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Coronaviruses: severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus in travelers

Al-Tawfiq, Jaffar A.d,e; Zumla, Alimuddina,c; Memish, Ziad A.a,b

Current Opinion in Infectious Diseases: October 2014 - Volume 27 - Issue 5 - p 411–417
doi: 10.1097/QCO.0000000000000089
TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Joseph M. Vinetz and Yukari C. Manabe

Purpose of review Middle East respiratory syndrome coronavirus (MERS-CoV) is currently the focus of global attention. In this review, we describe virological, clinical, epidemiological features and interim travel advice and guidelines regarding MERS-CoV. We compare and contrast these with the severe acute respiratory syndrome coronavirus (SARS-CoV).

Recent findings MERS-CoV is a novel β CoV that causes a spectrum of clinical illness from asymptomatic to the rapidly fatal disease mainly in those with comorbid conditions. Epidemiological and genomic studies show zoonotic transmission to humans from camels and possibly bats. In contrast to the SARS-CoV pandemic, very limited global spread of fatal MERS-CoV has occurred outside the Arabian Peninsula. Although mainly currently restricted to Middle Eastern countries, MERS-CoV was reported from at least 10 other countries in Europe, Asia and the United States. All primary cases have been linked to travel to the Middle East. Nosocomial transmission of MERS-CoV has occurred because of poor infection control measures. Specific molecular diagnostic tests are available. Currently, there are no specific drugs for prevention or treatment for MERS-CoV and vaccine development is in the early stages. Advice and guidance for travelers to the Middle East are updated regularly by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

Summary Like SARS-CoV, MERS-CoV threatens global health security. All physicians and travelers to the Middle East should be aware of the new threat caused by MERS-CoV and follow CDC and WHO guidelines. Those who develop ill health during their trip or soon after their return should seek medical care.

aGlobal Centre for Mass Gatherings Medicine, Ministry of Health

bCollege of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Aarabia

cDepartment of Infection, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, and NIHR Biomedical Research Centre, University College London Hospitals, London, UK

dJohns Hopkins Aramco Healthcare, Dhahran, Kingdom of Saudi Arabia

eIndiana University School of Medicine, Indianapolis, Indiana, USA

Correspondence to Professor Ziad A. Memish, MD, FRCP(Can), FRCP(Edin), FRCP(Lond), FACP, Ministry of Health, P.O. Box 54146, Riyadh 11514, Saudi Arabia. Tel: +966 5054 83515; e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.