Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Nov 8, 2016; 5(4): 391-396
Published online Nov 8, 2016. doi: 10.5409/wjcp.v5.i4.391
Middle East respiratory syndrome coronavirus disease is rare in children: An update from Saudi Arabia
Jaffar A Al-Tawfiq, Rana F Kattan, Ziad A Memish
Jaffar A Al-Tawfiq, Johns Hopkins Aramco Healthcare, Dhahran 31311, Kingdom of Saudi Arabia
Jaffar A Al-Tawfiq, Indiana University School of Medicine, Indianapolis, IN 46202, United States
Rana F Kattan, Department of Pediatric, King Saud bin Abdulaziz University for Health Sciences, King Abdullah Specialist Children’s Hospital, Riyadh 11514, Kingdom of Saudi Arabia
Ziad A Memish, Ministry of Health, Riyadh 1151, Kingdom of Saudi Arabia
Ziad A Memish, College of Medicine, Alfaisal University, Riyadh 11514, Kingdom of Saudi Arabia
Author contributions: Al-Tawfiq JA developed the research protocol, performed the research and data analysis; Al-Tawfiq JA, Kattan RF and Memish ZA authored and approved the article.
Conflict-of-interest statement: All authors have no competing interests to declare.
Data sharing statement: The dataset as presented in tables is available upon request to the corresponding author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ziad A Memish, Professor, College of Medicine, Alfaisal University, P.O. Box 54146, Riyadh 11514, Kingdom of Saudi Arabia. zmemish@yahoo.com
Telephone: +966-50-5483515 Fax: +966-11-2616464
Received: May 27, 2016
Peer-review started: May 30, 2016
First decision: July 6, 2016
Revised: August 16, 2016
Accepted: August 27, 2016
Article in press: August 29, 2016
Published online: November 8, 2016
Abstract
AIM

To summarize the reported Middle East respiratory syndrome-coronavirus (MERS-CoV) cases, the associated clinical presentations and the outcomes.

METHODS

We searched the Saudi Ministry of Health website, the World Health Organization website, and the Flutracker website. We also searched MEDLINE and PubMed for the keywords: Middle East respiratory syndrome-coronavirus, MERS-CoV in combination with pediatric, children, childhood, infancy and pregnancy from the initial discovery of the virus in 2012 to 2016. The retrieved articles were also read to further find other articles. Relevant data were placed into an excel sheet and analyzed accordingly. Descriptive analytic statistics were used in the final analysis as deemed necessary.

RESULTS

From June 2012 to April 19, 2016, there were a total of 31 pediatric MERS-CoV cases. Of these cases 13 (42%) were asymptomatic and the male to female ratio was 1.7:1. The mean age of patients was 9.8 ± 5.4 years. Twenty-five (80.6%) of the cases were reported from the Kingdom of Saudi Arabia. The most common source of infection was household contact (10 of 15 with reported source) and 5 patients acquired infection within a health care facility. Using real time reverse transcriptase polymerase chain reaction of pediatric patients revealed that 9 out of 552 (1.6%) was positive in the Kingdom of Saudi Arabia.

CONCLUSION

Utilizing serology for MERS-CoV infection in Jordan and Saudi Arabia did not reveal any positive patients. Thus, the number of the pediatric MERS-CoV is low; the exact reason for the low prevalence of the disease in children is not known.

Keywords: Pediatric, Middle East respiratory syndrome-coronavirus, Children, Respiratory tract infection

Core tip: The number of the pediatric Middle East respiratory syndrome-coronavirus (MERS-CoV) is low and the exact reason for the low prevalence is not known. A total of 31 pediatric MERS-CoV cases were reported since June 2012. Of all the cases 13 (42%) were asymptomatic and the male to female ratio was 1.7:1. The mean age of patients was 9.8 ± 5.4 years.The most common source of infection was household contact followed by infection within a health care facility. Using real time reverse transcriptase polymerase chain reaction of pediatric patients revealed that 9 out of 552 (1.6%) was positive in the Kingdom of Saudi Arabia.