Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV)

First reported in September 2012, the Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) has resulted in 206 laboratory-confirmed deaths, with a 42% mortality rate as of 27 March 2014. Closely related coronaviruses have been isolated in bats, but most evidence suggests that humans have become infected directly from camels in a number of separate transmission events, with limited human-to-human transmission reported thus far. The majority of cases originated in the Middle East (predominantly Saudi Arabia), including all the index cases. Clinical manifestations primarily involve fever, chills, and rapidly progressive respiratory failure, often resulting in an acute respiratory distress syndrome, with a minority of patients reporting gastrointestinal symptoms, as well. The majority of critically ill patients are older males with medical co-morbidities, and a large number of minimally symptomatic cases likely go undetected. Unfortunately, attempted therapies have all been unsuccessful thus far, and treatment remains supportive care.