title: Patterns of Human Respiratory Viruses and Lack of MERS-Coronavirus in Patients with Acute Upper Respiratory Tract Infections in Southwestern Province of Saudi Arabia.
abstract: We undertook enhanced surveillance of those presenting with respiratory symptoms at five healthcare centers by testing all symptomatic outpatients between November 2013 and January 2014 (winter time). Nasal swabs were collected from 182 patients and screened for MERS-CoV as well as other respiratory viruses using RT-PCR and multiplex microarray. A total of 75 (41.2%) of these patients had positive viral infection. MERS-CoV was not detected in any of the samples. Human rhinovirus (hRV) was the most detected pathogen (40.9%) followed by non-MERS-CoV human coronaviruses (19.3%), influenza (Flu) viruses (15.9%), and human respiratory syncytial virus (hRSV) (13.6%). Viruses differed markedly depending on age in which hRV, Flu A, and hCoV-OC43 were more prevalent in adults and RSV, hCoV-HKU1, and hCoV-NL63 were mostly restricted to children under the age of 15. Moreover, coinfection was not uncommon in this study, in which 17.3% of the infected patients had dual infections due to several combinations of viruses. Dual infections decreased with age and completely disappeared in people older than 45 years. Our study confirms that MERS-CoV is not common in the southwestern region of Saudi Arabia and shows high diversity and prevalence of other common respiratory viruses. This study also highlights the importance and contribution of enhanced surveillance systems for better infection control.
authors.affiliation: Unit of Medical Microbiology, Department of Medical Laboratory Technology, College of Applied Medical Science, Jazan University, Jazan, Saudi Arabia; Deanship of Scientific Affairs and Research, Jazan University, Jazan, Saudi Arabia.
authors.forename: Ahmed A
authors.identifier: 0000-0003-3650-1301
authors.initials: AA
authors.lastname: Abdulhaq
authors.affiliation: Unit of Medical Microbiology, Department of Medical Laboratory Technology, College of Applied Medical Science, Jazan University, Jazan, Saudi Arabia.
authors.forename: Vinod Kumar
authors.identifier: 0000-0003-4997-6592
authors.initials: VK
authors.lastname: Basode
authors.affiliation: Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Anwar M
authors.identifier: 0000-0002-8471-7011
authors.initials: AM
authors.lastname: Hashem
authors.affiliation: Department of Basic Health Sciences, Faculty of Pharmacy, Northern Border University, Arar, Saudi Arabia.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Alshrari
authors.affiliation: Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Nassrin A
authors.initials: NA
authors.lastname: Badroon
authors.affiliation: Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Hassan
authors.affiliation: Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Tagreed L
authors.initials: TL
authors.lastname: Alsubhi
authors.affiliation: Department of Public Health, Ministry of Health, Jazan, Saudi Arabia.
authors.forename: Yahia
authors.identifier: 0000-0002-1491-1441
authors.initials: Y
authors.lastname: Solan
authors.affiliation: Unit of Medical Microbiology, Department of Medical Laboratory Technology, College of Applied Medical Science, Jazan University, Jazan, Saudi Arabia.
authors.forename: Saleh
authors.initials: S
authors.lastname: Ejeeli
authors.affiliation: Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Esam I
authors.identifier: 0000-0002-1736-181X
authors.initials: EI
authors.lastname: Azhar