MERS-coronavirus: From discovery to intervention

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) still causes outbreaks despite public awareness and implementation of health care measures, such as rapid viral diagnosis and patient quarantine. Here we describe the current epidemiological picture of MERS-CoV, focusing on humans and animals affected by this virus and propose specific intervention strategies that would be appropriate to control MERS-CoV. One-third of MERS-CoV patients develop severe lower respiratory tract infection and succumb to a fatal outcome; these patients would require effective therapeutic antiviral therapy. Because of the lack of such intervention strategies, supportive care is the best that can be offered at the moment. Limiting viral spread from symptomatic human cases to health care workers and family members, on the other hand, could be achieved through prophylactic administration of MERS-CoV neutralizing antibodies and vaccines. To ultimately prevent spread of the virus into the human population, however, vaccination of dromedary camels - currently the only confirmed animal host for MERS-CoV - may be the best option to achieve a sustained drop in human MERS cases in time. In the end, a One Health approach combining all these different efforts is needed to tackle this zoonotic outbreak.

Keywords: Coronavirus; Dromedary camel; Intervention; MERS; Review.

Fig. 1

Animals and humans potentially involved in the MERS outbreak and the intervention strategies that would apply to these different groups. Bats have been suggested to be one of the natural hosts of MERS-CoV, however the evidence supporting transmission of this virus from bats to other species is currently lacking. On the other hand, MERS-CoV has been isolated from both camels and humans. A combined One Health approach may be needed in order to stop ongoing outbreaks of MERS-CoV.