Middle East respiratory syndrome coronavirus infection causes: Difference between revisions

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==Overview==
==Overview==
Ten years after the [[outbreak]] of [[SARS-CoV]], the [[MERS-CoV]] is identified as the agent of a [[lethal]] [[pneumonia]] in patients who have recently been related to the Arabian Peninsula. The [[Middle east respiratory syndrome]] [[coronavirus]] ([[MERS-CoV]]), also termed '''EMC/2012''' (HCoV-EMC/2012), is positive-sense, single-stranded [[RNA]] novel [[species]] of the genus ''Betacoronavirus''.<ref name="deGroot">{{cite journal
MERS-CoV is caused by a lineage C betacoronavirus, an enveloped, spherical (120 nm in diameter), single-stranded, positive-strand RNA virus that belongs to the family''[[Coronaviridae]]''of the order''[[Nidovirales]]. ''The natural reservoir of MERS-CoV is unknown, but bats are thought to be the most likely natural reservoir. MERS-CoV is thought to have a zoonotic activity, whereby transmission occurs from animals to humans. Limited data is available to confirm or rule out human-to-human transmission.
|author=De Groot RJ |title=Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group |journal=Journal of Virology |date=15 May 2013
|doi=10.1128/JVI.01244-13 |pmid=23678167 |pmc=3700179 |volume=87 |issue=14 |pages=7790–2|author-separator= |author2=and others |displayauthors=1 }}</ref><ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref> First called ''novel coronavirus 2012'' or simply ''novel coronavirus'', it was first reported in 2012 after [[genome]] sequencing of the [[virus]], isolated from [[sputum]] samples of patients, affected by a 2012 outbreak of a "new [[flu]]". Until May 2013, [[MERS-CoV]] was being described as a ''[[SARS]]-like virus'' or colloquially as "Saudi [[SARS]]. Since then it is known to be distinct, not only from [[SARS-CoV]], but also from other known [[endemic]] [[coronaviruses]], such as betacoronavirus HCoV-OC43 and HCoV-HKU1, as well as from the [[common cold virus|common cold coronavirus]].<ref name="sciencenews27feb2013">{{cite news |first=Tina Hesman |last=Saey|title=Scientists race to understand deadly new virus: SARS-like infection causes severe illness, but may not spread quickly |journal=[[Science News]] |volume=183 |number=6 |date=27 February 2013| url=http://www.sciencenews.org/view/generic/id/348643/description/Scientists_race_to_understand_deadly_new_virus|page=5}}</ref> As of May 2014, several [[MERS-CoV]] cases have been reported in different countries, including Saudi Arabia, Malaysia, Jordan, Qatar, Egypt, the United Arab Emirates, Tunisia, Kuwait, Oman, Algeria, Bangladesh, the United Kingdom and the United States.<ref>{{cite web|url=http://rt.com/usa/158852-mers-florida-health-virus/|title=Patient with deadly MERS virus waited hours in Florida ER|date=2014-05-14|accessdate=2014-05-14}}</ref>


==Causes==
==Causes==
{| style="float: right;"
| [[File:MERS electron micrograph.jpg|250px|thumb|none|This negatively-stained transmission electron micrograph revealed ultrastructural morphology of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 3.jpg|250px|thumb|none|This highly-magnified negatively-stained transmission electron micrograph revealed ultrastructural morphology of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 2.jpg|250px|thumb|none|This thin section transmission electron micrograph revealed ultrastructural morphology of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 4.jpg|250px|thumb|none|This highly-magnified transmission electron micrograph revealed the presence of numerous Middle East Respiratory Syndrome Coronavirus (MERS-CoV) virions in this tissue culture sample. <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 5.jpg|250px|thumb|none|This highly-magnified transmission electron micrograph revealed the presence of numerous Middle East Respiratory Syndrome Coronavirus (MERS-CoV) virions in this tissue culture sample. <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|}
MERS-CoV is caused by a lineage C betacoronavirus.
MERS-CoV is caused by a lineage C betacoronavirus.


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===Genome===
===Genome===
The betacoronavirus contains a [[genome]] composed of 30,119 [[nucleotides]] that encodes structural and non-structural [[proteins]]. The genome is considered the largest among all RNA virus genomes, reaching 27-32 kb in size.
The betacoronavirus contains a [[genome]] composed of 30,119 [[nucleotides]] that encodes structural and non-structural [[proteins]]. The genome is considered the largest among all RNA virus genomes, reaching 27-32 kb in size.


