2012 Middle East respiratory syndrome coronavirus outbreak
From Wikipedia the free encyclopedia
|WHO total as of Jan 2020||2506||862||34%|
|ECDC total as of December 2019||2494||912||37%|
|Reported confirmed cases per country|
|United Arab Emirates||77||10||13%|
Since 2012, an outbreak of Middle East respiratory syndrome coronavirus has affected several countries, primarily in its namesake, the Middle East. The virus, which causes Middle East respiratory syndrome (MERS), is a novel coronavirus that was first identified in a patient from Jeddah, Saudi Arabia on June 6, 2012.
Sporadic cases, small clusters, and large outbreaks have been reported in 24 countries, with over 1,000 cases of the virus and over 400 deaths, up to the middle of 2015.
Most infections with human coronaviruses are mild and associated with common colds. The seven coronaviruses known to infect humans are in the alpha and beta genera. Both MERS-CoV and SARS-CoV (severe acute respiratory syndrome) are betacoronaviruses.
The Fourth Meeting of the International Health Regulations Emergency Committee concerning MERS-CoV was held on 4 December 2013. The committee decided that the conditions for a Public Health Emergency of International Concern (PHEIC) had not at present been met.
In November 2012, Egyptian virologist Dr. Ali Mohamed Zaki sent a virus sample from the first confirmed case in Saudi Arabia to virologist Ron Fouchier, a leading coronavirus researcher at the Erasmus Medical Center (EMC) in Rotterdam, The Netherlands. The second laboratory-proven case was in London, confirmed by the UK Health Protection Agency (HPA). The HPA named the virus the London1_novel CoV 2012.
On 8 November 2012, in an article published in the New England Journal of Medicine, Dr. Zaki and co-authors from the Erasmus Medical Center published more details, including a scientific name, Human Coronavirus-Erasmus Medical Center (HCoV-EMC), which was then used in scientific literature. In the article, they noted four respiratory human coronaviruses (HCoV) known to be endemic: 229E, OC43, NL63, and HKU1.
In May 2013, the Coronavirus Study Group of the International Committee on Taxonomy of Viruses adopted the official designation, the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). which was adopted by the World Health Organization to "provide uniformity and facilitate communication about the disease"
By May 2013, 10 of the 22 people who died and 22 of 44 cases reported were in Saudi Arabia and over 80% were male. This gender disparity is thought to be because most women in Saudi Arabia wear veils that cover the mouth and nose, decreasing their chances of being exposed to the virus. By 19 June 2013, MERS had infected at least 60 people with cases reported in Jordan, Qatar, Saudi Arabia, the United Arab Emirates (UAE), Tunisia, Germany, the United Kingdom (UK), France and Italy, with a death toll of 38. Saudi officials expressed great concern that millions of Muslims from around the world would potentially be exposed to the virus during the autumn Hajj, or pilgrimage to Mecca.
In May 2014, the WHO said it was monitoring the situation as global cases of MERS appeared to be on the rise, but said the situation did not yet constitute a health emergency. On 3 June 2014, Saudi Arabia revised the country's total cases of MERS to date to 688 cases after re-examining the data as part of an effort to better understand the disease. A total of 282 people had died from MERS. The numbers represented a jump of 113 cases and 92 deaths. Despite the jump in reported cases, the number of new cases was on the decline according to Tariq Madany, head of the medical advisory council. At the same time, the Saudi deputy health minister was fired, the second high level health official fired within two months.
On 4 June 2014, a study published in The New England Journal of Medicine indicated that camel-to-human transmission of the virus was possible. In November 2013, a man became ill with MERS after tending to a sick camel. DNA samples taken from the man, who eventually died of the virus, and the sick animal were virtually identical. This provided very strong evidence that the man had gotten the virus from the camel. As of June 2015, there were 1,227 confirmed human cases of MERS, resulting in 449 deaths (37% mortality).
On 20 May 2013, the novel coronavirus reached Tunisia killing one man and infecting two of his relatives. Tunisia was the eighth country to be affected by MERS-CoV after Jordan, Saudi Arabia, Qatar, the United Kingdom, France, Germany, and the United Arab Emirates.
According to a European Centre for Disease Prevention and Control (ECDC) publication, in April 2014, Tunisia had a total of 3 cases with 1 fatality.
