MERS-CoV: Understanding the Latest Human Coronavirus Threat

Abstract

Human coronaviruses cause both upper and lower respiratory tract infections in humans. In 2012, a sixth human coronavirus (hCoV) was isolated from a patient presenting with severe respiratory illness. The 60-year-old man died as a result of renal and respiratory failure after admission to a hospital in Jeddah, Saudi Arabia. The aetiological agent was eventually identified as a coronavirus and designated Middle East respiratory syndrome coronavirus (MERS-CoV). MERS-CoV has now been reported in more than 27 countries across the Middle East, Europe, North Africa and Asia. As of July 2017, 2040 MERS-CoV laboratory confirmed cases, resulting in 712 deaths, were reported globally, with a majority of these cases from the Arabian Peninsula. This review summarises the current understanding of MERS-CoV, with special reference to the (i) genome structure; (ii) clinical features; (iii) diagnosis of infection; and (iv) treatment and vaccine development.

Keywords: MERS-CoV; clinical features; human coronavirus; lower respiratory tract infections; respiratory viruses; upper respiratory tract infections.

Figure 1

Schematic organization of human coronavirus (α and β CoVs) genomes. HCoVs genomes are 26 kb to 32 kb in size. At the 5′-end, overlapping reading frames 1a and 1b (blue) make up two-thirds of the genome. The remaining one third of the genome (expanded region) encodes for the structural (white) and accessory proteins (grey).