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===Transmission===
===Transmission===
* MERS-CoV is thought to have a zoonotic activity, whereby transmission may occur from animals to humans. Bats are the natural host of the betacoronavirus, but it is unknown if MERS coronavirus transmission to humans is through bats, through an intermediate animal hosts following crossover and subsequent adaptation, or through a completely different host.
* MERS-CoV is thought to have a zoonotic activity, whereby transmission occurs from animals to humans.
* Limited data is available to confirm or rule out human-to-human transmission.  
* Although bats are the natural host of the betacoronavirus, it is unknown if MERS coronavirus transmission to humans is through bats, through an intermediate animal hosts following crossover and subsequent adaptation, or through a completely different host.
 
* Limited data is available to confirm or rule out human-to-human transmission.
Since may 29th 2013, the [[WHO]] has warned that the [[MERS-CoV]] should be considered a "threat to the entire world".<ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref> [[Transmission]] of [[MERS-CoV]] is prone to occur in [[immunocompromised]] patients, or in patients with other [[comorbidities]], such as [[diabetes]] or [[renal failure]].<ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref> In a study of 23 patients of the largest [[outbreak]] so far, in Saudi Arabia, was determined that 74% had underlying [[diabetes mellitus]], 52% [[renal disease]] and 43% [[lung disease]], highlighting the impact of underlying [[comorbidities]] in the overall risk of [[infection]] with [[MERS-CoV]]. This evidence is further supported by the fact that cases of [[infected]] family members and health-care workers was only reported in 1 to 2% of contacts.<ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref><ref name="AssiriMcGeer2013">{{cite journal|last1=Assiri|first1=Abdullah|last2=McGeer|first2=Allison|last3=Perl|first3=Trish M.|last4=Price|first4=Connie S.|last5=Al Rabeeah|first5=Abdullah A.|last6=Cummings|first6=Derek A.T.|last7=Alabdullatif|first7=Zaki N.|last8=Assad|first8=Maher|last9=Almulhim|first9=Abdulmohsen|last10=Makhdoom|first10=Hatem|last11=Madani|first11=Hossam|last12=Alhakeem|first12=Rafat|last13=Al-Tawfiq|first13=Jaffar A.|last14=Cotten|first14=Matthew|last15=Watson|first15=Simon J.|last16=Kellam|first16=Paul|last17=Zumla|first17=Alimuddin I.|last18=Memish|first18=Ziad A.|title=Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus|journal=New England Journal of Medicine|volume=369|issue=5|year=2013|pages=407–416|issn=0028-4793|doi=10.1056/NEJMoa1306742}}</ref>
 
At the present time it is not known the stage at which an [[infected]] [[MERS-CoV]] patient becomes [[contagious]], if he is able to [[transmission|transmit]] the [[virus]] while there is still no evidence [[respiratory illness]], or if there is [[transmission]] only after [[symptom]] onset. If the first is correct, then the the control of a larger [[outbreak]] will be more challenging, considering the prevalence of global traveling nowadays.<ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref>
 
One of the major gaps of knowledge about this [[virus]] is that its prevalence in the community is not known, therefore, and since most of the identified cases were patients with underlying [[comorbidities]], there is a possibility of [[MERS-CoV]] to be a common [[infection]] in Saudi-Arabia, with which patients without these comorbidties only develop minor [[respiratory]] [[symptoms]] or are [[asymptomatic]].<ref name="Perlman2013">{{cite journal|last1=Perlman|first1=S.|title=The Middle East Respiratory Syndrome--How Worried Should We Be?|journal=mBio|volume=4|issue=4|year=2013|pages=e00531-13–e00531-13|issn=2150-7511|doi=10.1128/mBio.00531-13}}</ref>


