title: Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns.
abstract: The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 brought back memories of the occurrence of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002. More than 1500 MERS-CoV cases were recorded in 42 months with a case fatality rate (CFR) of 40%. Meanwhile, 8000 cases of SARS-CoV were confirmed in six months with a CFR of 10%. The clinical presentation of MERS-CoV ranges from mild and non-specific presentation to progressive and severe pneumonia. No predictive signs or symptoms exist to differentiate MERS-CoV from community-acquired pneumonia in hospitalized patients. An apparent heterogeneity was observed in transmission. Most MERS-CoV cases were secondary to large outbreaks in healthcare settings. These cases were secondary to community-acquired cases, which may also cause family outbreaks. Travel-associated MERS infection remains low. However, the virus exhibited a clear tendency to cause large outbreaks outside the Arabian Peninsula as exemplified by the outbreak in the Republic of Korea. In this review, we summarize the current knowledge about MERS-CoV and highlight travel-related issues.
authors.affiliation: Johns Hopkins Aramco Healthcare, Dhahran, 31311, Kingdom of Saudi Arabia.|Indiana University School of Medicine, Indianapolis, IN, 46202-3082, USA.
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
authors.affiliation: Department of Medicine, Section of Infectious Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Kingdom of Saudi Arabia.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Omrani
authors.affiliation: Ministry of Health, Riyadh, 11514, Kingdom of Saudi Arabia. zmemish@yahoo.com.|College of Medicine, Alfaisal University, Riyadh, 11533, Kingdom of Saudi Arabia. zmemish@yahoo.com.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D018352:Coronavirus Infections / Q000188:drug therapy / Q000453:epidemiology*; D003428:Cross Infection / Q000821:virology*; D004196:Disease Outbreaks; D006801:Humans; D065207:Middle East Respiratory Syndrome Coronavirus; D012621:Seasons; D014195:Travel
chemical_list: D000998:Antiviral Agents
keywords: MERS; Middle East respiratory syndrome; coronavirus