![]() Examples with specific geographical origins include severe acute respiratory syndrome coronavirus (SARS-CoV) and avian influenza A/H7N9 and H5N1 viruses in China, Nipah virus in Malaysia and Bangladesh, and Ebola and Marburg viruses in Africa ( 1, – 8, 329). Developing an effective camel MERS-CoV vaccine and implementing appropriate infection control measures may control the continuing epidemic.įrequent mixing of different animal species in markets in densely populated areas and human intrusions into the natural habitats of animals have facilitated the emergence of novel viruses. They should be evaluated in suitable animal models before clinical trials. Antivirals with potent in vitro activities include neutralizing monoclonal antibodies, antiviral peptides, interferons, mycophenolic acid, and lopinavir. Supportive treatment with extracorporeal membrane oxygenation and dialysis is often required in patients with organ failure. Reverse transcription-PCR on respiratory and/or extrapulmonary specimens rapidly establishes diagnosis. Clinical severity may be related to MERS-CoV's ability to infect a broad range of cells with DPP4 expression, evade the host innate immune response, and induce cytokine dysregulation. The disease is especially severe in elderly men with comorbidities. Most secondary cases are related to health care-associated clusters. Some of these patients had contacted camels which shed virus and/or had positive serology. All primary cases of MERS are epidemiologically linked to the Middle East. Subsequent hunting for novel coronaviruses (CoVs) led to the discovery of two additional human and over 40 animal CoVs, including the prototype lineage C betacoronaviruses, Tylonycteris bat CoV HKU4 and Pipistrellus bat CoV HKU5 these are phylogenetically closely related to the Middle East respiratory syndrome (MERS) CoV, which has affected more than 1,000 patients with over 35% fatality since its emergence in 2012. ![]() ![]() The source of the severe acute respiratory syndrome (SARS) epidemic was traced to wildlife market civets and ultimately to bats. ![]()
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