Algeria experienced 2 cases and 1 fatality.
One case occurred in Egypt.
In May 2015, the first case in South Korea was confirmed in a man who had visited several Middle Eastern countries. As of 16 June 2015, a total of 150 cases had been infected, including 18 deaths, according to the World Health Organization (WHO). As of 29 June 2015, 32 people in South Korea had died from this outbreak, with 182 confirmed cases of infection. At least 3800 were quarantined.
On 16 April 2014, Malaysia reported its first MERS-COV related death. The person was a 54-year-old man who had traveled to Jeddah, Saudi Arabia, together with pilgrimage group composed of 18 people, from 15 to 28 March 2014. He became ill by 4 April, and sought remedy at a clinic in Johor on 7 April. He was hospitalized by 9 April and died on 13 April.
On 11 May 2014, two people in Medan were suspected infected by MERS-Cov (Middle Eastern Respiratory Syndrome-Corona Virus).
On 16 April 2014, an Overseas Filipino Worker (OFW) who returned from Al Ain City, United Arab Emirates was found positive for MERS-CoV at the Ninoy Aquino International Airport. The OFW was tested for the virus in the United Arab Emirates (UAE) but immediately travelled to Manila. Doctors from UAE later contacted the Philippines Department of Health (DOH) confirming the condition of the OFW. The OFW, who was working as a nurse in the UAE, had contact with a Filipino paramedic who had died recently in the said country. The OFW together with four of his family members who fetched him at the airport were quarantined. In a press release on 19 April, DOH announced that the OFW who UAE doctors found positive for MERS-CoV was found negative for the virus in an subsequent test by Research Institute for Tropical Medicine (RITM). Explaining further regarding the test, Secretary Enrique Ona explained, "Since ten days had lapsed from the reported testing date at the UAE, our task force right away got in touch with him and decided to perform a test on him, and fortunately, as well for the comfort of everybody, the findings of our Research Institute for Tropical Medicine, he tested negative." In the same press release, DOH also announced that they were tracking all other 414 passengers of Etihad Airways Flight 424 (the flight the OFW took from Abu Dhabi, UAE to Manila) in order that they should be tested.
On 11 February 2015, a 32-year-old Filipino nurse from Saudi Arabia, who was also 1 month pregnant, was the country's first MERS-CoV case, DOH confirmed after the test for the virus turned out to be positive. The Evangelista Medical Hospital in San Pedro, Laguna, the facility where the patient was first admitted, was temporarily closed by DOH for fourteen days. On 17 February 2015, all those who had exposure or had contact with the said nurse were tested negative for the virus. On 6 March 2015, The Department of Foreign Affairs confirmed that three Filipino female healthcare workers in Saudi Arabia were infected with MERS-CoV.
On 6 July 2015, DOH confirmed the second detected case of MERS-CoV in the country. The patient who had contracted the virus was from the Middle East and was referred to the RITM on 4 July 2015. Another person, who was also showing symptoms, was placed in isolation after he had close contact with the said patient; eight others, who also had had contact with the patient, were identified. DOH took steps to track all the people with whom the patient had had contact.
The first known case of a previously unknown coronavirus was identified in a 60-year-old Saudi Arabian man with acute pneumonia, who died of kidney failure in Jeddah on June 20, 2012. As of 12 May 2013, two more deaths had been reported in the al-Ahsa region of Saudi Arabia. In the latest cluster of infections, 15 cases had been confirmed, and nine of those patients had died. Ten of the 22 people who died and 22 of 44 cases reported were in Saudi Arabia. An unconfirmed case in another Saudi citizen, for which no clinical information was available, was also reported around this time. On 22 September 2012, the Saudi Ministry of Health (MOH) announced that the two cases involving Saudi citizens, caused by what they termed a "rare pattern of coronavirus," had both proven fatal.
Two of the Saudi Arabia cases were from the same family and from that family at least one additional person presented similar symptoms but tested negative for the novel coronavirus.
On 21 February 2013, WHO stated that there had been 13 laboratory-confirmed cases, 6 cases (4 fatal) from Saudi Arabia, 2 cases (both fatal) from Jordan, 2 cases from Qatar, and 3 from the UK.
