Middle East respiratory syndrome coronavirus disease in children.
BACKGROUND
In the initial description of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, many affected patients were adults with underlying medical comorbidities. Data on the clinical presentation and outcome of pediatric cases are lacking. We report the clinical presentation and outcome of MERS-CoV infection in 11 pediatric patients.


METHODS
The clinical presentation, demographic and laboratory data of pediatric patients with MERS-CoV were analyzed.


RESULTS
A total of 11 pediatric cases that tested positive by screening and confirmatory polymerase chain reaction for MERS-CoV were reported from Saudi Arabia. Two patients were symptomatic and the other 9 cases were asymptomatic. The median age of patients was 13 (range 2-16) years. There were 8 females and 3 males (2.7:1 ratio). One symptomatic patient died and the other symptomatic patient recovered. The diagnosis of patients was based on positive nasopharyngeal swabs on 10 patients.


CONCLUSIONS
MERS-CoV disease is not limited to adults. Most cases of childhood MERS-CoV infection were asymptomatic and tested positive during contact investigation of older patients. Severe disease can occur in children with underlying conditions.
From the *Al-Faisal University, Riyadh; †Saudi Aramco Medical Services Organisation, Saudi ARAMCO, Dhahran; ‡Infection Prevention and Control Program, Public Health Directorate, Ministry of Health; §King Faisal Specialist Hospital; ¶Alhada Military Hospital; ‖Communicable Disease Program, Ministry of Health; **Jeddah Regional Laboratory, Ministry of Health, Jeddah; ††College of Medicine, King Saud University; and ‡‡Minister of Health, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
Ziad A
ZA
Memish
Jaffar A
JA
Al-Tawfiq
Abdullah
A
Assiri
Fahad A
FA
AlRabiah
Sami
S
Al Hajjar
Ali
A
Albarrak
Hesham
H
Flemban
Rafat F
RF
Alhakeem
Hatem Q
HQ
Makhdoom
Sarah
S
Alsubaie
Abdullah A
AA
Al-Rabeeah
D000293:Adolescent; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D018352:Coronavirus Infections / Q000150:complications* / Q000175:diagnosis* / Q000821:virology; D003371:Cough / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000821:virology; D006801:Humans; D008297:Male; D065207:Middle East Respiratory Syndrome Coronavirus; D009305:Nasopharynx / Q000821:virology*; D012131:Respiratory Insufficiency / Q000821:virology