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Severe acute respiratory syndrome vs. the Middle East respiratory syndrome.
Curr Opin Pulm Med. 2014 May; 20(3):233-41.CO

Abstract

PURPOSE OF REVIEW

This review compares the clinical features, laboratory aspects and treatment options of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS).

RECENT FINDINGS

Bats are the natural reservoirs of SARS-like coronaviruses (CoVs) and are likely the reservoir of MERS coronavirus (MERS-CoV). Although a small number of camels have been found to have positive nasal swabs by real-time polymerase chain reaction and to carry antibody against MERS-CoV, the transmission route and the intermediary animal source remain uncertain amongst the sporadic primary cases. Both SARS-CoV and MERS-CoV may cause severe respiratory failure and extrapulmonary features such as diarrhoea, whereas mild or asymptomatic cases also occur in both conditions. In comparison with SARS, patients with MERS are older with male predominance, more comorbid illness and relatively lower human-to-human transmission potential. Although the viral kinetics of MERS-CoV remain unknown, nosocomial infections of MERS occur early within the first week of illness of the index case, whereas those of SARS occurred mainly in the second week of illness when the patient's upper airway viral load peaks on day 10 of illness. In-vitro data suggest that interferon (IFN) with or without ribavirin and mycophenolic acid may inhibit MERS-CoV, whereas protease inhibitors and IFN have inhibitory activity against SARS-CoV.

SUMMARY

Although there are some similarities in the clinical features, MERS progresses to respiratory failure much more rapidly than SARS. The higher case fatality rate of MERS is likely related to older age and comorbid illness. More studies are needed to understand MERS-CoV in order to guide public health infection control measures and treatment.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Hui DS
aDepartment of Medicine & Therapeutics, Stanley Ho Center for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong bMinistry of Health, Al-Faisal University, Riyadh, Kingdom of Saudi Arabia cDivision of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London dNIHR Biomedical Research Centre, University College London Hospitals, London, UK.
Memish ZA
No affiliation info available
Zumla A
No affiliation info available

MeSH

Age DistributionAnimalsAntiviral AgentsCamelusChiropteraCoronavirusCoronavirus InfectionsCross InfectionDiagnosis, DifferentialDisease ProgressionFemaleHumansImmunity, InnateInfectious Disease Incubation PeriodInterferonsLungMaleMiddle EastMycophenolic AcidPublic HealthRadiographyReal-Time Polymerase Chain ReactionRibavirinSevere Acute Respiratory SyndromeSex DistributionViral Load

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

24626235

Citation

Hui, David S., et al. "Severe Acute Respiratory Syndrome Vs. the Middle East Respiratory Syndrome." Current Opinion in Pulmonary Medicine, vol. 20, no. 3, 2014, pp. 233-41.
Hui DS, Memish ZA, Zumla A. Severe acute respiratory syndrome vs. the Middle East respiratory syndrome. Curr Opin Pulm Med. 2014;20(3):233-41.
Hui, D. S., Memish, Z. A., & Zumla, A. (2014). Severe acute respiratory syndrome vs. the Middle East respiratory syndrome. Current Opinion in Pulmonary Medicine, 20(3), 233-41. https://doi.org/10.1097/MCP.0000000000000046
Hui DS, Memish ZA, Zumla A. Severe Acute Respiratory Syndrome Vs. the Middle East Respiratory Syndrome. Curr Opin Pulm Med. 2014;20(3):233-41. PubMed PMID: 24626235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severe acute respiratory syndrome vs. the Middle East respiratory syndrome. AU - Hui,David S, AU - Memish,Ziad A, AU - Zumla,Alimuddin, PY - 2014/3/15/entrez PY - 2014/3/15/pubmed PY - 2015/1/13/medline SP - 233 EP - 41 JF - Current opinion in pulmonary medicine JO - Curr Opin Pulm Med VL - 20 IS - 3 N2 - PURPOSE OF REVIEW: This review compares the clinical features, laboratory aspects and treatment options of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS). RECENT FINDINGS: Bats are the natural reservoirs of SARS-like coronaviruses (CoVs) and are likely the reservoir of MERS coronavirus (MERS-CoV). Although a small number of camels have been found to have positive nasal swabs by real-time polymerase chain reaction and to carry antibody against MERS-CoV, the transmission route and the intermediary animal source remain uncertain amongst the sporadic primary cases. Both SARS-CoV and MERS-CoV may cause severe respiratory failure and extrapulmonary features such as diarrhoea, whereas mild or asymptomatic cases also occur in both conditions. In comparison with SARS, patients with MERS are older with male predominance, more comorbid illness and relatively lower human-to-human transmission potential. Although the viral kinetics of MERS-CoV remain unknown, nosocomial infections of MERS occur early within the first week of illness of the index case, whereas those of SARS occurred mainly in the second week of illness when the patient's upper airway viral load peaks on day 10 of illness. In-vitro data suggest that interferon (IFN) with or without ribavirin and mycophenolic acid may inhibit MERS-CoV, whereas protease inhibitors and IFN have inhibitory activity against SARS-CoV. SUMMARY: Although there are some similarities in the clinical features, MERS progresses to respiratory failure much more rapidly than SARS. The higher case fatality rate of MERS is likely related to older age and comorbid illness. More studies are needed to understand MERS-CoV in order to guide public health infection control measures and treatment. SN - 1531-6971 UR - https://www.unboundmedicine.com/medline/citation/24626235/Severe_acute_respiratory_syndrome_vs__the_Middle_East_respiratory_syndrome_ DB - PRIME DP - Unbound Medicine ER -