In March 2013, the Saudi Arabia Ministry of Health reported the death of a 39-year-old man, the 15th case and 9th death reported to WHO. On 2 May 2013, the Saudi Ministry of Health announced five people died and two other people were in critical condition with confirmed cases of a SARS-like virus. The delays in obtaining data and absence of basic information (which would usefully include: sex, age, other medical conditions and smoking status) were noted and decried by Dr. Margaret Chan and in Pro-Med comments on numerous briefings. At the annual meeting of the world's health ministers, Dr. Chan, director-general of the World Health Organization, said the virus was now her "greatest concern."
On 28 May 2013, the Saudi Ministry of Health reported five more cases of MERS-CoV. The cases had been "recorded among citizens in the Eastern Region, ranging in age from 73 to 85 years, but they have all chronic diseases." With this announcement, the unofficial global case count reached 49 while the death toll stood at 24 according to the CDC. As of 26 June 34 deaths have been recorded in the kingdom.
On 1 August 2013, the World Health Organization announced three new MERS-CoV cases in that Saudi Arabia, all of them in women, two of whom were healthcare workers. "With the three new cases, Saudi Arabia's posted MERS tally increases to 74 cases with 39 deaths. The cases raise the WHO's MERS count to 94 cases and 46 deaths."
On 31 October 2013, the WHO announced that three patients in Saudi Arabia died of MERS. The patients were one woman and two men and "all had underlying medical conditions but all reported having had no contact with animals before falling ill".
Early on 23 April 2014, 11 new cases including a first case for Mecca were reported by the Health Ministry. An additional 13 cases were reported on the same day. With the additional reported cases, there were now a total of 285 cases with 83 deaths in the Kingdom.
A hospital-related outbreak in Riyadh brought the total in Saudi Arabia to 1,115 cases and 480 fatalities as of 18 August 2015. Since May 2015, most of the cases had occurred at the King Abdulaziz Medical City, a large national guard hospital.
Due to fears of the MERS virus, attendance in the hajj in 2013 was lower than the previous year. The Saudi government asked "elderly and chronically ill Muslims to avoid the hajj this year" and restricted the number of people allowed "to perform the pilgrimage".
Saudi Health Minister Abdullah Al-Rabia said "that authorities had so far detected no cases among the pilgrims" of MERS. However, the Spanish government, in November 2013, reported a woman in Spain, who had recently traveled to Saudi Arabia for the Islamic pilgrimage, contracted the disease.
In April 2012, six hospital workers were diagnosed with acute respiratory failure of unknown origin. Of the six, two died. All the cases were reported to the European Centre for Disease Prevention and Control (ECDC). After the September identification of a novel CoV strain, a retroactive analysis of the hospital workers was performed. Epidemiologists discovered the Jordan cases. Using stored laboratory samples for all six, it was found that samples from the two patients who had died tested positive for nCoV.
On 24 April 2014, a 25-year-old male was found positive for the coronavirus. He had history of exposure to camels and had consumed camel milk.
On 31 October 2013, the World Health Organization (WHO) confirmed that one person in Oman had MERS. The WHO said "the patient in Oman is a 68-year-old man from Al Dahkliya region who became ill" on 26 October 2013.
United Arab Emirates
On 14 April 2014, one Filipino paramedic died in the United Arab Emirates, with six other reported to be infected with the virus. On 17 April, the UAE Ministry of Health reported another fatality and four additional cases, including the Filipino medical worker who travelled to the Philippines on 16 April.
On 21 April 2014, the Health Ministry of UAE reported an additional 9 cases.
The Ministry of Health and Medical Education of Iran reported that two women had been diagnosed with MERS and on 29 May 2014 one of the women died of the disease in the city of Kerman. According to Dr. Mohammad Mehdi Gooya, Chief of the Center for Management of Contagious Diseases of Iran, the patient had been diagnosed with high blood pressure and her immune system, therefore, wasn't strong enough to fend off the disease. The second patient is said to be in a good condition.
Four days later, on 4 June 2014, the Ministry of Health reported that 3 more people including a doctor and a nurse who came in contact with the deceased patient were suspected to have contracted the disease. The victim's son-in-law is also reported to have been infected. According to Dr. Gooya, the infection of 1 out of the 3 suspected patients was confirmed and more tests were under way to determine the situation of the other two patients.
