Published online Aug 12, 2015. doi: 10.5501/wjv.v4.i3.185
Peer-review started: February 8, 2015
First decision: April 10, 2015
Revised: April 18, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: August 12, 2015
Processing time: 187 Days and 15.1 Hours
In 2012 Middle-East respiratory syndrome coronavirus (MERS-CoV) was evolved in the Arabian Peninsula. Tremendous and successful efforts have been conducted to discover the genome structure, epidemiology, clinical signs, pathogenesis, diagnosis and antiviral therapy. Taphozous perforatus bats are the incriminated reservoir host and camels are the currently confirmed animal linker. The virus resulted in less than 1000 infected cases and 355 deaths. The case fatality rate of the MERS-CoV is high, however, many survivors of MERS-CoV infection showed inapparent infections and, in several cases, multiple co-infecting agents did exist. Although MERS-CoV appears to be a dangerous disease, it is argued here that a full assessment of current knowledge about the disease does not suggest that it is a truly scary killer.
Core tip: Middle-East respiratory syndrome coronavirus (MERS-CoV) emerged as a novel human coronavirus in 2012. Although it induces a high level of case fatality, fatal infections were recorded mainly in immune compromised patients and co-infections were frequently recorded. Camels are the currently known natural animal host and are susceptible to mild non-fatal infections. There is a growing evidence that the virus has been circulating in camels for decades in the Middle East, Africa and possibly other areas where camel herds are present. The fact that the virus has existed for decades, together with the absence of large-scale human mortalities from unknown respiratory infections, gives a first indication that MERS-CoV is not a particularly dangerous virus.