===Natural Reservoir===
===Natural Reservoir===
In contrast to the [[SARS-CoV]], that in its [[outbreak]] back in 2002/2003 had adapted so much to the [[human]] population that it could no longer [[infect]] bat [[cells]], the [[MERS-CoV]] is able to [[infect]] both [[animal]] and [[human]] [[cells]]. This fact suggests the existence of a possible bat to [[human]] [[transmission]].<ref name="MullerRaj2012">{{cite journal|last1=Muller|first1=M. A.|last2=Raj|first2=V. S.|last3=Muth|first3=D.|last4=Meyer|first4=B.|last5=Kallies|first5=S.|last6=Smits|first6=S. L.|last7=Wollny|first7=R.|last8=Bestebroer|first8=T. M.|last9=Specht|first9=S.|last10=Suliman|first10=T.|last11=Zimmermann|first11=K.|last12=Binger|first12=T.|last13=Eckerle|first13=I.|last14=Tschapka|first14=M.|last15=Zaki|first15=A. M.|last16=Osterhaus|first16=A. D. M. E.|last17=Fouchier|first17=R. A. M.|last18=Haagmans|first18=B. L.|last19=Drosten|first19=C.|title=Human Coronavirus EMC Does Not Require the SARS-Coronavirus Receptor and Maintains Broad Replicative Capability in Mammalian Cell Lines|journal=mBio|volume=3|issue=6|year=2012|pages=e00515-12–e00515-12|issn=2150-7511|doi=10.1128/mBio.00515-12}}</ref> However, considering the low probability of every [[infected]] [[human]] having been in contact with bats, it is more likely that another [[animal]] host, common in the Arabian Peninsula such as goats or camels, was the source for the [[infection]]. This is supported by the discovery of neutralizing [[antibodies]] for [[MERS-CoV]] in all dromedary camels of Oman, as well as by the full-[[genome]] sequence of [[MERS-CoV]] from dromedaries that was revealed to be 99.9% similar with the [[genome]] of [[human]] [[clade]] B of [[MERS-CoV]]. A further study on dromedary camels from Saudi Arabia, published in December 2013, revealed the presence of [[MERS-CoV]] in 90% of the evaluated dromedary camels, suggesting that dromedary camels not only could be the main reservoir of [[MERS-CoV]], but also the animal origin of [[MERS]]. This discoveries are of extreme relevance since they allow the definition of the [[human]] populations at risk, so that further protective measures might be taken.<ref name="ReuskenHaagmans2013">{{cite journal|last1=Reusken|first1=Chantal BEM|last2=Haagmans|first2=Bart L|last3=Müller|first3=Marcel A|last4=Gutierrez|first4=Carlos|last5=Godeke|first5=Gert-Jan|last6=Meyer|first6=Benjamin|last7=Muth|first7=Doreen|last8=Raj|first8=V Stalin|last9=Vries|first9=Laura Smits-De|last10=Corman|first10=Victor M|last11=Drexler|first11=Jan-Felix|last12=Smits|first12=Saskia L|last13=El Tahir|first13=Yasmin E|last14=De Sousa|first14=Rita|last15=van Beek|first15=Janko|last16=Nowotny|first16=Norbert|last17=van Maanen|first17=Kees|last18=Hidalgo-Hermoso|first18=Ezequiel|last19=Bosch|first19=Berend-Jan|last20=Rottier|first20=Peter|last21=Osterhaus|first21=Albert|last22=Gortázar-Schmidt|first22=Christian|last23=Drosten|first23=Christian|last24=Koopmans|first24=Marion PG|title=Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study|journal=The Lancet Infectious Diseases|volume=13|issue=10|year=2013|pages=859–866|issn=14733099|doi=10.1016/S1473-3099(13)70164-6}}</ref><ref>{{cite web|url=http://dx.doi.org/10.3201/eid2007.140571|title=MERS coronavirus in dromedary camel herd, Saudi Arabia.|last=Hemida first=Maged G|last2=Chu|first2=Daniel KW|last3=Poon|first3=Ranawaka|last4=Perera|first4=Mohammad A A|last5=Ng|first5= Hoiyee-Y|quote=The full-genome sequence of MERS-CoV from dromedaries in this study is 99.9% similar to genomes of human clade B MERS-CoV.|date=Jul 2014|accessdate=22 Apr 2014}}</ref><ref>{{cite journal|last=Hemida|first=MG|title=Middle East Respiratory Syndrome (MERS) coronavirus seroprevalence in domestic livestock in Saudi Arabia, 2010 to 2013|journal=Euro Surveillance|date=2013|volume=18|issue=50|url=http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20659}}</ref>
* The natural reservoir of MERS-CoV is unknown.
According to the March 2014 [[MERS-CoV]] summary update from the [[WHO]], recent studies claim that camels serve as the primary source of the [[MERS-CoV]] [[infection]] in [[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 [[coronavirus]] to the [[human]] type.<ref>{{cite web|url=http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_Update_27_March_2014.pdf?ua=1|title=Middle East respiratory syndrome coronavirus (MERS‐CoV)Summary and literature update – as of 27 March2014|date=27 Mar 2014|accessdate=24 Apr 2014}}</ref>
* The following are thought to be the natural reservoirs of MERS-CoV:
** Bats (The majority of reports hypothesized that bats are the natural reservoir of MERS-CoV)
** Camels
** Goats