On 12 May 2013, in a case of human to human transmission, a man previously hospitalized in the same room as the first patient was confirmed by French Ministry of Social Affairs and Health.
France reported its first death from MERS near the end of May 2013. On 28 May 2013, a report by the Associated Press said a French patient died of the novel coronavirus related to SARS. Fifty percent of those infected have died.
On 20 April 2014, Greece reported its first MERS-CoV case. The infected individual was a 69-year-old Greek male who had returned to Greece on 17 April from Saudi Arabia. People with close contact with the infected man were identified and were being followed up.
On 31 May 2013, the Italian health ministry announced its first case of MERS-CoV in a 45-year-old man who had traveled to Jordan. The patient was being treated in a hospital in Tuscany and his condition was reported as not life-threatening.
On 1 November 2013, a woman who had recently traveled to Saudi Arabia for the Hajj, contracted the disease. She was stated to be in stable condition, and investigators from the World Health Organization are investigating whom she came in contact with.
In February 2013, the first UK case of the novel coronavirus was confirmed in Manchester in an elderly man who had recently visited the Middle East and Pakistan; it was the 10th case globally. The man's son, whom he visited in the hospital in Birmingham, was immuno-suppressed because of a brain tumour, and contracted the virus, providing the first clear evidence for person-to-person transmission. He died on 19 February 2013.
The second patient was a 49-year-old Qatari man who had visited Saudi Arabia before falling ill. He was flown privately by air ambulance from Doha to London on 11 September where he was admitted to St Mary's Hospital and later was transferred to St Thomas's Hospital. As a result of Dr Zaki's post on Pro-MED, the novel coronavirus was quickly identified. He was treated for respiratory disease and, like the first patient in Saudi Arabia, died of kidney failure in October 2012.
Another patient who had been in Guys and St Thomas hospital in the UK since September 2012 after visiting the Middle East died on 28 June 2013. A spokesperson for the hospital stated that "Guys and St Thomas can confirm that the patient with severe respiratory illness due to novel coronavirus (MERS-COV) died on Friday 28 June, after his condition deteriorated despite every effort and full supportive treatment."
As of April 2014, the European Centre for Disease Prevention and Control reported a total of 4 cases in the United Kingdom, 3 of which were fatalities.
On 2 May 2014, the United States Centers for Disease Control (CDC) confirmed the first diagnosis of MERS-CoV in the United States in Indiana. The man diagnosed was a healthcare worker who had been in Saudi Arabia a week earlier, and was reported to be in good condition. Another case, a Florida man from the Orlando area, was reported, and a third Illinois man was at that point asymptomatic but had tested positive for a past infection with the healthcare worker from Indiana. The latter case was the first human-to-human transmission in the United States. On 28 May 2014, the CDC announced that the third person who was found positive for the virus was not infected. The announcement came after a further laboratory analysis by CDC indicating that the person was never infected with the virus.
- As noted in the article published in The Economist on 20 April 2013, ProMED is an online reporting programme at the International Society for Infectious Diseases, part of improved surveillance systems that "use a range of sources to provide quick information on emerging threats" that were not available at the time of the SARS outbreak (in 2003), H5N1 bird flu (in 2005) and H1N1 swine flu (in 2009).
- "Middle East respiratory syndrome coronavirus (MERS-CoV) – United Arab Emirates". World Health Organization. 31 January 2020.
- "Distribution of confirmed cases of MERS-CoV by place of infection and month of onset, from March 2012 to 2 December 2019". European Centre for Disease Prevention and Control. 6 December 2019.
- "Statistics of MERS-CoV Cases in Saudi Arabia as of 12 June 2015". Command & Control Center – Ministry of Health. 12 June 2015. Retrieved 12 June 2015.
- "MERS forces total sealing off of two hospitals". Korea JoongAng Daily. 12 June 2015. Retrieved 12 June 2015.
- "Rapid Risk Assessment: Middle East respiratory syndrome coronavirus (MERS-CoV) — Seventeenth update, 11 June 2015" (PDF). European Centre for Disease Prevention and Control. 11 June 2015. Retrieved 12 June 2015.
