title: Middle East respiratory syndrome coronavirus disease is rare in children: An update from Saudi Arabia.
abstract: OBJECTIVE
  To summarize the reported Middle East respiratory syndrome-coronavirus (MERS-CoV) cases, the associated clinical presentations and the outcomes.
  
  
  METHODS
  We searched the Saudi Ministry of Health website, the World Health Organization website, and the Flutracker website. We also searched MEDLINE and PubMed for the keywords: Middle East respiratory syndrome-coronavirus, MERS-CoV in combination with pediatric, children, childhood, infancy and pregnancy from the initial discovery of the virus in 2012 to 2016. The retrieved articles were also read to further find other articles. Relevant data were placed into an excel sheet and analyzed accordingly. Descriptive analytic statistics were used in the final analysis as deemed necessary.
  
  
  RESULTS
  From June 2012 to April 19, 2016, there were a total of 31 pediatric MERS-CoV cases. Of these cases 13 (42%) were asymptomatic and the male to female ratio was 1.7:1. The mean age of patients was 9.8 ± 5.4 years. Twenty-five (80.6%) of the cases were reported from the Kingdom of Saudi Arabia. The most common source of infection was household contact (10 of 15 with reported source) and 5 patients acquired infection within a health care facility. Using real time reverse transcriptase polymerase chain reaction of pediatric patients revealed that 9 out of 552 (1.6%) was positive in the Kingdom of Saudi Arabia.
  
  
  CONCLUSIONS
  Utilizing serology for MERS-CoV infection in Jordan and Saudi Arabia did not reveal any positive patients. Thus, the number of the pediatric MERS-CoV is low; the exact reason for the low prevalence of the disease in children is not known.
authors.affiliation: Jaffar A Al-Tawfiq, Johns Hopkins Aramco Healthcare, Dhahran 31311, Kingdom of Saudi Arabia.
authors.forename: Jaffar A
authors.initials: JA
authors.lastname: Al-Tawfiq
authors.affiliation: Jaffar A Al-Tawfiq, Johns Hopkins Aramco Healthcare, Dhahran 31311, Kingdom of Saudi Arabia.
authors.forename: Rana F
authors.initials: RF
authors.lastname: Kattan
authors.affiliation: Jaffar A Al-Tawfiq, Johns Hopkins Aramco Healthcare, Dhahran 31311, Kingdom of Saudi Arabia.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Memish
keywords: Children; Middle East respiratory syndrome-coronavirus; Pediatric; Respiratory tract infection