Summary of your 'study carrel' ============================== This is a summary of your Distant Reader 'study carrel'. The Distant Reader harvested & cached your content into a collection/corpus. It then applied sets of natural language processing and text mining against the collection. The results of this process was reduced to a database file -- a 'study carrel'. The study carrel can then be queried, thus bringing light specific characteristics for your collection. These characteristics can help you summarize the collection as well as enumerate things you might want to investigate more closely. This report is a terse narrative report, and when processing is complete you will be linked to a more complete narrative report. Eric Lease Morgan Number of items in the collection; 'How big is my corpus?' ---------------------------------------------------------- 71 Average length of all items measured in words; "More or less, how big is each item?" ------------------------------------------------------------------------------------ 5311 Average readability score of all items (0 = difficult; 100 = easy) ------------------------------------------------------------------ 47 Top 50 statistically significant keywords; "What is my collection about?" ------------------------------------------------------------------------- 67 Middle 64 East 59 MERS 9 SARS 8 respiratory 7 CoV 4 middle 4 ear 4 Saudi 3 Fig 2 virus 2 protein 2 outbreak 2 food 2 country 2 coronavirus 2 Syndrome 2 Respiratory 2 RNA 2 ICU 2 Coronavirus 2 Arabia 1 variant 1 treatment 1 syndrome 1 present 1 patient 1 ome 1 neck 1 nasal 1 infection 1 egyptian 1 disease 1 day 1 child 1 airway 1 WNV 1 United 1 Turkey 1 Salmonella 1 Region 1 RBD 1 Qatar 1 Pakistan 1 PPE 1 OC43 1 Ministry 1 Lebanon 1 Korea 1 Kingdom Top 50 lemmatized nouns; "What is discussed?" --------------------------------------------- 2684 coronavirus 2624 infection 2256 syndrome 1990 patient 1986 case 1417 virus 1353 study 1315 % 1266 outbreak 1187 camel 1083 cov 998 disease 899 protein 862 antibody 757 cell 756 transmission 684 mouse 655 day 603 vaccine 592 risk 568 animal 565 treatment 553 hospital 545 food 544 dromedary 512 response 512 country 504 human 482 child 473 symptom 471 sample 448 contact 441 datum 434 control 429 model 409 health 408 group 394 analysis 379 lung 375 care 366 receptor 350 pneumonia 348 factor 345 therapy 338 number 336 time 335 year 332 development 324 illness 322 interferon Top 50 proper nouns; "What are the names of persons or places?" -------------------------------------------------------------- 5464 MERS 3350 CoV 2438 East 2412 Middle 1077 SARS 684 Saudi 673 Arabia 459 al 418 Korea 367 et 363 RNA 359 . 351 Respiratory 343 Syndrome 320 Coronavirus 258 Health 253 South 237 PCR 223 S 214 RBD 213 ICU 203 DPP4 185 Fig 182 CoV-2 172 IFN 155 United 138 CoV. 129 China 122 World 119 S1 116 May 114 Africa 110 Hospital 108 Organization 108 KSA 108 Egypt 107 COVID-19 106 Al 104 sera 99 CoVs 97 Jordan 97 Arab 95 Arabian 93 WHO 93 Peninsula 91 Disease 90 Republic 88 Jeddah 82 Table 76 C Top 50 personal pronouns nouns; "To whom are things referred?" ------------------------------------------------------------- 662 it 530 we 293 they 127 i 112 them 86 he 17 you 16 she 12 themselves 11 us 11 itself 8 him 6 one 3 mrnas 3 me 2 her 1 ys110 1 sdpp4 1 p6.they 1 ourselves 1 ours 1 oneself 1 nsp15 1 em 1 asc09f Top 50 lemmatized verbs; "What do things do?" --------------------------------------------- 11688 be 2607 have 872 include 822 use 680 report 500 associate 470 show 420 develop 406 cause 405 infect 381 confirm 370 identify 348 base 342 do 327 occur 320 find 305 require 305 detect 274 follow 264 bind 253 neutralize 246 emerge 242 increase 236 suggest 232 provide 231 relate 226 compare 215 induce 213 need 207 test 192 reduce 191 indicate 189 describe 188 result 188 observe 181 perform 179 make 177 inhibit 173 remain 171 suspect 170 consider 164 involve 164 contain 160 target 160 demonstrate 159 receive 157 treat 157 prevent 155 know 150 take Top 50 lemmatized adjectives and adverbs; "How are things described?" --------------------------------------------------------------------- 3122 respiratory 1187 human 1006 not 852 viral 802 severe 799 clinical 744 high 679 acute 671 other 665 also 543 more 471 - 423 such 408 however 393 first 392 most 369 low 367 novel 336 specific 328 well 307 only 301 positive 286 middle 286 immune 284 common 275 large 245 potential 243 infectious 237 several 236 as 232 early 232 different 206 available 205 infected 203 new 202 asymptomatic 200 single 199 further 196 many 195 antiviral 194 medical 187 small 186 important 184 negative 182 likely 179 mild 178 significant 174 old 170 epidemiological 169 therapeutic Top 50 lemmatized superlative adjectives; "How are things described to the extreme?" ------------------------------------------------------------------------- 133 most 92 Most 50 high 48 least 45 large 28 good 22 great 20 late 13 early 5 low 5 close 5 big 4 bad 2 narrow 1 ~3 1 wealthy 1 small 1 preharv 1 poor 1 nonsevere 1 new 1 near 1 long 1 likeli 1 heavy 1 furth 1 deep 1 cord-322760-tsxniu3j 1 cord-278238-w1l8h8g8 1 bright 1 -wheat Top 50 lemmatized superlative adverbs; "How do things do to the extreme?" ------------------------------------------------------------------------ 259 most 55 least 7 well 2 worst 2 hard Top 50 Internet domains; "What Webbed places are alluded to in this corpus?" ---------------------------------------------------------------------------- 6 www.who.int 5 doi.org 4 creativecommons.org 3 orcid.org 2 wwwnc.cdc.gov 2 www.ebi.ac.uk 2 clinicaltrials.gov 1 www.viprbrc.org 1 www.promedmail.org 1 www.moh.gov.sa 1 www.moh.gov.bh 1 www.moh 1 www.mefosa.com 1 www.jeealliance.org 1 www.fda.gov 1 www.emro.who.int 1 www.ecfr.gov 1 www.cdc.gov 1 www.cbs.dtu.dk 1 www.addgene 1 who-blueprint-mapping-tool.surge.sh 1 translate.google.com 1 pcingola.github.io 1 github.com 1 creativecommons 1 cran.r-project.org 1 cloud.ihme.washington.edu 1 cid.oxfordjournals.org 1 cepi.net 1 bigd.big.ac.cn 1 agsci.oregonstate.edu Top 50 URLs; "What is hyperlinked from this corpus?" ---------------------------------------------------- 2 http://www.who.int/emergencies/mers-cov/en/ 2 http://creativecommons.org/licenses/by/4.0/ 1 http://wwwnc.cdc.gov/EID/article/25/5/18-1728-App1.pdf 1 http://wwwnc.cdc.gov/EID/ 1 http://www.who.int/mediacentre/news/ 1 http://www.who.int/emer 1 http://www.who.int/csr/disease/coronavirus_ 1 http://www.who.int/ 1 http://www.viprbrc.org/ 1 http://www.promedmail.org 1 http://www.moh.gov.sa/ 1 http://www.moh.gov.bh/ 1 http://www.moh 1 http://www.mefosa.com/ 1 http://www.jeealliance.org/ 1 http://www.fda.gov/ 1 http://www.emro.who.int/health-topics/mers-cov/mers-outbreaks.html 1 http://www.ecfr.gov/cgibin/text-idx?tpl=/ecfrbrowse/Title21/21cfr312_main_02 1 http://www.ebi.ac.uk/Tools/msa/clustalo/ 1 http://www.ebi.ac.uk/Tools/ 1 http://www.cdc.gov/epiinfo 1 http://www.cbs.dtu.dk/ 1 http://www.addgene 1 http://who-blueprint-mapping-tool.surge.sh/ 1 http://translate.google.com/ 1 http://pcingola.github.io/SnpEff/SnpEff.html 1 http://orcid.org/0000-0002-6513-6422 1 http://orcid.org/0000-0002-3010-2265 1 http://orcid.org/0000-0001-7664-9568 1 http://github.com/sanger-pathogens/snp-sites 1 http://doi.org/10.3904/kjim.2018.031 1 http://doi.org/10.1038/s41598-019-43586-9 1 http://doi.org/10.1038/s41597-019-0330-0.Correspondence 1 http://doi.org/10.1016/j.ijid.2018.03.005 1 http://doi.org/10.1016/j.antiviral.2018.09.002 1 http://creativecommons.org/publicdomain/zero/1.0/ 1 http://creativecommons.org/licenses/by/4.0/.The 1 http://creativecommons 1 http://cran.r-project.org/ 1 http://cloud.ihme.washington.edu/index 1 http://clinicaltrials.gov/ct2/home 1 http://clinicaltrials.gov/ct2/ 1 http://cid.oxfordjournals.org 1 http://cepi.net/mission 1 http://bigd.big.ac.cn/ncov 1 http://agsci.oregonstate.edu/files/main/roadmap2.pdf Top 50 email addresses; "Who are you gonna call?" ------------------------------------------------- Top 50 positive assertions; "What sentences are in the shape of noun-verb-noun?" ------------------------------------------------------------------------------- 15 coronavirus neutralizing antibodies 15 cov infected patients 8 cov causes lethal 7 cov has not 6 cov is endemic 6 protein induces much 5 cases have also 5 cov has also 5 cov neutralizing antibodies 5 disease is rare 5 virus was first 4 coronavirus causes lethal 4 coronavirus causes multiple 4 coronavirus causes widespread 4 cov does not 4 cov is not 4 infection is not 4 mice are not 4 vaccine induces protective 3 arabia reported higher 3 cases were secondary 3 cov has yet 3 cov is dpp4 3 cov neutralizing antibody 3 cov was not 3 disease was first 3 mers was first 3 patients requiring icu 3 protein induces partial 3 studies have also 3 virus is not 2 % had at 2 % had severe 2 % were asymptomatic 2 % were nurses 2 % were physicians 2 animals are also 2 camels are likely 2 camels are present 2 camels was highly 2 case causing mers 2 case finding severe 2 case report surveillance 2 cases are likely 2 cases are not 2 cases are still 2 cases was slightly 2 cases were due 2 cases were male 2 cov are generally Top 50 negative assertions; "What sentences are in the shape of noun-verb-no|not-noun?" --------------------------------------------------------------------------------------- 4 mice are not susceptible 3 cov has not yet 2 cases reported no symptoms 1 camels show no evidence 1 camels