- "Middle East respiratory syndrome coronavirus (MERS-CoV) summary and literature update–as of 20 January 2014" (PDF). World Health Organization. 20 January 2014. Retrieved 13 May 2014.
- Lisa Schnirring (21 January 2014). "US detects 2nd MERS case; Saudi Arabia has 18 more". Center for Infectious Disease Research and Policy. Retrieved 13 May 2014.
- "Second Dutchman infected with lung virus MERS". NRC Handelsblad. 15 May 2014. Retrieved 17 May 2014.
- "Egypt detects first case of MERS virus". Press TV. 26 April 2014. Archived from the original on 29 April 2014. Retrieved 29 April 2014.
- "Lebanon Records First Case of MERS Virus". Associated Press. Time. 9 May 2014. Retrieved 10 May 2014.
- "Case‐control study to assess potential risk factors related to human illness caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)" (PDF). World Health Organization. 28 March 2014. Retrieved 24 April 2014.
- Zaki, Ali M; Van Boheemen, Sander; Bestebroer, Theo M; Osterhaus, Albert D.M.E; Fouchier, Ron A.M (2012). "Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia". New England Journal of Medicine. 367 (19): 1814–1820. doi:10.1056/NEJMoa1211721. PMID 23075143.
- Saey, Tina Hesman (27 February 2013). "Scientists race to understand deadly new virus: SARS-like infection causes severe illness, but may not spread quickly". Science News. Vol. 183 no. 6. p. 5.
- "An ounce of prevention: As new viruses emerge in China and the Middle East, the world is poorly prepared for a global pandemic". The Economist. Bangkok and New York. 20 April 2013. Retrieved 20 April 2013.
- Härtl, Gregory (4 December 2014). "WHO Statement on the Fourth Meeting of the IHR Emergency Committee concerning MERS-CoV". World Health Organization. Retrieved 24 April 2014.
- Heilprin, John (23 May 2013). The Associated Press (AP) (ed.). "WHO: Probe into deadly coronavirus delayed by sample dispute". Geneva: CTV News.
- Lu, Guangwen; Liu, Di (2012). "SARS-like virus in the Middle East: A truly bat-related coronavirus causing human diseases". Protein & Cell. 3 (11): 803–805. doi:10.1007/s13238-012-2811-1. PMC 4875465. PMID 23143870.
- Acute respiratory illness associated with a new virus identified in the UK (Report). Health Protection Agency. 23 September 2012. Archived from the original on 1 February 2014.
- Roos, Robert (25 September 2013). UK agency picks name for new coronavirus isolate (Report). University of Minnesota, Minneapolis, MN: Center for Infectious Disease Research and Policy.
- De Groot, R. J; Baker, S. C; Baric, R. S; Brown, C. S; Drosten, C; Enjuanes, L; Fouchier, R. A. M; Galiano, M; Gorbalenya, A. E; Memish, Z. A; Perlman, S; Poon, L. L. M; Snijder, E. J; Stephens, G. M; Woo, P. C. Y; Zaki, A. M; Zambon, M; Ziebuhr, J (2013). "Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group". Journal of Virology. 87 (14): 7790–7792. doi:10.1128/JVI.01244-13. PMC 3700179. PMID 23678167.
- Novel coronavirus infection – update (Middle East respiratory syndrome- coronavirus) (Report). World Health Organization. 23 May 2013.
- Khazan, O. (21 June 2013). "Face Veils and the Saudi Arabian Plague". The Atlantic. Retrieved 25 June 2013.
- Assiri, Abdullah; McGeer, Allison; Perl, Trish M; Price, Connie S; Al Rabeeah, Abdullah A; Cummings, Derek A.T; Alabdullatif, Zaki N; Assad, Maher; Almulhim, Abdulmohsen; Makhdoom, Hatem; Madani, Hossam; Alhakeem, Rafat; Al-Tawfiq, Jaffar A; Cotten, Matthew; Watson, Simon J; Kellam, Paul; Zumla, Alimuddin I; Memish, Ziad A (2013). "Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus". New England Journal of Medicine. 369 (5): 407–416. doi:10.1056/NEJMoa1306742. PMC 4029105. PMID 23782161.
