Middle East respiratory syndrome coronavirus—a 10-year (2012-2022) global analysis of human and camel infections, genomic sequences, lineages, and geographical origins. (June 2023)

• Record Type: Journal Article
• Authors: Azhar, Esam I.; Velavan, Thirumalaisamy P.; Rungsung, Ikrormi; Traore, Tieble; Hui, David S.; McCloskey, Brian; El-Kafrawy, Sherif A.; Zumla, Alimuddin
• Is Part Of: International journal of infectious diseases. Volume 131(2023)
• Page Start: 87
• Page End: 94
• Publication Date: 2023-06
• Subjects: MERS-CoV -- Genetic diversity -- S-gene -- Phylogenetic analysis -- Zoonotic reservoir -- MERS; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2023.03.046
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) remains on the World Health Organization priority pathogens list. The World Health Organization reports that 2184 of a total of 2591 human MERS cases are from Saudi Arabia. Three MERS-CoV clades were identified: clade B (n = 462), clade A (n = 10), and clade C (n = 5). New MERS-CoV variants and co-infections continue to circulate in camels. Proactive virus surveillance and genomic analyses in camels and humans is required. Abstract: Objectives: The World Health Organization priority zoonotic pathogen Middle East respiratory syndrome (MERS) coronavirus (CoV) has a high case fatality rate in humans and circulates in camels worldwide. Methods: We performed a global analysis of human and camel MERS-CoV infections, epidemiology, genomic sequences, clades, lineages, and geographical origins for the period January 1, 2012 to August 3, 2022. MERS-CoV Surface gene sequences (4061 bp) were extracted from GenBank, and a phylogenetic maximum likelihood tree was constructed. Results: As of August 2022, 2591 human MERS cases from 26 countries were reported to the World Health Organization (Saudi Arabia, 2184 cases, including 813 deaths [case fatality rate: 37.2%]) Although declining in numbers, MERS cases continue to be reported from the Middle East. A total of 728 MERS-CoV genomes were identified (the largest numbers were from Saudi Arabia [222: human = 146, camels = 76] and the United Arab Emirates [176: human = 21, camels = 155]). A total of 501 'S'-gene sequences were used for phylogenetic tree construction (camels [n = 264], humans [n = 226], bats [n = 8], other [n=3]). Three MERS-CoV clades were identified: clade B, which is the largest, followed by clade A and clade C. Of the 462 clade B lineages, lineage 5 was predominant (n = 177). Conclusion: MERS-CoV remains a threat to global health security. MERS-CoV variants continue circulating in humans and camels. The recombination rates indicate co-infections with different MERS-CoV lineages. Proactive surveillance of MERS-CoV infections and variants of concern in camels and humans worldwide, and development of a MERS vaccine, are essential for epidemic preparedness.