==Gallery==
==Gallery==
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Image: Coronavirus02.jpeg|SEM reveals ultrastructural details at the site of interaction of two spherical-shaped Middle East Respiratory Syndrome Coronavirus (MERS-CoV) viral particles, colorized blue, that were on the surface of a camel epithelial cell, colorized red. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
Image: Coronavirus02.jpeg|SEM reveals ultrastructural details at the site of interaction of two spherical-shaped Middle East Respiratory Syndrome Coronavirus (MERS-CoV) viral particles, colorized blue, that were on the surface of a camel epithelial cell, colorized red. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
Image: Coronavirus01.jpeg|SEM reveals ultrastructural details at the site of interaction of numerous yellow-colored Middle East respiratory syndrome Coronavirus (MERS-CoV) viral particles on the surface of a Vero E6 cell (blue). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
Image: Coronavirus01.jpeg|SEM reveals ultrastructural details at the site of interaction of numerous yellow-colored Middle East respiratory syndrome Coronavirus (MERS-CoV) viral particles on the surface of a Vero E6 cell (blue). <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
{| style="float: right;"
| [[File:MERS electron micrograph.jpg|250px|thumb|none|This negatively-stained transmission electron micrograph revealed ultrastructural morphology of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 3.jpg|250px|thumb|none|This highly-magnified negatively-stained transmission electron micrograph revealed ultrastructural morphology of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 2.jpg|250px|thumb|none|This thin section transmission electron micrograph revealed ultrastructural morphology of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 4.jpg|250px|thumb|none|This highly-magnified transmission electron micrograph revealed the presence of numerous Middle East Respiratory Syndrome Coronavirus (MERS-CoV) virions in this tissue culture sample. <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|-
| [[File:MERS electron micrograph 5.jpg|250px|thumb|none|This highly-magnified transmission electron micrograph revealed the presence of numerous Middle East Respiratory Syndrome Coronavirus (MERS-CoV) virions in this tissue culture sample. <SMALL>Courtesy: ''[http://phil.cdc.gov/phil/home.asp Public Health Image Library (PHIL), Centers for Disease Control and Prevention (CDC)]''<ref>{{Cite web | title = http://phil.cdc.gov/phil/details.asp | url = http://phil.cdc.gov/phil/details.asp}}</ref></SMALL>]]
|}


</gallery>
</gallery>
==Related chapters==
* [[Middle East respiratory syndrome coronavirus]]


==References==
==References==
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[[category:Disease]]
[[category:Disease]]
[[Category:Infectious disease]]
 
[[category:Virology]]
[[category:Virology]]

Latest revision as of 18:04, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

MERS-CoV is caused by a lineage C betacoronavirus, an enveloped, spherical (120 nm in diameter), single-stranded, positive-strand RNA virus that belongs to the familyCoronaviridaeof the orderNidovirales. The natural reservoir of MERS-CoV is unknown, but bats are thought to be the most likely natural reservoir. MERS-CoV is thought to have a zoonotic activity, whereby transmission occurs from animals to humans. Limited data is available to confirm or rule out human-to-human transmission.

Causes

MERS-CoV is caused by a lineage C betacoronavirus.

Taxonomy

Betacoronavirus is an enveloped, spherical (120 nm in diameter), single-stranded, positive-strand RNA virus that belongs to the family Coronaviridae of the order Nidovirales.

Genome

The betacoronavirus contains a genome composed of 30,119 nucleotides that encodes structural and non-structural proteins. The genome is considered the largest among all RNA virus genomes, reaching 27-32 kb in size.

Tropism

Transmission

  • MERS-CoV is thought to have a zoonotic activity, whereby transmission occurs from animals to humans.
  • Although bats are the natural host of the betacoronavirus, it is unknown if MERS coronavirus transmission to humans is through bats, through an intermediate animal hosts following crossover and subsequent adaptation, or through a completely different host.
  • Limited data is available to confirm or rule out human-to-human transmission.

Natural Reservoir

  • The natural reservoir of MERS-CoV is unknown.
  • The following are thought to be the natural reservoirs of MERS-CoV:
    • Bats (The majority of reports hypothesized that bats are the natural reservoir of MERS-CoV)
    • Camels
    • Goats

Gallery

Related chapters

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 "Public Health Image Library (PHIL)".

External links

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