- Garrett, L.; Builder, M. (28 June 2013). "The Middle East Plague Goes Global". Foreign Policy. Retrieved 29 June 2013.
- "Saudi Arabia Review Finds Higher Number Of MERS Cases". The Huffington Post. Associated Press. 3 June 2014. Retrieved 5 June 2014.
- Donald G. McNeil Jr. (5 June 2014). "DNA Test Indicates Camel-to-Human Transmission of MERS". The New York Times. Retrieved 5 June 2014.
- Peck, Kayla M.; Burch, Christina L.; Heise, Mark T.; Baric, Ralph S. (2015). "Coronavirus Host Range Expansion and Middle East Respiratory Syndrome Coronavirus Emergence: Biochemical Mechanisms and Evolutionary Perspectives". Annual Review of Virology. 2 (1): 95–117. doi:10.1146/annurev-virology-100114-055029. PMID 26958908.
- Roos, R. (20 May 2013). "Coronavirus cases, deaths reported in Tunisia, Saudi Arabia". Center for Infectious Disease Research and Policy. Retrieved 22 May 2013.
- Szabo, Liz (2 June 2015). "South Korean MERS outbreak likely to spread, health officials say". USA Today.
- Jack, A (2015). "Why the panic? South Korea's MERS response questioned". BMJ. 350: h3403. doi:10.1136/bmj.h3403. PMID 26108610.
- "MERS forces total sealing off of two hospitals". 12 June 2015.
- Park, Ju-min; Pomfret, James (8 June 2015). "REFILE-UPDATE 2-Hong Kong to issue "red travel alert" to South Korea as MERS spreads". Reuters. (Article published in Eastern Daylight Time)
- "Filipino Positive for MERS Virus Home From UAE". ABC News. 16 April 2014. Retrieved 17 April 2014.
- "Middle East respiratory syndrome coronavirus (MERS-CoV) – April 17 update". World Health Organization. 17 April 2014. Retrieved 18 April 2014.
- Kusrisep (8 May 2014). "Virus MERS : Seorang lagi korban suspect dirujuk ke M djamil" (in Indonesian). Kliksiar. Archived from the original on 12 May 2014. Retrieved 8 May 2014.
- Bong Lozada; Jerome Aning (16 April 2014). "OFW brings MERS virus to Philippines". The Philippine Daily Inquirer. Retrieved 17 April 2014.
- "OFW from UAE tests positive for MERS-CoV". ABS-CBN News. 16 April 2014. Retrieved 17 April 2014.
- Patrick Quintos (19 April 2014). "New tests on OFW negative for MERS-CoV". ABS-CBN News. Retrieved 23 April 2014.
- "Aquino wants all Etihad flight passengers contacted by Tuesday - DOH". GMA News. 22 April 2014. Retrieved 23 April 2014.
- "Nurse from Saudi tests positive for MERS-COV". ABS-CBN News. 12 February 2015. Retrieved 12 February 2015.
- Jocelyn R. Uy (17 February 2015). "All persons exposed to nurse with MERS-CoV test negative for virus – DOH". Philippine Daily Inquirer. Retrieved 19 February 2015.
- "3 Pinoys infected with MERS-CoV in Saudi –DFA". GMA News. 6 March 2015. Retrieved 6 March 2015.
- "DOH reports new MERS-CoV case in PHL". GMA News. 6 July 2015. Retrieved 6 July 2015.
- "DOH confirms first MERS-CoV case in the PH". CNN Philippines. 6 July 2015. Retrieved 6 July 2015.
- "DOH: Foreigner in PH tests positive for MERS". Rappler. 6 July 2015. Retrieved 6 July 2015.
- Doucleef, Michaeleen (26 September 2012). "Scientists Go Deep on Genes of SARS-Like Virus". Associated Press. NPR. Retrieved 27 September 2012.
- Sander van Boheemena; Miranda de Graafa; Chris Lauberb; Theo M. Bestebroera; V. Stalin Raja; Ali Moh Zakic; Albert D. M. E. Osterhausa; Bart L. Haagmansa; Alexander E. Gorbalenyabd; Eric J. Snijderb; Ron A. M. Fouchiera (20 November 2012). "Genomic Characterization of a Newly Discovered Coronavirus Associated with Acute Respiratory Distress Syndrome in Humans". American Society for Microbiology. 3 (6). doi:10.1128/mBio.00473-12. PMC 3509437. PMID 23170002.