was not apparent 1 camels were not actively 1 case are not well 1 cases are not unexpected 1 cases were not seriously 1 cells are not evenly 1 cells was not signifi 1 cov are not well 1 cov did not generally 1 cov does not currently 1 cov does not yet 1 cov is not currently 1 cov is not fully 1 cov was not formally 1 covs have not yet 1 days were not indicators 1 disease is not present 1 disease was not likely 1 disease was not significantly 1 east was not clear 1 infection are not clear 1 infection is not clear 1 infection is not necessary 1 infection is not solely 1 infection is not well 1 infection were not present 1 infections are not common 1 infections are not only 1 infections is not dissimilar 1 mice showed no severe 1 patient is not unconscious 1 proteins are not only 1 sars is no longer 1 studies do not overall 1 studies showed no difference 1 study found no evidence 1 study has not yet 1 study is not free 1 transmission are not fully 1 treatment found no difference 1 treatment has not yet 1 treatment is not informative 1 vaccine does not yet A rudimentary bibliography -------------------------- id = cord-323428-jd91k19z author = Ababneh, Mustafa title = Recombinant adenoviral vaccine encoding the spike 1 subunit of the Middle East Respiratory Syndrome Coronavirus elicits strong humoral and cellular immune responses in mice date = 2019-10-11 keywords = East; MERS; Middle summary = CONCLUSION: The results of this study suggest that this recombinant adenovirus vaccine encoding the S1 subunit of MERS-CoV elicits potentially protective antigen-specific humoral and cellular immune responses in mice. Distribution and expression of the S1 subunit of the MERS-CoV spike protein in mice tissues were detected at weeks 3 and 5 post first immunization in the kidneys and lungs of the vaccinated group but not in control groups using conventional PCR (Figure-1 ). In contrast, IL-4 production in cell culture showed a significant increase in control animals after antigen stimulation, while the production of this cytokine was significantly decreased in the At week 4, the fold change in IFN-γ gene expression was significantly higher in the Ad-Middle East respiratory syndrome (MERS)-S1 group than that of both control groups (Ad-cytomegalovirus [CMV] and phosphate-buffered saline). doi = 10.14202/vetworld.2019.1554-1562 id = cord-354302-l2kywzro author = Adney, Danielle R. title = Replication and Shedding of MERS-CoV in Upper Respiratory Tract of Inoculated Dromedary Camels date = 2014-12-17 keywords = East; MERS; Middle summary = Epidemiologic investigations identified dromedary camels as the likely source of zoonotic transmission of Middle East respiratory syndrome coronavirus (MERS-CoV). Epidemiologic investigations identified dromedary camels as the likely source of zoonotic transmission of Middle East respiratory syndrome coronavirus (MERS-CoV). We inoculated 3 adult camels with a human isolate of MERS-CoV and a transient, primarily upper respiratory tract infection developed in each of the 3 animals. We inoculated 3 adult camels with a human isolate of MERS-CoV and a transient, primarily upper respiratory tract infection developed in each of the 3 animals. T he Middle East respiratory syndrome coronavirus (MERS-CoV) was first recognized in 2012 related to a fatal human case of pneumonia in Saudi Arabia (1) . MERS-CoV shedding started during 1-2 dpi, as detected by the presence of infectious virus and viral RNA by qPCR in nasal swab samples. Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels doi = 10.3201/eid2012.141280 id = cord-343302-g9vcchrh author = Agrawal, Anurodh Shankar title = Passive Transfer of A Germline-like Neutralizing Human Monoclonal Antibody Protects Transgenic Mice Against Lethal Middle East Respiratory Syndrome Coronavirus Infection date = 2016-08-19 keywords = CoV; East; MERS; Middle summary = title: Passive Transfer of A Germline-like Neutralizing Human Monoclonal Antibody Protects Transgenic Mice Against Lethal Middle East Respiratory Syndrome Coronavirus Infection Here, we further characterized this novel human mAb in our Tg mouse model of MERS-CoV infection and showed prophylactic and therapeutic protection of mice treated with m336 before and after a lethal challenge with the virus, respectively. In our studies, we noted that passively transferred with 1 mg and 0.1 mg of m336 monoclonal antibodies to individual mice 12 h prior to challenge with 1,000 LD 50 of MERS-CoV resulted in 100% and 75% protection against lethality, respectively (Fig. 1) , suggesting that using 0.1 mg m336/mouse as a prophylaxis is suboptimal to completely neutralize viral infection, thereby allowing residual viruses to replicate within lungs during the course of infection. doi = 10.1038/srep31629 id = cord-318181-xxc7vdnt author = Ahmed, Anwar E. title = Early identification of pneumonia patients at increased risk of Middle East respiratory syndrome coronavirus infection in Saudi Arabia date = 2018-03-14 keywords = East; MERS; Middle summary = A total of 360 patients with confirmed pneumonia who were evaluated for MERS-CoV infection by real-time reverse transcription polymerase chain reaction (rRT-PCR) between September 1, 2012 and June 1, 2016 at King Abdulaziz Medical City in Riyadh and King Fahad General Hospital in Jeddah, were included. Nineteen predictive variables were included: age, sex, fever (temperature !38 C), one composite respiratory symptom (the presence of cough, bloody cough, shortness of breath, or chest pain), one composite gastrointestinal symptoms (the presence of diarrhea, vomiting, or nausea), seven MERS-CoV potential risk factors (contact with sick patients or camels, severe illness (defined according to the patient''s clinical status, ''yes/no'', which is based on clinical judgment), diabetes, lung disease, liver disease, renal disease, and heart disease), and seven laboratory measurements (white blood cell (WBC) count (Â10 9 /l), platelets (Â10 9 /l), creatinine (mmol/l), bilirubin (mmol/l), alanine aminotransferase (ALT; U/l), aspartate aminotransferase (AST; U/l), and albumin (g/ l)). doi = 10.1016/j.ijid.2018.03.005 id = cord-345046-str19r9a author = Al Ghamdi, Mohammed title = Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia date = 2016-04-21 keywords = East; MERS; Middle summary = title: Treatment outcomes for patients with Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) infection at a coronavirus referral center in the Kingdom of Saudi Arabia In this recent cohort, when comparing survivors to nonsurvivors, survival was associated with male gender, vomiting on admission, elevated respiratory rate, abnormal lung exam on physical exam, working as a healthcare worker, history of hypertension, elevated ALT, clearance of MERS CoV on repeat PCR testing, and receiving mycophenolate mofetil or beta interferon (Table 1 ). In analyzing the relationship between severity of illness and treatments administered, beta interferon and mycophenolate mofetil were given to less severely ill patients (Table 3) Discussion MERS-CoV is an emerging disease for which the initial epidemiology has been described, but in-depth clinical studies and the role of therapy in incompletely understood. We present data from a retrospective cohort of ill patients with Mers-CoV and the results of the evaluation of the clinical efficacy of beta interferon beta, alpha interferon, ribavirin and mycophenolate mofetil in addition to routine supportive care. doi = 10.1186/s12879-016-1492-4 id = cord-323125-qtlevnbt author = Al Hosani, Farida Ismail title = Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts—Abu Dhabi, United Arab Emirates date = 2019-02-01 keywords = East; MERS; Middle summary = BACKGROUND: Although there is evidence of person-to-person transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent to which disease severity affects transmission. METHODS: A seroepidemiological investigation was conducted among MERS-CoV case patients (cases) and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. In this investigation, we use serological detection of MERS-CoV antibodies to evaluate if asymptomatic or mildly ill case patients had detectable MERS-CoV antibodies, estimate transmission rates from known cases to their household contacts, and identify potential risk factors. For each MERS-CoV case identified in the investigation, clinical information, including symptoms, was collected using the International Severe Acute Respiratory and Emerging Infection Consortium form, which was filled out in real time by healthcare providers and subsequently verified by retrospective chart review. doi = 10.1093/cid/ciy503 id = cord-298941-xf2ukinp author = Al-Abdallat, Mohammad Mousa title = Hospital-Associated Outbreak of Middle East Respiratory Syndrome Coronavirus: A Serologic, Epidemiologic, and Clinical Description date = 2014-05-14 keywords = East; MERS; Middle; outbreak summary = BACKGROUND: In April 2012, the Jordan Ministry of Health investigated an outbreak of lower respiratory illnesses at a hospital in Jordan; 2 fatal cases were retrospectively confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) to be the first detected cases of Middle East respiratory syndrome (MERS-CoV). Following the discovery of Middle East respiratory syndrome coronavirus (MERS-CoV) in September 2012 [2] , specimens from the 2 fatal cases in Jordan were retrospectively tested and both yielded positive results for MERS-CoV by real-time reverse