New coronavirus MERS decrypted

Scientists first describe disease progression after MERS infection

18/06/2013

The World Health Organization (WHO) warned just a few weeks before the new coronavirus: this is „At the 66th World Health Assembly in Geneva, WHO Director-General Margaret Chan said, "It's a world-wide danger." Now, an international research team led by the University of Bonn has studied the MERS virus and, for the first time, looked at the disease He described the example of a man who died in Munich in March this year, according to which the new coronavirus, spread primarily in the Middle East, mainly spreads via the respiratory tract, as compared to the causative agent of the infectious disease „SARS“, which also belongs to the coronaviruses, the researchers had only occasionally found viruses in patients' stools.

WHO warns of one „Danger to the whole world“
According to the WHO, go from the new, so-called “Mers-CoV” According to the organization, 61 diseases were confirmed by MERS-CoV as of June 15, and 34 patients had already died as a result of this disease (Middle East Respiratory Syndrome Coronavirus). It was not until the end of March that a 73-year-old patient died in Munich of the virus that had been flown to Germany for treatment from Abu Dhabi.

Researchers examine 73-year-old victim of the disease
Now, a research team consisting predominantly of German physicians has taken a closer look at this case and has thus made great progress in understanding the disease - because until now, according to Prof. Christian Drosten, director of the Institute of Virology at the University Hospital Bonn, only “little information about the course of the infection“ submitted to, „In addition, we have so far been unable to assess the origins and spread of the infection because of a lack of data“, the scientist currently in the journal "The Lancet".

Man from the United Arab Emirates died after 18 days
The 73-year-old man from the United Arab Emirates initially showed flu-like symptoms, and two days later he was admitted to a hospital in Abu Dhabi, where doctors diagnosed pneumonia and prescribed antibiotics and artificial respiration. After no improvement, the patient was transferred on the twelfth day of the disease to a clinic in Munich, where his condition continued to deteriorate and he finally died 18 days after onset of the disease from sepsis and multiple organ failure.

Researchers find greatest viral load viral load in the lower respiratory tract
Based on this case, the researchers would have „first the distribution of MERS-CoV viral load on the various organs“ can describe, says Prof. Drosten. They came to the conclusion that the viral load had been greatest in the lower respiratory tract. This was also confirmed by the WHO, which had issued the recommendation to take samples of patients from this area in patients.

Small amounts of pathogens in urine and stool surprise the scientists
According to the scientists, the high concentration of lower respiratory viruses would indicate that the virus is excreted primarily through the respiratory tract. In addition, the urine and stool of the Abu Dhabi patient had found low levels of pathogens: „This result surprised us, as early renal failure is described in connection with MERS-CoV cases and, according to laboratory experiments, these viruses can proliferate in the kidney“, said Prof. Drosten. In addition, the low levels of virus in the urine, stool and blood samples would then indicate, “that the risk of infection via these paths is low.”

Investigation brings important findings for practice
In addition, the 73-year-old's study yielded even more interesting results. It was particularly important for the practice to recognize that the low amount of pathogens in the stool had clearly differed from the clinical picture of the patients infected with the SARS (Severe Acute Respiratory Syndrome). For so far, physicians had been in the treatment of the new corona virus on the course of SARS oriented, which almost ten years ago almost 1,000 people worldwide had fallen victim. Already at that time, Prof. Christian Drosten had played a key role in the research - in his time at the Bernhard Nocht Institute for Tropical Medicine (BNI) in Hamburg, together with his colleague Stephan Günther, the virologist had identified and described the SARS virus for what the two had received the prize of the Werner Otto Foundation.

Two new genome sequences of MERS coronavirus completely decrypted
In the course of the examination of the deceased patient, the researchers were also able to completely decrypt two new genome sequences of MERS coronaviruses and to conclude by comparing them with other cases on the evolution of the pathogen. Consequently, according to Drosten the „MERS-CoV pathogen first appeared in 2011“ and since then, the virologist's conjecture has essentially passed from person to person.

First case of MERS-CoV in the summer of 2012
The new „Middle East Respiratory Syndrome Coronavirus“ (MERS-CoV) was first established in the summer of 2012, which according to the University of Bonn from Jordan, Saudi Arabia, Qatar and the United Arab Emirates began and later appeared in Germany, Britain, Tunisia, France and Italy. Symptoms of severe respiratory disease include pneumonia and dyspnoea; for 31 infected patients, MERS-CoV infection has been fatal.

MERS-CoV outbreak compared to SARS in the early stages?
Compared to the development of SARS ten years ago, the MERS-CoV outbreak may therefore still be in the early stages, as Benoit Guery and Sylvie van der Werf from Hopital Huriez in Lille, France, comment in a commentary on the current release. Therefore, the international research community would urgently need to find and evaluate effective therapies, according to the French scientists. (No)

Picture: Aka