Epidemiology and Transmission of Middle East Respiratory Syndrome Coronavirus
Summary
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a zoonotic betacoronavirus first identified in 2012. The primary animal reservoir is the dromedary camel, with serological surveys indicating widespread camel infection across the Arabian Peninsula and parts of Africa. Sporadic spill-over to humans occurs through direct or indirect contact with camels or camel products, leading to occasional clusters of primary cases. Human-to-human transmission is inefficient under most circumstances, with a basic reproduction number (R) typically below unity; however, amplification in healthcare settings has produced superspreading events that drive local outbreaks. Clinical presentation ranges from asymptomatic or mild respiratory illness to severe pneumonia and multi-organ failure, with higher fatality rates among older adults and those with comorbidities. Epidemiological studies have revealed substantial under-ascertainment of mild or subclinical infections, underscoring the importance of seroepidemiological surveys. Molecular analyses of viral sequences from camels and humans have delineated distinct viral clades and identified genetic variations linked to host adaptation. Control efforts focus on infection prevention and control measures in hospitals, surveillance of camel populations, and risk-based public health advisories to minimise zoonotic exposure. The global significance of MERS-CoV lies in its pandemic potential, its contribution to understanding coronavirus emergence, and the lessons it offers for preparedness against novel respiratory pathogens.
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Epidemiology and Transmission of Middle East Respiratory Syndrome Coronavirus publication trend
The graph below shows the total number of articles in epidemiology and transmission of middle east respiratory syndrome coronavirus across all publications each year (not limited to Nature Index journals).
Technical terms
Zoonotic transmission: Spread of a pathogen from animals to humans.
Superspreading event: Incident in which an infected individual transmits a pathogen to an unusually large number of secondary cases.
Dipeptidyl peptidase 4 (DPP4): Host cell receptor that MERS-CoV binds to initiate infection.
Reproduction number (R): Average number of secondary infections generated by one case in a susceptible population.
Nosocomial transmission: Spread of infection within healthcare settings.
References
- Genetic diversity and molecular epidemiology of Middle East Respiratory Syndrome Coronavirus in dromedaries in Ethiopia, 2017–2020. Emerging Microbes & Infections (2023).
- Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022–2023 - Volume 30, Number 3—March 2024 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2024).
- Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study. BMC Medicine (2015).
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