transcription polymerase chain reaction (rRT-PCR), and were reported to the World Health Organization (WHO). Using newly developed serologic assays to determine MERS-CoV antibody responses among case contacts in this outbreak, epidemiologists from the JMoH, US Centers for Disease Control and Prevention (CDC), and regional partners conducted a retrospective seroepidemiologic investigation to (1) confirm whether surviving outbreak members had presence of antibodies to MERS-CoV, (2) ascertain whether viral transmission occurred among household contacts or to other healthcare personnel, and (3) describe the clinical features of all detected MERS-CoV infections in Jordan. doi = 10.1093/cid/ciu359 id = cord-345591-zwh1xj5u author = Al-Dorzi, Hasan M. title = The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study date = 2016-10-24 keywords = East; ICU; MERS; Middle summary = doi = 10.1186/s13613-016-0203-z id = cord-345081-15s2i6f0 author = Al-Sehaibany, Fares S. title = Middle East respiratory syndrome in children: Dental considerations date = 2017-04-17 keywords = East; MERS; Middle summary = As of January 2016, 1,633 laboratory-confirmed cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection and 587 MERS-related deaths have been reported by the World Health Organization globally. Middle East Respiratory Syndrome Coronavirus may also spread through aerosols generated during various dental treatments, resulting in transmission between patients and dentists. 1, 17 Viral infections, such as severe acute respiratory syndrome Saudi Med J 2017; Vol. 38 (4) www.smj.org.sa (SARS-CoV), may be transmitted to healthcare workers from infected patients through aerosols. 19 This review is an attempt to discuss MERS-CoV infection among children and those providing dental treatment to them, including precautions and considerations pertaining to the practice of pediatric dentistry. In pediatric dental practice, effective infection control measures for the prevention or minimization of viral infection transmission can be implemented by a) controlling the gag or cough reflex; b) reducing aerosol/ splatter generation; c) managing contaminated air and; d) improving personal protection. doi = 10.15537/smj.2017.4.15777 id = cord-307995-8q7efrqk author = Al-Tawfiq, Jaffar A. title = Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns date = 2016-05-04 keywords = East; MERS; Middle summary = Middle East respiratory syndrome coronavirus (MERS-CoV): summary and risk assessment of current situation in the Republic of Korea and China -as of 19 Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study A family cluster of Middle East Respiratory syndrome coronavirus infections related to a likely unrecognized asymptomatic or mild case Community case clusters of Middle East respiratory syndrome coronavirus in Hafr Al-Batin, Kingdom of Saudi Arabia: a descriptive genomic study Transmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive genomic study KSA MERS-CoV Investigation Team.Hospital outbreak of Middle East respiratory syndrome coronavirus Middle East respiratory syndrome coronavirus: a case-control study of hospitalized patients Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study doi = 10.1007/s11684-016-0446-y id = cord-349010-n4s8dzgp author = Al-Tawfiq, Jaffar A. title = Update on therapeutic options for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) date = 2016-12-24 keywords = East; MERS; Middle summary = doi = 10.1080/14787210.2017.1271712 id = cord-299519-hfgmmuy6 author = Alenazi, Thamer H. title = Severe Middle East Respiratory Syndrome (MERS) Pneumonia date = 2019-10-26 keywords = East; MERS; Middle; Saudi summary = A febrile acute respiratory illness with clinical, radiological, or histopathological evidence of pulmonary parenchymal disease (e.g. pneumonia or Acute Respiratory Distress Syndrome) that cannot be explained fully by any other etiology AND The person resides or traveled in the Middle East, or in countries where MERS-CoV is known to be circulating in dromedary camels or where human infections have recently occurred AND Testing for MERS-CoV is inconclusive. Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: An observational study Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: A descriptive study Middle East respiratory syndrome coronavirus infection during pregnancy: A report of 5 cases from Saudi Arabia An observational, laboratory-based study of outbreaks of middle East respiratory syndrome coronavirus in Jeddah and Riyadh, kingdom of Saudi Arabia Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: A retrospective cohort study doi = 10.1016/b978-0-12-801238-3.11488-6 id = cord-297062-dmiplvt2 author = Almekhlafi, Ghaleb A. title = Presentation and outcome of Middle East respiratory syndrome in Saudi intensive care unit patients date = 2016-05-07 keywords = East; ICU; MERS; Middle summary = authors: Almekhlafi, Ghaleb A.; Albarrak, Mohammed M.; Mandourah, Yasser; Hassan, Sahar; Alwan, Abid; Abudayah, Abdullah; Altayyar, Sultan; Mustafa, Mohamed; Aldaghestani, Tareef; Alghamedi, Adnan; Talag, Ali; Malik, Muhammad K.; Omrani, Ali S.; Sakr, Yasser BACKGROUND: Middle East respiratory syndrome coronavirus infection is associated with high mortality rates but limited clinical data have been reported. We describe the clinical features and outcomes of patients admitted to an intensive care unit (ICU) with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. METHODS: Retrospective analysis of data from all adult (>18 years old) patients admitted to our 20-bed mixed ICU with Middle East respiratory syndrome coronavirus infection between October 1, 2012 and May 31, 2014. We performed a retrospective study to describe the clinical features and outcomes of patients admitted to our ICU with laboratory-confirmed MERS-CoV infection. This report describes the clinical features and outcomes of 31critically ill patients with confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) infection. doi = 10.1186/s13054-016-1303-8 id = cord-287761-73qgx58i author = Aly, Mahmoud title = Occurrence of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) across the Gulf Corporation Council countries: Four years update date = 2017-10-13 keywords = East; MERS; Middle summary = Within a time span of 4 years from June 2012 to July 2016, we collect samples form MERS-CoV infected individuals from National Guard Hospital, Riyadh, and Ministry of health Saudi Arabia and other GCC countries. GCC countries including Saudi Arabia now have the infrastructure in place that allows physicians and scientific community to identify and immediately respond to the potential risks posed by new outbreaks of MERS-CoV infections in the region. The emergence of MERS-CoV dates back to July 2012 when an elderly patient of age 60 years died from an acute pneumonia in Saudi Arabia, and a new coronavirus strain was isolated from his lung tissue [1] . With regard to viral origin and transmission, the first case of MERS-CoV infection did not relate it to any particular contact with animals before the disease onset; however, other studies did link it to Dromedary camels [5] [6] [7] [8] . doi = 10.1371/journal.pone.0183850 id = cord-300536-8okuomi6 author = Baloch, Zulqarnain title = Unique Challenges to Control the Spread of COVID-19 in the Middle East date = 2020-07-13 keywords = East; Middle summary = These challenges include compromised healthcare systems, prolonged regional conflicts and humanitarian crises, suboptimal levels of transparency and cooperation, and frequent religious gatherings. These challenges include compromised healthcare systems, prolonged regional conflicts and humanitarian crises, suboptimal levels of transparency and cooperation, and frequent religious gatherings. Besides weakening healthcare systems, wars and conflicts in the Middle East have also led to large-scale humanitarian crises. In Iran, the early COVID-19 cases were recorded in Qom (Fig. 3B) , a city that attracts millions of pilgrims from countries including Lebanon, As pilgrims concentrating on religious rituals, there are close contacts among worshipers and insufficient self-protective measures, and therefore amplify the risk of transmission and potential super spreading of SARS-CoV-2 [24] . These include compromised healthcare systems, prolonged regional conflicts and humanitarian crises, suboptimal levels of transparency and cooperation, and frequent religious gatherings. doi = 10.1016/j.jiph.2020.06.034 id = cord-293505-1t3hg4wi author = Bernard-Stoecklin, Sibylle title = Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017 date = 2019-05-14 keywords = East; MERS; Middle summary = Such large healthcare-associated (HCA) outbreaks have mainly been limited to the Kingdom of Saudi Arabia (KSA) and the United Arabian Emirates (UAE) until the spring 2015, when a single imported case of MERS returning from the Middle East initiated a cluster of 186 cases in the Republic of Korea (ROK) across at least 17 hospitals and much of the country 18 . We analyzed epidemiological datasets of laboratory-confirmed MERS patients and focused our study on eleven healthcare-associated outbreaks that were reported in KSA and ROK since 2015, when policies and procedures for case identification and comprehensive contact identification and follow up became systematic and were implemented by affected countries. We defined a HCA-outbreak as the occurrence of 5 or more laboratory-confirmed