Monday, June 24, 2013

Lancet Studay Links #MERS Case to UAE and Qatar #Coronavirus

There is much news today, regarding a case back in March 2013.  A 73yo from UAE.  The news today, is in relation to a Lancet study, in regards to the sequencing, that ties the man to Qatar, the Lancet publication is below.

Prof Christian Drosten MD a Corresponding AuthorEmail Address, Michael Seilmaier MD b, Victor M Corman MD a, Wulf Hartmann MD b, Gregor Scheible MD b, Prof Stefan Sack MD b, Wolfgang Guggemos MD b, Rene Kallies PhD a, Doreen Muth PhD a, Sandra Junglen PhD a, Marcel A Müller PhD a, Walter Haas MD c, Hana Guberina MD d, Tim Röhnisch MD f, Prof Monika Schmid-Wendtner MD f, Souhaib Aldabbagh DVM a, Prof Ulf Dittmer PhD e, Hermann Gold MD g, Petra Graf MD g, Frank Bonin MD h, Andrew Rambaut DPhil i j, Prof Clemens-Martin Wendtner MD b Corresponding AuthorEmail Address



The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging virus involved in cases and case clusters of severe acute respiratory infection in the Arabian Peninsula, Tunisia, Morocco, France, Italy, Germany, and the UK. We provide a full description of a fatal case of MERS-CoV infection and associated phylogenetic analyses.


We report data for a patient who was admitted to the Klinikum Schwabing (Munich, Germany) for severe acute respiratory infection. We did diagnostic RT-PCR and indirect immunofluorescence. From time of diagnosis, respiratory, faecal, and urine samples were obtained for virus quantification. We constructed a maximum likelihood tree of the five available complete MERS-CoV genomes.


A 73-year-old man from Abu Dhabi, United Arab Emirates, was transferred to Klinikum Schwabing on March 19, 2013, on day 11 of illness. He had been diagnosed with multiple myeloma in 2008, and had received several lines of treatment. The patient died on day 18, due to septic shock. MERS-CoV was detected in two samples of bronchoalveolar fluid. Viral loads were highest in samples from the lower respiratory tract (up to 1·2 × 106 copies per mL). Maximum virus concentration in urine samples was 2691 RNA copies per mL on day 13; the virus was not present in the urine after renal failure on day 14. Stool samples obtained on days 12 and 16 contained the virus, with up to 1031 RNA copies per g (close to the lowest detection limit of the assay). One of two oronasal swabs obtained on day 16 were positive, but yielded little viral RNA (5370 copies per mL). No virus was detected in blood. The full virus genome was combined with four other available full genome sequences in a maximum likelihood phylogeny, correlating branch lengths with dates of isolation. The time of the common ancestor was halfway through 2011. Addition of novel genome data from an unlinked case treated 6 months previously in Essen, Germany, showed a clustering of viruses derived from Qatar and the United Arab Emirates.


We have provided the first complete viral load profile in a case of MERS-CoV infection. MERS-CoV might have shedding patterns that are different from those of severe acute respiratory syndrome and so might need alternative diagnostic approaches.


European Union; German Centre for Infection Research; German Research Council; and German Ministry for Education and Research.

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