Family Cluster of Middle East Respiratory Syndrome Coronavirus Infections

Abstract

A human coronavirus, called the Middle East respiratory syndrome coronavirus (MERS-CoV), was first identified in September 2012 in samples obtained from a Saudi Arabian businessman who died from acute respiratory failure. Since then, 49 cases of infections caused by MERS-CoV (previously called a novel coronavirus) with 26 deaths have been reported to date. In this report, we describe a family case cluster of MERS-CoV infection, including the clinical presentation, treatment outcomes, and household relationships of three young men who became ill with MERS-CoV infection after the hospitalization of an elderly male relative, who died of the disease. Twenty-four other family members living in the same household and 124 attending staff members at the hospitals did not become ill. MERS-CoV infection may cause a spectrum of clinical illness. Although an animal reservoir is suspected, none has been discovered. Meanwhile, global concern rests on the ability of MERS-CoV to cause major illness in close contacts of patients.

Lack of Transmission among Close Contacts of Patient with Imported Case of Middle East Respiratory Syndrome into the United States, 2014

“…Similarly, the absence of transmission to the community contact may have been due to the case-patient's lack of respiratory symptoms during the 2 meetings. The absence of transmission to household and community contacts in this investigation is similar to that seen in contact investigations of several other patients with MERS (11-13); however, in other settings, transmission to household members who provided care to persons with MERS-CoV infection have been reported, and household clusters have been documented (3)(4)(5)(6)(7)16).…”

Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels, Qatar, April 2014

“…While the source or reservoir of MERS-CoV is unknown, the disease is transmitted from person to person, for example by close contacts or in healthcare facilities [17][18][19][20][21][22][23][24]. Based on information related to the first 77 cases, the basic reproduction number of the infection (R0) was estimated to be 0.69 (95% CI 0.50-0.92) at the time [25], indicating a low pandemic potential [26].…”

Epidemiological and Clinical Characteristics of Patients with Middle East Respiratory Syndrome Coronavirus in Iran in 2014

“…MERS-CoV has a very high mortality rate (2,3). Studies have indicated that this infection can present a wide range of respiratory and non-respiratory symptoms (4)(5)(6)(7)(8)(9). Disease presentations may not start with respiratory symptoms.…”