MERS-CoV infections with reported epidemiologic links between cases and during which the human-to-human transmission events were documented within a single healthcare facility, with no more than 14 days apart between cases symptom onset. doi = 10.1038/s41598-019-43586-9 id = cord-272513-umuiovrd author = Bindayna, Khalid Mubarak title = Variant analysis of SARS-CoV-2 genomes in the Middle East date = 2020-10-09 keywords = East; Middle; variant summary = We also aim to analyse the variants of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to characterise the common genome variants and provide useful data in the global effort to prevent further spread of COVID-19. Methods The approach uses bioinformatics approaches including multiple sequence alignment, variant calling and annotation and phylogenetic analysis to identify the genomic variants found in the region. The approach uses 122 samples from the 13 countries of the Middle East sourced from the Global Initiative on Sharing All Influenza Data (GISAID). Variant alignment and phylogenetic tree generation indicates that samples from Iran likely introduced COVID-19 to the rest of the Middle East. • Our hypothesis is that variants found in SARS-CoV-2 genomes from Middle Eastern samples will indicate delivery from Iran. • The aim is to explore the structure of Middle Eastern genome strains using multiple sequence alignment, tree generation and variant prediction (and others). doi = 10.1101/2020.10.09.332692 id = cord-252883-1ub01j2x author = Bleibtreu, A. title = Focus on Middle East respiratory syndrome coronavirus (MERS-CoV) date = 2019-11-11 keywords = Arabia; East; MERS; Middle; Saudi summary = Since the first case of human infection by the Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in June 2012, more than 2260 cases of confirmed MERS-CoV infection and 803 related deaths have been reported since the 16th of October 2018. The first case of infection attributed to Middle East respiratory syndrome coronavirus (MERS-CoV) was detected in Saudi Arabia in June 2012 [1] . Despite these viruses being identified in several reports as causing lower respiratory tract infections, it was generally accepted that coronaviruses were of low pathogenicity until the emergence of SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus) in 2002, a virus with a fatality rate estimated at 10%. Very shortly afterwards, in September 2012, a second patient was admitted to hospital in the United Kingdom for severe respiratory infection related to a novel coronavirus following travel to the Middle East. Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission doi = 10.1016/j.medmal.2019.10.004 id = cord-323133-gdg50omp author = Buzatto, G. P. title = The pathogens profile in children with otitis media with effusion and adenoid hypertrophy date = 2017-02-23 keywords = ear; middle; ome; patient summary = OBJECTIVES: To evaluate the presence of viruses and bacteria in middle ear and adenoids of patients with and without otitis media with effusion (OME). METHODS: Adenoid samples and middle ear washes (MEW) were obtained from children with OME associated with adenoid hypertrophy undergoing adenoidectomy and tympanostomy, and compared to those obtained from patients undergoing cochlear implant surgery, as a control group. Therefore, the present study was carried out to compare the detection of common respiratory viruses and bacteria in adenoids and middle ear fluid in children with OME and in controls. In our study, we used a sensitive method to detect nucleic acid of a comprehensive panel of respiratory viruses and bacteria to compare the microbial colonization of adenoid and its correspondence in the middle ear in both OME children and controls. Concluding, in children with OME and adenoid hypertrophy we observed higher detection rates of potentially pathogenic bacteria, but not respiratory viruses, by real-time PCR in middle ear samples, as compared to control patients without adenoid hypertrophy. doi = 10.1371/journal.pone.0171049 id = cord-337825-ujq9mxk7 author = Chen, Bin title = Overview of lethal human coronaviruses date = 2020-06-10 keywords = ACE2; CoV; CoV-2; East; MERS; Middle; SARS; coronavirus; protein summary = Coronaviruses are the largest +ssRNA viruses and contain at least 14 ORFs, 16 protein combines with viral RNA to form a nucleocapsid, which is involved in the replication of SARS-CoV and is the most abundant protein in virus-infected cells. MERS-CoV can infect T-cells from human lymphoid organs and causes the peripheral blood inducing apoptosis by intrinsic and extrinsic pathways, thus avoiding host immune response detection method, Nanopore Targeted Sequencing, also has the potential for efficiently detecting viruses in a reasonable time. The structural and accessory proteins M, ORF 4a, ORF 4b, and ORF 5 of Middle East respiratory syndrome coronavirus (MERS-CoV) are potent interferon antagonists Middle East respiratory syndrome coronavirus (MERS-CoV) entry inhibitors targeting spike protein Identification of a receptor-binding domain in the S protein of the novel human coronavirus Middle East respiratory syndrome coronavirus as an essential target for vaccine development Receptor-binding domain of SARS-CoV spike protein induces highly potent neutralizing antibodies: implication for developing subunit vaccine doi = 10.1038/s41392-020-0190-2 id = cord-016451-k8m2xz0e author = Chertow, Daniel S. title = Influenza, Measles, SARS, MERS, and Smallpox date = 2020-01-03 keywords = East; MERS; Middle; SARS; respiratory; virus summary = Influenza, measles, SARS, MERS, and smallpox illnesses are caused by highly infectious viral pathogens that induce critical illness. Measles infects and disrupts tissues throughout the body; however, severe disease is primarily due to lower respiratory tract and neurological complications [72] . Global epidemiology of avian influenza A H5N1 virus infection in humans, 1997-2015: a systematic review of individual case data Transmission of Middle East respiratory syndrome coronavirus infections in healthcare settings Viral shedding and antibody response in 37 patients with Middle East respiratory syndrome coronavirus infection Viral RNA in blood as indicator of severe outcome in Middle East respiratory syndrome coronavirus infection Clinical features and viral diagnosis of two cases of infection with Middle East respiratory syndrome coronavirus: a report of nosocomial transmission Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection doi = 10.1007/978-3-030-33803-9_5 id = cord-295633-vkjcheaz author = Hao, Xin‐yan title = The characteristics of hDPP4 transgenic mice subjected to aerosol MERS coronavirus infection via an animal nose‐only exposure device date = 2019-10-30 keywords = East; MERS; Middle; day summary = After infection, we analyzed the mouse characteristics of weight loss, survival, viral replication, tissue pathology, viral antigen distribution, and cytokine and chemokine profiles, which provide additional data to investigate the pathogenesis of MERS-CoV-induced disease and evaluate relevant therapeutics and vaccines. Instillation control DMEM suspension To analyze clinical signs, weight loss, and survival On days 3, 5, 7, and 9 postinfection, three animals randomly selected from each group underwent necropsy to obtain tissue specimens for assessing viral distribution, associated histopathology, and cytokine levels using quantitative reverse transcription-PCR (qRT-PCR), hematoxylin and eosin (H&E) staining, immunohistochemistry (IHC), and enzyme-linked immunosorbent assay (ELISA). *P < .05, **P < .01, ***P < .001, and ****P < .0001 Mice in the instillation group died acutely or were euthanized when they researched 25% weight loss; these mice had a 0% survival rate by day 5, so no tissue lesion results were available on days 7 and 9 mice infected with MERS-CoV via the aerosol inhalation or intranasal instillation route, but no obvious lesions were found in other tissues. doi = 10.1002/ame2.12088 id = cord-017615-zjr6csla author = Hillman, John R. title = Food Security in an Insecure Future date = 2016-11-25 keywords = Arab; East; International; Middle; Region; United; country; food summary = Food security in the Middle East is directly affected by a challenging combination of ongoing destructive conflicts, a global economic downturn, widespread poverty, high population growth, corruption, intolerance, and the potentially damaging consequences of climate change. In a previous article , we considered definitions of food security in the modern era of rising global populations, discussing how food security might be attained in terms of security of water and fossil-fuel-derived energy supplies, climate change, rapid urbanisation, changing dietary trends, and modification of the natural environment leading to depleted natural resources, increasing environmental pollution, and the need to introduce modern technologies. Here, we consider potential adaptations to an insecure global future generally, and to the concerns in the Arab Middle East specifically, in the light of the economic realities of wide disparities in wealth, competition for resources, and widespread poverty in many parts of the globe, coupled to a relatively high population growth, on-going conflicts, attempted cultural genocides, potential conflicts, endemic corruption and nepotism, and epidemics of infectious diseases. doi = 10.1007/978-3-319-48920-9_12 id = cord-267540-9p4rky4c author = Joseph, Iype title = Middle east respiratory syndrome corona virus (MERS CoV): The next steps date = 2015-03-26 keywords = MERS; Middle summary = title: Middle east respiratory syndrome corona virus (MERS CoV): The next steps Developing countries are at risk of importing Middle East Respiratory Syndrome Corona Virus (MERS CoV) from the Middle East. To assess the disease transmission in these countries, supplemental surveillance strategies are urgently needed beyond the currently recommended measures. Saudi Arabia reported the first case of Middle East Respiratory Syndrome Corona Virus (MERS-CoV) in September, 2012. Using the current strategy of virological testing of patients fulfilling the WHO case definition, India, Pakistan, Egypt, Bangladesh, Philippines, Sri Lanka, and Indonesia 13 (countries having sizable numbers of health workers employed in the Middle-East) have not yet detected more than one case each. When all care givers of a patient acutely ill with MERS CoV are immune, further transmission within the hospital is unlikely. Middle east respiratory syndrome coronavirus infections in health care workers doi = 10.1057/jphp.2015.9 id = cord-269232-rhhmvnlp author = Joseph, Sunitha title = First isolation of West Nile virus from a dromedary camel date = 2016-06-08 keywords = East; Middle; WNV summary = Although antibodies against West Nile virus (WNV) have been detected in the sera of dromedaries in the Middle East, North Africa and Spain, no WNV has been isolated or amplified from dromedary or Bactrian camels. Notably, the amino-acid residues at 14 positions in the present dromedary WNV genome differed from those in most of the closely related WNV strains in cluster 2 of lineage 1a, with the majority of these differences observed in the putative E and NS5 proteins. [6] [7] [8] [9] [10] [11] [12] [13] In this article, we report the first isolation of WNV from a dromedary calf in the United Arab Emirates during the process of MERS-CoV screening and the results of the comparative genome and phylogenetic analysis. 20 Notably, 14 amino-acid residues in the present dromedary WNV genome differed from those in most of the closely related WNV strains in cluster 2 of lineage 1a (Figure 3) , with the majority of these differences observed in the putative E and NS5 proteins. doi = 10.1038/emi.2016.53 id = cord-265666-27ckjl7w author = Kang, Hee Sun title = Working experiences of nurses during the Middle East respiratory syndrome outbreak date = 2018-05-30 keywords = East; MERS; Middle summary = RESULTS: The following 4 major themes emerged: "experiencing burnout owing to the heavy workload," "relying on personal protective equipment for safety," "being busy with catching up with the new guidelines related to Middle East respiratory syndrome," and "caring for suspected or infected patients with caution." Participants experienced burnout because of the high volume of work and expressed safety concerns about being infected. CONCLUSION: This study showed that creating a supportive and safe work environment is essential by ensuring adequate nurse staffing, supplying best‐quality personal protective equipment, and improving communication to provide the quality of care during infection outbreak. The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: An observational study doi = 10.1111/ijn.12664 id = cord-330343-p7a8chn4 author = Kelly-Cirino, Cassandra title = An updated roadmap for MERS-CoV research and product development: focus on diagnostics date = 2019-02-01 keywords = CoV; East; MERS; Middle; respiratory summary = ► Diagnostic research and development (R&D) needs to include point-of-care testing options, syndromic panels for differential diagnosis, a greater understanding of viral and antibody kinetics, improved access to clinical specimens, and establishment of international reference standards. Diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the Middle East respiratory syndrome-coronavirus (MERS-CoV), one of the high-priority pathogens identified by the WHO. Diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the Middle East respiratory syndrome-coronavirus (MERS-CoV), one of the high-priority pathogens identified by the WHO. In this review we identified sources for molecular and serological diagnostic tests used in MERS-CoV detection, case management and outbreak investigations, as well as surveillance for humans and animals (camels), and summarised the performance of currently available tests, diagnostic needs, and associated challenges for diagnostic test development and implementation. doi = 10.1136/bmjgh-2018-001105 id = cord-304054-sn7rswab author = Khan, Gulfaraz title = Chapter 8 The Middle East Respiratory Syndrome Coronavirus: An Emerging Virus of Global Threat date = 2020-12-31 keywords = East; MERS; Middle summary = Abstract Middle East respiratory syndrome (MERS) is a viral respiratory illness caused by a coronavirus (CoV), first identified in Saudi Arabia in 2012. Although the natural reservoir of MERS-CoV infection and mode of transmission to humans is not known, one factor appears to be common to all primary cases; they are epidemiologically linked to the Middle East region. Cross-sectional surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels and other mammals in Egypt Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans, Saudi Arabia Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study Middle East respiratory syndrome coronavirus infection during pregnancy: a report of 5 cases from Saudi Arabia Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission Transmission of Middle East Respiratory syndrome coronavirus infections in healthcare settings doi = 10.1016/b978-0-12-819400-3.00008-9 id = cord-256806-g42n51n9 author = Khudhair, Ahmed title = Risk Factors for MERS-CoV Seropositivity among Animal Market and Slaughterhouse Workers, Abu Dhabi, United Arab Emirates, 2014–2017 date = 2019-05-17 keywords = East; MERS; Middle summary = title: Risk Factors for MERS-CoV Seropositivity among Animal Market and Slaughterhouse Workers, Abu Dhabi, United Arab Emirates, 2014–2017 Camel contact is a recognized risk factor for Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Our study aimed to identify risk factors for MERS-CoV seropositivity among live-animal market and slaughterhouse workers. The survey consisted of questions covering worker demographics; occupational history; contact with various animal species; travel history; medical history; consumption of raw camel milk, raw camel meat, and camel urine; specific tasks performed with camels; types of personal protective equipment (PPE) worn; and handwashing practices (Appendix 1, https://wwwnc.cdc.gov/EID/article/25/5/18-1728-App1.pdf). Our study investigated risk factors for MERS-CoV seropositivity in animal market and slaughterhouse workers at a site previously associated with zoonotic transmission of MERS-CoV. Among market workers, handling live camels and either administering medications to camels or cleaning equipment were practices associated with significantly increased risk for MERS-CoV seropositivity. doi = 10.3201/eid2505.181728 id = cord-316392-bp988sir author = Kupfer, Bernd title = Severe Pneumonia and Human Bocavirus in Adult date = 2006-10-17 keywords = Kingdom; Middle summary = To the Editor: The newly identified human bocavirus (hBoV), a member of the Parvovirus family, is suspected to infect the cells of the respiratory tract and thus may be an etiologic agent of respiratory disease in humans (1) . Retrospectively, however, human bocavirus DNA in the archived BAL strongly suggests that pulmonary symptoms were caused by this agent rather than by a yet unknown bacterial or fungal infection. This finding led to the conclusion that a "new" virus that induces the identical clinical symptoms, like the human bocavirus, may also contribute to severe respiratory infections. Besides the first proof for visceral leishmaniasis in paleopathology, we provide evidence that leishmaniasis was present in Nubia in the early Christian period and that the organism also infected ancient Egyptians, probably because of close trading contacts to Nubia, during the Middle Kingdom. Detection of human bocavirus in Japanese children with lower respiratory tract infections doi = 10.3201/eid1210.060520 id = cord-329514-dnh3rx0q author = Kurono, Yuichi title = Middle Ear and Eustachian Tube date = 2007-05-09 keywords = ear; middle summary = Although specific IgG antibodies are protective against the invasion of bacterial antigen into the middle ear, some evidence suggests that systemic immune system may be involved in inducing or sustaining MEEs. Ueyama et al. The presence of antigen-specific IgA antibodies in MEEs of patients with AOM as well as OME suggests that the mucosal immune system in the middle ear plays a role in the pathogenesis of those diseases. (1996) also reported that parenteral immunization with P6 did not alter the extent or duration of nasopharyngeal colonization by NTHi. These results indicate that IgA antibodies in nasopharyngeal secretions inhibit the adherence of middle ear pathogens to nasopharyngeal mucosa and facilitate the clearance of those bacteria from the nasopharynx. Induction of specific immunoglobulin A and Th2 immune responses to P6 outer membrane protein of nontypeable Haemophilus influenzae in middle ear mucosa by intranasal immunization doi = 10.1016/b978-012491543-5/50092-9 id = cord-287156-3plpi6i9 author = Lassandro, Giuseppe title = Children in Coronaviruses’ Wonderland: What Clinicians Need to Know date = 2020-07-01 keywords = COVID-19; East; MERS; Middle; SARS; respiratory summary = Among the seven coronaviruses that affect humans (SARS)-CoV, the Middle East respiratory syndrome (MERS)-CoV, and the most recent coronavirus disease 2019 (COVID-19) represent potential life-threatening diseases worldwide. Children appear to be less susceptible to develop severe clinical disease and present usually with mild and aspecific symptoms similar to other respiratory infections typical of childhood. 