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Our Perspective on MERS CoV (2013): Is MERS Similar to SARS?

Image of Dr. Amesh Adalja
Amesh A. Adalja, MD
Date posted:
May 07, 2013
Publication type:

Our Perspective on MERS CoV: May 7, 2013

Open access

Yesterday’s report that a healthcare facility in Saudi Arabia was harboring a cluster of 13 people infected with the novel coronavirus—now named MERS-CoV, for Middle East respiratory syndrome coronavirus—raises the possibility that human-to-human transmission of this virus is occurring. There is no definitive treatment for MERS-CoV.

Until now, it has been thought that only limited transmission of this virus between humans has occurred, with 2 confirmed cases in the United Kingdom (UK). To date, there are 30 cases of MERS-CoV confirmed, with 18 deaths. All but the 2 cases in the UK have originated in the Middle East nations of Saudi Arabia, Jordan, Qatar, or the United Arab Emirates.1

The Saudi Cluster

An unnamed healthcare facility in Saudi Arabia has reported 13 patients infected with MERS-CoV; 7 of those patients have died. Illness onset occurred between April 4 and May 1, making human transmission probable, as exposure to suspected reservoir species would not be expected to occur in a healthcare facility. Additionally, the length of time between cases is adequate for in-hospital transmission to occur. It is less likely, based on the available information, that all 13 individuals had exposure to an infected animal source over such a long period of time. One prior experience with MERS-CoV in Jordan at a healthcare facility last year resulted in 2 confirmed and 11 probable cases, the majority of which were healthcare workers.[1]

Comparison with SARS

The evolving outbreak of MERS-CoV bears some similarity to the SARS outbreak in 2003. Points of similarity include the following:

  • Disease is caused by a novel coronavirus.
  • Bats are the suspected reservoir species from which the virus originates.
  • The intermediary animal from which the virus spills into human populations is not known.
  • Disease spread may be occurring in healthcare facilities.

At this point, there are several key differences between SARS and this virus:

  • There is no evidence of human MERS-CoV superspreaders who disproportionately transmit the virus among people.
  • There is no evidence yet of sustained human-to-human transmission.
  • MERS-CoV infects a broader range of cell types throughout the body.[2]
  • MERS-CoV may respond to treatment with medications similar to those used to treat hepatitis C.[3]

As more information on the Saudi healthcare cluster is released, including clinical, epidemiologic, and surveillance details, the pattern of transmission and the potential for this virus to cause a wider outbreak will become more clear.


  1. Saudis cite health facility as coronavirus cluster grows. CIDRAP May 7, 2013. Accessed May 7, 2013.
  2. Chan JF, Chan KH, Choi GK, et al. Differential cell line susceptibility to the emerging novel human betacoronavirus 2c EMC/2012: implications for disease pathogenesis and clinical manifestation. J Infect Dis2013;207:1743-1752.
  3. Falzarano D, de Wit E, Martellaro C, et al. Inhibition of novel ? coronavirus replication by a combination of interferon-?2b and ribavirin. Sci Rep April 18, 2013. Accessed May 7, 2013.



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