old man from Qatar who developed pulmonary and renal failure in September 2012. As of May 12, 2014, 536 laboratory-confirmed cases of MERS-CoV infection have been reported by WHO. Although some individuals experience only mild illness, 62% of cases have develoed severe respiratory illness requiring hospitalization, Mortality rate has been 27%. All reported cases have been directly or indirectly linked through travel or residence to seven countries in the Arabian Peninsula including Saudi Arabia, UAE, Qatar, Oman, Jordan, Kuwait, and Yemen. Travel associated MERS cases have been reported in countries outside the Arabian Peninsula including the United Kingdom, France, Tunisia, and Italy, Malaysia, Greece, and Egypt.

Recently, CDC reported the first two cases of MERS-CoV occurring in the United States. The first patient was a health care worker employed in Saudi Arabia who returned to the United States on April 27, 2014 and was hospitalized in Indiana on April 28, 2014. The second case involved a traveler from Saudi Arabia who was hospitalized in Florida on May 11, 2014.

Suspected cases should be reported immediately to CDC, who also provides laboratory confirmation by MERS CoV PCR testing. CDC recommends collecting multiple specimens from different sites at different times after symptom onset including nasopharyngeal swab, oropharyngeal swab, sputum, serum, and stool/rectal swab. Collection of lower respiratory specimens such as sputum or bronchoalveolar lavage is recommended because MERS-CoV has been detected in these specimens even though nasopharyngeal swabs tested negative.

Guidance on evaluation of patients for MERS, infection control, interim home care and isolation, and collection and testing of clinical specimens for MERS-CoV infection is available on CDC's MERS website (http://www.cdc.gov/coronavirus/mers/index.html).

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