Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Travellers

Middle East respiratory Syndrome Coronavirus (MERS-CoV) emerged in 2012 in the Kingdom of Saudi Arabia. Since then, it has been reported from 27 countries, and all cases were epidemiologically linked to the Arabian Peninsula. The transmission of MERS-CoV is thought be either through intra-familial transmission or large healthcare-associated infections, in addition to sporadic isolated cases. The clinical presentation includes asymptomatic, mild cases, and severe fatal disease. The best diagnostic test relies on molecular identification of MERS-CoV by PCR. The mainstay of therapy for patients with MERS relies on supportive care. The MIRACLE study, a randomized controlled trial, utilized lopinavir-ritonavir and interferon-β1b vs. placebo with the start of treatment within 7 days after symptom onset. The study showed a reduction in the 90-day mortality with a relative risk of 0.19 (95% CI, 0.05–0.75). In addition, using a human polyclonal IgG antibody (SAB-301) was safe and well tolerated in phase I clinical trials.