Unanswered questions about the Middle East respiratory syndrome coronavirus (MERS-CoV)

被引:12
作者
Gardner L.M. [1 ,2 ]
Macintyre C.R. [3 ]
机构
[1] CE 112 School of Civil and Environmental Engineering, University of New South Wales, Sydney
[2] NICTA, Sydney
[3] School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney
关键词
Emerging infectious disease; Epidemiology; MERS-CoV;
D O I
10.1186/1756-0500-7-358
中图分类号
学科分类号
摘要
Background: The Middle East respiratory syndrome coronavirus (MERS-CoV) represents a current threat to the Arabian Peninsula, and potential pandemic disease. As of June 3, 2014, MERS CoV has reportedly infected 688 people and killed 282. We briefly summarize the state of the outbreak, and highlight unanswered questions and various explanations for the observed epidemiology. Findings. The continuing but infrequent cases of MERS-CoV reported over the past two years have been puzzling and difficult to explain. The epidemiology of MERS-CoV, with many sporadic cases and a few hospital outbreaks, yet no sustained epidemic, suggests a low reproductive number. Furthermore, a clear source of infection to humans remains unknown. Also puzzling is the fact that MERS-CoV has been present in Saudi Arabia over several mass gatherings, including the 2012 and 2013 Hajj and Umrah pilgrimages, which predispose to epidemics, without an epidemic arising. Conclusions: The observed epidemiology of MERS-CoV is quite distinct and does not clearly fit either a sporadic or epidemic pattern. Possible explanations of the unusual features of the epidemiology of MERS-CoV include sporadic ongoing infections from a non-human source; human to human transmission with a large proportion of undetected cases; or a combination of both. The virus has been identified in camels; however the mode of transmission of the virus to humans remains unknown, and many cases have no history of animal contact. In order to gain a better understanding of the epidemiology of MERS CoV, further investigation is warranted. © 2014 Gardner and MacIntyre; licensee BioMed Central Ltd.
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