It began routinely enough. A patient with severe respiratory disease at the Dr. Soliman Fakeeh Hospital in Jeddah, Saudi Arabia was getting worse and no one knew why. A sample of sputum was sent to Dr. Ali Mohamed Zaki to identify the culprit, as he had identified these diseases many times before. However, this time would be different. The sample showed no positive hits on any of the virus assays he normally used. He contacted Dr. Ron Fouchier, at Erasmus Medical College in Rotterdam, Netherlands, to see if he could be of help. Dr. Zaki's initial idea was that the virus was a paramyxovirus, and Dr Fouchier had recently published a Pan-paramyxovirus polymerase chain reaction (PCR) assay . In Dr. Fouchier's lab, the virus was identified as a novel coronavirus, one that had never been seen before.
This novel coronavirus, now called Middle East respiratory syndrome coronavirus (MERS-CoV), has been identified in several countries across the Middle East and Europe, with primary infections found in Saudi Arabia, Qatar, Jordan, and The United Arab Emirates (UAE) (http://www.who.int/csr/disease/coronavirus_infections/en/). Infections in the United Kingdom, Tunisia, France, Italy, and Germany have been imported by travel from the Middle East. The Italian cluster is believed to be from a patient traveling to Jordan and back, and the French cluster originated from a patient traveling to the UAE. The largest cluster of cases, 23 in total, is in Saudi Arabia. As of July 25, 2013, there are 90 confirmed infections, of which 45 have resulted in death, resulting in a 50% case fatality rate. MERS-CoV has been sequenced from nine infected individuals, and its genome sequence places it in the same sub-family (Group 2) as SARS coronavirus (SARS-CoV), but in a new lineage (called Group 2c) (sequences reported in – and at http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317138176202; http://www.ncbi.nlm.nih.gov/nuccore/KC776174)(http://www.virology-bonn.de/index.php?id=46).