8, 9 Additionally, three HCoVs responsible for outbreaks involving high case fatality rates have been detected in humans in the last two decades: the severe acute respiratory syndrome (SARS)-CoV, the Middle East respiratory syndrome (MERS)-CoV and the new coronavirus disease 2019 (COVID-19) ( Table 1) . Principal features of severe acute respiratory syndrome (SARS)-CoV, the Middle East respiratory syndrome (MERS)-CoV and the most recent coronavirus disease 2019 (COVID19) . Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission doi = 10.4084/mjhid.2020.042 id = cord-265380-2gs34xcw author = Leist, Sarah R. title = Genetically Engineering a Susceptible Mouse Model for MERS-CoV-Induced Acute Respiratory Distress Syndrome date = 2019-09-14 keywords = East; Fig; MERS; Middle; respiratory summary = Precise molecular engineering of mouse DPP4 (mDPP4) with clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 technology maintained inherent expression profiles, and limited MERS-CoV susceptibility to tissues that naturally express mDPP4, notably the lower respiratory tract wherein MERS-CoV elicits severe pulmonary pathology. utilized a unique approach for producing susceptible mice that could replicate human isolates of MERS-CoV in the lungs by infecting mouse lungs with an adenovirus that constitutively expresses the full-length hDPP4 gene ( Fig. 1) [37] . Attempts to restrict hDPP4 expression to epithelial cells of the lungs using constitutive tissue specific promoters (e.g., cytokeratin K18) yielded outcomes similar to those observed with SARS-CoV mouse models, wherein high levels of MERS-CoV infection/replication were detected in the brains (Fig. 1 ) [39] . Elevated human dipeptidyl peptidase 4 expression reduces the susceptibility of hDPP4 transgenic mice to Middle East respiratory syndrome coronavirus infection and disease doi = 10.1007/978-1-0716-0211-9_12 id = cord-252222-wyamc46k author = Leung, Chi Hung Czarina title = Middle East respiratory syndrome date = 2014-05-13 keywords = East; Middle summary = Middle East respiratory syndrome (MERS) is due to RNA betacoronavirus (MERS-CoV) infection. The apparent epidemiology may be biased by selective reporting of more severe cases and the small total number of patients makes it susceptible to distortion by individual outbreaks. Clinical suspicion, therefore, depends on vigilance and, for the present time, on a history of travel to the Middle East or contact with a patient with respiratory disease and an appropriate travel history [11] . Middle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility Interhuman transmissibility of Middle East respiratory syndrome coronavirus: estimation of pandemic risk Emerging human Middle East respiratory syndrome coronavirus causes widespread infection and alveolar damage in human lungs Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study doi = 10.1007/s00134-014-3303-y id = cord-255488-nvgz53su author = Li, Kun title = Development of a Mouse-Adapted MERS Coronavirus date = 2019-09-14 keywords = East; MERS; Middle summary = An animal model that supports MERS-CoV infection and causes severe lung disease is useful to study pathogenesis and evaluate therapies and vaccines. To generate a mouse model with associated morbidity and mortality from respiratory disease, we serially passaged HCoV-EMC/2012 strain in the lungs of young hDPP4 KI mice. Alternative strategies for the creation of mouse models of MERS-CoV infection are generation of DPP4 humanized mice and adaptation of the virus to the animals. Similarly, our human DPP4 knock-in mouse model supported MERS-CoV replication but did not lead to a severe lung disease phenotype [33] . Generation of a transgenic mouse model of Middle East respiratory syndrome coronavirus infection and disease Middle East respiratory syndrome coronavirus causes multiple organ damage and lethal disease in mice transgenic for human dipeptidyl peptidase 4 Mouse-adapted MERS coronavirus causes lethal lung disease in human DPP4 knockin mice doi = 10.1007/978-1-0716-0211-9_13 id = cord-312741-0au4nctt author = Lin, Panpan title = Coronavirus in human diseases: Mechanisms and advances in clinical treatment date = 2020-10-01 keywords = East; MERS; Middle; RNA; SARS; coronavirus; protein; respiratory; syndrome summary = doi = 10.1002/mco2.26 id = cord-349287-mwj2qby4 author = Mackay, Ian M. title = MERS coronavirus: diagnostics, epidemiology and transmission date = 2015-12-22 keywords = Coronavirus; East; KSA; MERS; Middle; Respiratory; Syndrome summary = The first known cases of Middle East respiratory syndrome (MERS), associated with infection by a novel coronavirus (CoV), occurred in 2012 in Jordan but were reported retrospectively. Most human cases of MERS have been linked to lapses in infection prevention and control (IPC) in healthcare settings, with approximately 20 % of all virus detections reported among healthcare workers (HCWs) and higher exposures in those with occupations that bring them into close contact with camels. Since asymptomatic zoonoses have been posited [72] , an absence of antibodies to MERS-CoV among some humans who have regular and close contact with camels may reflect the rarity of actively infected animals at butcheries, a limited transmission risk associated with slaughtering DCs [70] , a pre-existing cross-protective immune status or some other factor(s) resulting in a low risk of disease and concurrent seroconversion developing after exposure in this group. First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-tohuman transmission doi = 10.1186/s12985-015-0439-5 id = cord-305317-08a1oin2 author = Maltezou, Helena C. title = Middle East respiratory syndrome coronavirus: Implications for health care facilities date = 2014-12-31 keywords = East; MERS; Middle summary = Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel betacoronavirus of the Coronaviridae family that causes a severe respiratory disease with a high case fatality rate. 2, 3, 6, 8, 22, 24 During the largest so farepublished outbreak of MERS-CoV that occurred in Al-Hasa, Saudi Arabia, in 2013, 4 health care facilities were affected through transfer of patients but also possibly because of repeated introductions of cases from the community. Studies about the effectiveness of infection control measures will provide answers and eventually promote safety in health care facilities both for patients and HCWs. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study Investigation of an imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Interim infection prevention and control recommendations for hospitalized patients with Middle East respiratory syndrome coronavirus (MERS-CoV) doi = 10.1016/j.ajic.2014.06.019 id = cord-318585-cp76qr9f author = Matsuyama, Ryota title = Clinical determinants of the severity of Middle East respiratory syndrome (MERS): a systematic review and meta-analysis date = 2016-11-29 keywords = East; MERS; Middle summary = BACKGROUND: While the risk of severe complications of Middle East respiratory syndrome (MERS) and its determinants have been explored in previous studies, a systematic analysis of published articles with different designs and populations has yet to be conducted. We identified older age, male sex and underlying medical conditions, including diabetes mellitus, renal disease, respiratory disease, heart disease and hypertension, as clinical predictors of death associated with MERS. PICO statement: Our study question is focused on laboratory confirmed cases of MERS regardless of their treatment status, and thus, involves only retrospective observational studies, measuring their risks of admission to Intensive Care Unit (ICU) and death and comparing those risks by age, gender and underlying comorbidities. The present study systematically reviewed the risk of severe manifestations and death by MERS by systematically searching and analyzing published articles from the KSA and the ROK and calculating not only the CFR but [16] . For Fig. 4 Estimated risks associated with Middle East respiratory syndrome (MERS) by study design. doi = 10.1186/s12889-016-3881-4 id = cord-286472-pqtem19t author = McFee, R.B. title = MIDDLE EAST RESPIRATORY SYNDROME (MERS) CORONAVIRUS date = 2020-07-28 keywords = East; MERS; Middle; SARS; respiratory summary = This newly identified respiratory viral illness was caused by a novel coronavirus, which was initially designated as human betacoronavirus (2) (3) (4) (5) , but was eventually named Middle East Respiratory Syndrome Coronavirus (MERS CoV). It is important to consider multisystem function as well as pulmonary status in patients with severe respiratory illness, including suspected MERS CoV, especially those returning from regions where aggressive pathogens are noted. Patients recently returning from the Middle East, presenting with significant respiratory illness, with CT findings of peribronchial region abnormalities, organizing pneumonia, should be considered for MERS CoV infection, and if possible, queried about international travel and occupational exposures. Middle East Respiratory Syndrome Coronavirus (MERS CoV) Infection Feasibility, safety, clinical and laboratory effects of convalescent plasma therapy for patients with Middle East respiratory syndrome coronavirus infection: a study protocol doi = 10.1016/j.disamonth.2020.101053 id = cord-256784-wfaqim7d author = Modjarrad, Kayvon title = MERS-CoV vaccine candidates in development: The current landscape date = 2016-06-03 keywords = East; MERS; Middle summary = Middle East Respiratory Syndrome (MERS-CoV) was first isolated in September 2012 from a patient in Saudi Arabia who presented two months earlier with severe acute respiratory infection and acute renal failure [1] . Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia A truncated receptor-binding domain of MERS-CoV spike protein potently inhibits MERS-CoV infection and induces strong neutralizing antibody responses: implication for developing therapeutics and vaccines Effects of human anti-spike protein receptor binding domain antibodies on severe acute respiratory syndrome coronavirus neutralization escape and fitness Middle East respiratory syndrome coronavirus spike protein delivered by modified vaccinia virus Ankara efficiently induces virus-neutralizing antibodies Systemic and mucosal immunity in mice elicited by a single immunization with human adenovirus type 5 or 41 vector-based vaccines carrying the spike protein of Middle East respiratory syndrome coronavirus Exceptionally potent neutralization of Middle East respiratory syndrome coronavirus by human monoclonal antibodies doi = 10.1016/j.vaccine.2016.03.104 id = cord-275313-mfyff9ne author = Modjarrad, Kayvon title = Treatment strategies for Middle East respiratory syndrome coronavirus date = 2016-01-01 keywords = CoV; East; MERS; Middle summary = Most recently, Middle East respiratory syndrome coronavirus (MERS-CoV) has emerged as a novel cause of severe acute respiratory illness after first being identified in a Saudi Arabian patient in 2012 [2] . Much of the work to develop safe and effective MERS-CoV countermeasures has centred on vaccines, but the relatively low prevalence of the disease, the sporadic nature of the case clusters and the dearth of detailed knowledge on chains of transmission highlight the need for greater investments into the discovery of effective therapeutic and secondary prophylactic regimens for infected and exposed individuals. Feasibility, safety, clinical, and laboratory effects of convalescent plasma therapy for patients with Middle East respiratory syndrome coronavirus infection: a study protocol Towards the prophylactic and therapeutic use of human neutralizing monoclonal antibodies for Middle East respiratory syndrome coronavirus (MERS-CoV) Repurposing of clinically developed drugs for treatment of Middle East respiratory syndrome coronavirus infection doi = nan id = cord-317688-mr851682 author = Oh, Myoung-don title = Middle East respiratory syndrome: what we learned from the 2015 outbreak in the Republic of Korea date = 2018-02-27 keywords = East; Korea; MERS; Middle summary = Middle East Respiratory Syndrome coronavirus (MERS-CoV) was first isolated from a patient with severe pneumonia in 2012. Middle East respiratory syndrome coronavirus (MERS-CoV) was first isolated from a patient with severe pneumonia in September 2012 [1] . The first patient (index case) with MERS-CoV infection was a 68-year-old Korean man returning from the Middle East. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications Risk factors for transmission of Middle East respiratory syndrome coronavirus infection during the 2015 outbreak in South Korea Clinical implications of 5 cases of Middle East respiratory syndrome coronavirus infection in a South Korean outbreak Renal complications and their prognosis in Korean patients with Middle East respiratory syndrome-coronavirus from the central MERS-CoV designated hospital Successful treatment of suspected organizing pneumonia in a patient with Middle East respiratory syndrome coronavirus infection: a case report doi = 10.3904/kjim.2018.031 id = cord-278238-w1l8h8g8 author = Okba, Nisreen MA title = Middle East respiratory syndrome coronavirus vaccines: current status and novel approaches date = 2017-04-13 keywords = East; MERS; Middle; SARS summary = Nisreen MA Okba, V Stalin Raj and Bart L Haagmans Middle East respiratory syndrome coronavirus (MERS-CoV) is a cause of severe respiratory infection in humans, specifically the elderly and people with comorbidities. The other candidate MVA-S, a viral-vector-based vaccine, induced systemic neutralizing antibodies and mucosal immunity which conferred protection against MERS-CoV challenge and reduced virus shedding in vaccinated camels [52 ] Therefore, this vaccine candidate may provide a means to prevent zoonotic transmission of the virus to the human population. Prophylaxis with a Middle East respiratory syndrome coronavirus (MERS-CoV)-specific human monoclonal antibody protects rabbits from MERS-CoV infection T cell responses are required for protection from clinical disease and for virus clearance in severe acute respiratory syndrome coronavirus-infected mice The recombinant Nterminal domain of spike proteins is a potential vaccine against Middle East respiratory syndrome coronavirus (MERS-CoV) infection doi = 10.1016/j.coviro.2017.03.007 id = cord-263016-28znb322 author = Omrani, A.S. title = Middle East respiratory syndrome coronavirus (MERS-CoV): what lessons can we learn? date = 2015-08-22 keywords = East; MERS; Middle; Saudi summary = Infection prevention/control and management guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection Infection prevention and control guidelines for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection Revised interim case definition for reporting to WHO e Middle East respiratory syndrome coronavirus (MERS-CoV) Revised interim case definition for reporting to WHO e Middle East respiratory syndrome coronavirus (MERS-CoV) Investigation of cases of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV); interim guidance updated 3 Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia Investigation of an imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in doi = 10.1016/j.jhin.2015.08.002 id = cord-332237-8oykgp0h author = Omrani, Ali S title = Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study date = 2014-09-29 keywords = East; MERS; Middle summary = title: Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study We aimed to compare ribavirin and interferon alfa-2a treatment for patients with severe MERS-CoV infection with a supportive therapy only. INTERPRETATION: In patients with severe MERS-CoV infection, ribavirin and interferon alfa-2a therapy is associated with significantly improved survival at 14 days, but not at 28 days. 8 We aimed to assess outcomes of a treatment programme for patients with severe MERS-CoV infection that consisted of oral ribavirin and subcutaneous pegylated interferon alfa-2a. In critically ill patients with severe MERS-CoV infection, our study shows that ribavirin and pegylated interferon alfa-2a therapy is associated with a signifi cant 14-day survival benefi t compared with standard treatment. 18 In another report, 19 a patient with severe MERS-CoV infection received ribavirin and interferon therapy with good clinical response and no signifi cant adverse eff ects. doi = 10.1016/s1473-3099(14)70920-x id = cord-318872-0e5zjaz1 author = Park, Ji-Eun title = MERS transmission and risk factors: a systematic review date = 2018-05-02 keywords = East; MERS; Middle summary = BACKGROUND: Since Middle East respiratory syndrome (MERS) infection was first reported in 2012, many studies have analysed its transmissibility and severity. The incubation period was reported to be 6.83-7 days in South Korea [4, 5] , but 5.5 in a study using data from multiple areas [6] and 5.2 in Saudi Arabia [7] . Although one study from Saudi Arabia reported longer than 17 days from onset to death [36] , Sha et al., comparing data between the Middle East and South Korea, reported similar periods of 11.5 and 11 days, respectively [29] . Mortality of MERS patients was found to be 20.4% in South Korea based on a report including all cases [27] , but most studies from Saudi Arabia reported higher rates, from 22 to 69.2% [7, 22, 33, [37] [38] [39] . Risk factors for transmission of Middle East respiratory syndrome coronavirus infection during the 2015 outbreak in South Korea doi = 10.1186/s12889-018-5484-8 id = cord-284374-sqxlnk9e author = Park, Jiyeon title = Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea date = 2020-01-15 keywords = East; MERS; Middle; PPE summary = title: Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea Our experience with setting up a temporary negative-pressure operation room and our conservative approach for managing MERS-related patients can be referred in cases of future unexpected MERS outbreaks in non-endemic countries. Anesthesiologists were recommended to apply enhanced PPE (including PAPR from the middle of the outbreak) when managing all MERS-related patients because they were most directly exposed to the aerosol-producing high-risk procedures, such as endotracheal intubation and extubation. Almost all hospitals