- McDowall, Angus (12 May 2013). "Two more people die of novel coronavirus in Saudi Arabia". Reuters. Retrieved 12 May 2013.
- "Novel coronavirus infection – update". World Health Organization. 23 November 2012.
- Wappes, J. (21 February 2013). "WHO confirms 13th novel coronavirus case". Center for Infectious Disease Research and Policy. Retrieved 6 March 2013.
- Abedine, Saad (13 March 2013). "Death toll from new SARS-like virus climbs to 9". CNN. Retrieved 13 March 2013.
- "Saudi Arabia: 7 Cases of SARS-like Virus Seen". Associated Press. 3 May 2013. p. 4.
- "New Tools to Hunt New Viruses". The New York Times. 27 May 2013.
- Roos, Robert (28 May 2013). "Saudi Arabia reports 5 more MERS-CoV cases". Center for Infectious Disease Research and Policy. Retrieved 24 April 2014.
- Roos, Robert (1 August 2013). "Saudi Arabia announces three new MERS cases". Center for Infectious Disease Research and Policy. Retrieved 24 April 2014.
- Kate Kelland (31 October 2013). "WHO confirms four more cases of Middle East virus". Reuters. Retrieved 31 October 2013.
- "Saudi Arabia reports 11 new cases of MERS virus, first in Mecca". The Malay Mail. 23 April 2014. Retrieved 24 April 2014.
- "WHO office sounds alarm as MERS cases push higher". Center for Infectious Disease Research and Policy. 23 April 2014. Retrieved 24 April 2014.
- "Hospital emerges as epicenter of Riyadh MERS outbreak". CIDRAP News and Perspective. University of Minnesota. Retrieved 19 August 2015.
- "Two million Muslim pilgrims begin annual hajj". Agence France-Presse. 13 October 2013. Archived from the original on 18 October 2013. Retrieved 17 October 2013.
- "Muslim pilgrims urged to heal rifts at hajj zenith". Agence France-Presse. 14 October 2013. Archived from the original on 18 October 2013. Retrieved 17 October 2013.
- "MERS virus claims three more lives in Saudi Arabia". Agence France-Presse. Yahoo! News. 7 September 2013. Retrieved 8 September 2013.
Authorities have urged the elderly and chronically ill Muslims to avoid the hajj this year and have cut back on the numbers of people they will allow to perform the pilgrimage.
- Katz, Andrew (16 October 2013). "As the Hajj Unfolds in Saudi Arabia, A Deep Look Inside the Battle Against MERS". Time. Retrieved 17 October 2013.
- Branswell, Helen (7 November 2013). "Spain reports its first MERS case; woman travelled to Saudi Arabia for Hajj". The Vancouver Sun. Retrieved 12 November 2013.
- Guery, B.; Poissy, J.; El Mansouf, L.; Séjourné, C.; Ettahar, N.; Lemaire, X.; Vuotto, F.; Goffard, A.; Behillil, S.; Enouf, V.; Caro, V.; Mailles, A.; Che, D.; Manuguerra, J. C.; Mathieu, D.; Fontanet, A.; van der Werf, S.; Mers-Cov Study, Group (2013). "Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission". Lancet. 381 (9885): 2265–72. doi:10.1016/S0140-6736(13)60982-4. PMID 23727167.
- "Update: Severe respiratory disease associated with a novel coronavirus" (PDF) (PDF). European Centre for Disease Prevention and Control. 7 December 2012. Archived from the original (PDF) on 28 September 2013. Retrieved 19 April 2014.
- "Alert & Response Operations Diseases Global Outbreak Alert & Response Network Biorisk Reduction Middle East respiratory syndrome coronavirus (MERS-CoV) – April 24 update". World Health Organization. 24 April 2014. Retrieved 24 April 2014.
- Ira Pedrasa (14 April 2014). "DFA confirms OFW death in UAE due to MERS-CoV". ABS-CBN News. Retrieved 17 April 2014.
- "Middle East respiratory syndrome coronavirus (MERS-CoV) – update". World Health Organization. 23 April 2014. Retrieved 23 April 2014.
