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In an ahead-of-print article in Virology Journal [1], Cui and associates report the results of a study of the molecular evolution of DPP4, a cell-surface receptor, across the mammalian phylogeny.   Their analyses showed that the dN/dS value on the bat lineage (0.96) was four times greater than the mammalian average leading to the conclusion that Middle East respiratory syndrome coronavirus (MERS-CoV) ultimately has a bat-origin. From the article – Our analysis therefore suggests that the evolutionary lineage leading to current MERS-CoV co-evolved with bat hosts for an extended time period, eventually jumping species boundaries to infect humans and perhaps through an intermediate host. As such, the emergence of MERS-CoV may parallel that of the related SARS-CoV. Although one bat species, Taphozous erforatus , in Saudi Arabia has been found to harbour a small RdRp (RNA-Dependent RNA Polymerase) fragment of MERS-CoV, a larger viral sampling of bats and other animals with close ex...

As previously noted, at least seven clusters of Middle East respiratory syndrome coronavirus (MERS-CoV) cases have occurred in the Kingdom of Saudi Arabia (KSA) [1]. An additional eighth cluster can be inferred from official reports for the city of Medina [2]. Besides Medina, 3 clusters have been reported from Riyadh, and one each from Al Hofuf, Mecca, Asir Province (Bisha?), and Hafar Al-Batin.  Besides these clusters, in July, the World Health Organization (WHO) reported laboratory confirmation of a female healthcare worker from Hafar Al-Batin   who had contact with a previously confirmed case [3]. The only prior confirmed case from Hafar Al-Batin   was a 16-year-old male who was reported to have died in June [4]. This would constitute another cluster from Hafar Al-Batin. Since August 1, the KSA   Ministry of Health has reported at least seven individuals from Riyadh who were in contact with previously confirmed cases. Because of the lack of case details it is not...

Recently, the European Centre for Disease Prevention and Control (ECDC) produced a summary report on the status of the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak for the 130+ cases that have been reported since March 2012 [1]. While epidemiological data about these cases are presented in this report, several aspects of the report need further elaboration and discussion. As discussed on a USA Center for Disease Control web page [2] and noted in the ECDC report,   human clusters are prevalent for this novel disease. At least 14 MERS-CoV clusters have been reported. Single clusters have been reported from several countries, France, Italy, Jordan, Tunisia, and the United Kingdom. And the Kingdom of Saudi Arabia, which has reported more than 100 MERS-CoV cases, has experienced at least seven cluster outbreaks in seven separate geographic areas. The ECDC authors state We identified 14 clusters of 2-34 cases, where the primary cases were identified or suspected. How...

Since February 2013, a novel avian influenza virus, A (H7N9), has infected more than   130 individuals in the People’s Republic of China and Taiwan. At least 44 of these infected individuals have died.   In a current article in the journal Respiratory Care , Chinese medical specialists report on the case-patient details of the first officially confirmed case from March 2013.[1]   Even with treatment, The 87-year-old man died a few days after admission to the hospital on March 4, 2013.   The authors state  . . . we identified the world’s first human case of avian influenza A H7N9 virus infection. When we first admitted this patient, there were no health care guidelines that we could follow. Even in the absence of a definite diagnosis of influenza infection, we actively carried out isolation protection in accordance with the   standard   hospital   infection-protection   protocols   while   closely coordinating the activities of diff...

Since August 28, seven cases of Middle East respiratory syndrome coronavirus (MERS-Cov) infection have been reported from the city of Madinah (Medina) by the Kingdom of Saudi Arabia Ministry of Health. Only minimal information about these cases has been provided in media statements.   The table below presents the information on these seven cases. Several have had contact with previously confirmed cases. Three individuals have died. Two individuals including one healthcare worker are reported as asymptomatic. And two individuals including the first reported case from Medina are still being treated.   Although it is possible that the initial case, the 55M, may have died and is double counted and reported as Case 2 in the table below. It is difficult to reconcile this case list with unconfirmed media reports from September 7 of   a doctor’s death in Medina. [1] Without more information, it is not possible to speculate whether there is one or more clusters, and whether or no...