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Middle East Respiratory Syndrome Coronavirus Disease in Children

Memish, Ziad A. MD, FRCP*; Al-Tawfiq, Jaffar A MD; Assiri, Abdullah MD; AlRabiah, Fahad A. MD§; Al Hajjar, Sami MD§; Albarrak, Ali MD§; Flemban, Hesham MD; Alhakeem, Rafat F. MD; Makhdoom, Hatem Q. PhD**; Alsubaie, Sarah MD††; Al-Rabeeah, Abdullah A. MD, FRCS‡‡

The Pediatric Infectious Disease Journal: September 2014 - Volume 33 - Issue 9 - p 904–906
doi: 10.1097/INF.0000000000000325
Original Studies

Background: In the initial description of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, many affected patients were adults with underlying medical comorbidities. Data on the clinical presentation and outcome of pediatric cases are lacking. We report the clinical presentation and outcome of MERS-CoV infection in 11 pediatric patients.

Methods: The clinical presentation, demographic and laboratory data of pediatric patients with MERS-CoV were analyzed.

Results: A total of 11 pediatric cases that tested positive by screening and confirmatory polymerase chain reaction for MERS-CoV were reported from Saudi Arabia. Two patients were symptomatic and the other 9 cases were asymptomatic. The median age of patients was 13 (range 2–16) years. There were 8 females and 3 males (2.7:1 ratio). One symptomatic patient died and the other symptomatic patient recovered. The diagnosis of patients was based on positive nasopharyngeal swabs on 10 patients.

Conclusions: MERS-CoV disease is not limited to adults. Most cases of childhood MERS-CoV infection were asymptomatic and tested positive during contact investigation of older patients. Severe disease can occur in children with underlying conditions.

From the *Al-Faisal University, Riyadh; Saudi Aramco Medical Services Organisation, Saudi ARAMCO, Dhahran; Infection Prevention and Control Program, Public Health Directorate, Ministry of Health; §King Faisal Specialist Hospital; Alhada Military Hospital; Communicable Disease Program, Ministry of Health; **Jeddah Regional Laboratory, Ministry of Health, Jeddah; ††College of Medicine, King Saud University; and ‡‡Minister of Health, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.

Accepted for publication February 14, 2014.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Ziad A. Memish, MD, FRCP, FACP, Al-Faisal University, Riyadh 11176, Kingdom of Saudi Arabia. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.