- "Iran: MERS Virus Reaches Its 20th Country". The New York Times. 29 May 2014. Retrieved 29 May 2014.
- "Iran announces first Mers death". The Straits Times. 30 May 2014. Retrieved 30 May 2014.
- مرگ نخستین بیمار مبتلا به بیماری تنفسی 'کرونا' در ایران (in Persian). BBC Persian. 30 May 2014. Retrieved 30 May 2014.
- شناسایی سه مورد تازه مشکوک به بیماری کرونا در کرمان (in Persian). BBC Persian. 4 June 2014. Retrieved 4 June 2014.
- "The Ministry of Social Affairs and Health in France has informed WHO of one confirmed case with infection of the novel coronavirus". World Health Organization. 8 May 2013.
- "Nouveau coronavirus – Point de situation : Un nouveau cas d'infection confirmé" (in French). Minister of Social Affairs of France. 12 May 2013.
- Savary, Pierre (29 May 2013). "First coronavirus sufferer in France dies in hospital | Reuters". Reuters. Reuters. Retrieved 31 May 2013.
- "New SARS-Linked Virus Kills Man in France". Express. Associated Press. 29 May 2013.
- "Middle East respiratory syndrome coronavirus (MERS-CoV) – April 20 update". World Health Organization. 20 April 2014. Retrieved 24 April 2014.
- "Epidemiological update: First imported case of MERS-CoV in Greece". European Centre for Disease Prevention and Control. 23 April 2014. Retrieved 24 April 2014.
- "Italy announces first case of SARS-like coronavirus". Reuters. Reuters. 31 May 2013. Retrieved 1 June 2013.
- "CIDRAP Italy resident has MERS after trip to Jordan". Center for Infectious Disease Research and Policy. Retrieved 1 June 2013.
- "WHO: Novel coronavirus infection –update". World Health Organization. 11 February 2013. Retrieved 13 February 2013.
- "WHO: Novel coronavirus infection – update". World Health Organization. 13 February 2013. Retrieved 13 February 2013.
- James Gallagher (13 February 2013). "Coronavirus: Signs the new Sars-like virus can spread between people". BBC News. Retrieved 13 February 2013.
- Kelland, Kate (19 February 2013). "Britain dies after contracting new SARS-like virus". Reuters. Retrieved 19 February 2013.
- "Novel coronavirus - Saudi Arabia (03): UK HPA, WHO, Qatar". ProMED-mail. 23 September 2013. Retrieved 19 April 2014.
- Nebehay, Stephanie (26 September 2012). "WHO issues guidance on new virus, gears up for haj". Reuters. Retrieved 27 September 2012.
- "Scientists race to understand deadly new virus". Science News. Vol. 183 no. 6. 23 March 2013. Retrieved 19 April 2014.
- Bermingham, A.; Chand, MA.; Brown, CS.; Aarons, E.; Tong, C.; Langrish, C.; Hoschler, K.; Brown, K.; et al. (27 September 2012). "Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012" (PDF). Eurosurveillance. 17 (40): 20290. PMID 23078800.
- Falco, Miriam (24 September 2012). "New SARS-like virus poses medical mystery". CNN. Retrieved 27 September 2012.
- Al-Ahdal, MN.; Al-Qahtani, AA.; Rubino, S. (October 2012). "Coronavirus respiratory illness in Saudi Arabia". J Infect Dev Ctries. 6 (10): 692–4. doi:10.3855/jidc.3084. PMID 23103889.
- "Britain records new death from MERS virus". The Huffington Post. Associated Press. 4 July 2013. Retrieved 18 July 2013.
- Mike Stobbe (2 May 2014). "CDC Confirms First Case of MERS in US". ABC News. Retrieved 4 May 2014.
- McKay, Betsy (3–4 May 2014). "American Returns from Mideast With MERS Virus". The Wall Street Journal. pp. A3.
- Jonel Aleccia (18 May 2014). "Illinois Man is Third U.S. MERS Infection, CDC Says". NBC News. Retrieved 18 May 2014.
- Kaplan, Karen (28 May 2014). "CDC: Illinois man who met with U.S. MERS patient was not infected after all". Los Angeles Times. Chicago Tribune. Retrieved 8 June 2014.