generally have positive-pressure operating rooms and they may experience an outbreak without facilities that are prepared for perioperative management of MERS patients, as our hospital did in 2015. First, although the previous guidelines recommended that asymptomatic MERS-exposed patients be managed as general patients undergoing surgery, we applied standard PPE to HCWs and we performed MERS-CoV PCR screening twice. doi = 10.1038/s41598-019-57216-x id = cord-351186-llnlto7p author = Park, Yong-Shik title = The first case of the 2015 Korean Middle East Respiratory Syndrome outbreak date = 2015-11-14 keywords = MERS; Middle summary = Valuable lessons learned included: (1) epidemiological knowledge on the MERS transmission pattern and medical knowledge on its clinical course; (2) improvement of epidemiological investigative methods via closed-circuit television, global positioning system tracking, and review of Health Insurance Review and Assessment Service records; (3) problems revealed in the existing preventive techniques, including early determination of the various people contacted; (4) experiences with preventive methods used for the first time in Korea, including cohort quarantine; (5) reconsideration of the management systems for infectious disease outbreaks across the country, such as this case, at the levels of central government, local government, and the public; (6) reconsideration of hospital infectious disease management systems, culture involving patient visitation, and emergency room environments. Through personal and phone interviews we contacted employees at business facility in Saudi Arabia who may have had contact with Patient #1 during the incubation period; we investigated the places he visited, presence or absence of MERS symptoms in the individuals he contacted, history of visiting medical facilities in the Middle East, and history of consuming camel milk or meat, among other things. doi = 10.4178/epih/e2015049 id = cord-286631-3fmg3scx author = Pormohammad, Ali title = Comparison of confirmed COVID‐19 with SARS and MERS cases ‐ Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta‐analysis date = 2020-06-05 keywords = East; MERS; Middle; SARS summary = title: Comparison of confirmed COVID‐19 with SARS and MERS cases ‐ Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta‐analysis The trigger for rapid screening and treatment of COVID-19 patients is based on clinical symptoms, laboratory, and radiographic findings that are similar to SARS and MERS infections. In this study, we attempted to distinguish the clinical symptoms, laboratory findings, radiographic signs, and outcomes of confirmed COVID-19, SARS, and MERS patients. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection Middle East respiratory syndrome coronavirus: a case-control study of hospitalized patients doi = 10.1002/rmv.2112 id = cord-022582-2e9i3m4b author = Potsic, William P. title = Otolaryngologic Disorders date = 2012-03-21 keywords = airway; child; ear; infection; middle; nasal; neck; present; treatment summary = When fluid persists in the middle ear for 3 to 4 months, causing a hearing loss or is associated with ASOM, myringotomy and tympanostomy tube placement is helpful to resolve the hearing loss and reduce the frequency and severity of infection. In addition to antibiotics, treatment should include a wide field myringotomy from the anterior inferior quadrant to the posterior inferior quadrant, a tympanostomy tube placement for middle ear drainage, and a postauricular mastoidectomy to drain the subperiosteal abscess and the mastoid. These infections may be caused by a variety of viral and bacterial pathogens; and in addition to sore throat, symptoms include fever, mucopurulent nasal drainage, nasal obstruction, and facial pain. Symptoms typically appear at birth or soon thereafter and include inspiratory stridor, feeding difficulties, and, rarely, apnea or signs of severe airway obstruction. Children afflicted with recurrent respiratory papillomatosis present initially with hoarseness but may also have symptoms and signs of airway obstruction, including stridor. doi = 10.1016/b978-0-323-02842-4.50055-3 id = cord-329190-kv9n2qj3 author = Rabaan, Ali A. title = A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective date = 2017-09-01 keywords = CoV; East; IFN; MERS; Middle; SARS summary = The current therapies have mainly been adapted from severe acute respiratory syndrome (SARS-CoV) treatments, including broad-spectrum antibiotics, corticosteroids, interferons, ribavirin, lopinavir–ritonavir or mycophenolate mofetil, and have not been subject to well-organized clinical trials. The Medline database was searched using combinations and variations of terms, including ''Middle East respiratory syndrome coronavirus'', ''MERS-CoV'', ''SARS'', ''therapy'', ''molecular'', ''vaccine'', ''prophylactic'', ''S protein'', ''DPP4'', ''heptad repeat'', ''protease'', ''inhibitor'', ''anti-viral'', ''broad-spectrum'', ''interferon'', ''convalescent plasma'', ''lopinavir ritonavir'', ''antibodies'', ''antiviral peptides'' and ''live attenuated viruses''. A position paper on the evidence base for specific MERS-CoV therapies, published by Public Health England (PHE) and the World Health Organization-International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC-WHO), suggested that benefit was likely to exceed risk for convalescent plasma, lopinavir-ritonavir, IFNs and monoclonal/polyclonal antibodies, while, by contrast, for ribavirin monotherapy and corticosteroids it was considered that the risks would outweigh the benefits [42] . doi = 10.1099/jmm.0.000565 id = cord-266260-t02jngq0 author = Ramshaw, Rebecca E. title = A database of geopositioned Middle East Respiratory Syndrome Coronavirus occurrences date = 2019-12-13 keywords = Coronavirus; East; MERS; Middle; Respiratory; Syndrome summary = As a World Health Organization Research and Development Blueprint priority pathogen, there is a need to better understand the geographic distribution of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and its potential to infect mammals and humans. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) emerged as a global health concern in 2012 when the first human case was documented in Saudi Arabia 1 . Previous literature reviews have looked at healthcare-associated outbreaks 9 , importation events resulting in secondary cases 10, 11 , occurrences among dromedary camels 12, 13 , or to summarize current knowledge and knowledge gaps of MERS-CoV 14, 15 . This database seeks fill gaps in literature and build upon existing notification data by enhancing the geographic resolution of MERS-CoV data and providing occurrences of both mammal and environmental detections in addition to human cases. First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission doi = 10.1038/s41597-019-0330-0 id = cord-303272-1w8epdht author = Reusken, Chantal BEM title = Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study date = 2013-08-09 keywords = East; MERS; Middle; OC43 summary = title: Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study Cattle (n=80), sheep (n=40), goats (n=40), dromedary camels (n=155), and various other camelid species (n=34) were tested for specific serum IgG by protein microarray using the receptor-binding S1 subunits of spike proteins of MERS-CoV, severe acute respiratory syndrome coronavirus, and human coronavirus OC43. We tested the sera for the presence of IgG antibodies reactive with MERS-CoV, SARS-CoV, and human coronavirus OC43 S1 antigens in a protein microarray. plaque reduction neutralisation tests for bovine coronavirus and MERS-CoV (B): two representative sera are shown (numbers 15 and 5, corresponding to camel ID numbers in table 2) in dilutions of 1/40, 1/160, and 1/640 as well as the virus input control. Sera were tested for IgG antibodies reactive with MERS-CoV, SARS-CoV, and human coronavirus OC43 S1 antigens in a protein microarray (fi gure 1). doi = 10.1016/s1473-3099(13)70164-6 id = cord-322760-tsxniu3j author = Sha, Jianping title = Fatality risks for nosocomial outbreaks of Middle East respiratory syndrome coronavirus in the Middle East and South Korea date = 2016-09-23 keywords = East; MERS; Middle summary = doi = 10.1007/s00705-016-3062-x id = cord-331228-wbd0s4fo author = Shehata, Mahmoud M. title = Middle East respiratory syndrome coronavirus: a comprehensive review date = 2016-01-20 keywords = Arabia; East; MERS; Middle; Saudi; respiratory summary = authors: Shehata, Mahmoud M.; Gomaa, Mokhtar R.; Ali, Mohamed A.; Kayali, Ghazi Role of the spike glycoprotein of human Middle East respiratory syndrome coronavirus (MERS-CoV) in virus entry and syncytia formation Middle East respiratory syndrome coronavirus (MERS-CoV)-Saudi Arabia Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study First cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission Clinical features and viral diagnosis of two cases of infection with Middle East respiratory syndrome coronavirus: a report of nosocomial transmission Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia doi = 10.1007/s11684-016-0430-6 id = cord-311937-6hadssmh author = Sherbini, Nahid title = Middle East respiratory syndrome coronavirus in Al-Madinah City, Saudi Arabia: Demographic, clinical and survival data date = 2016-06-11 keywords = East; MERS; Middle summary = title: Middle East respiratory syndrome coronavirus in Al-Madinah City, Saudi Arabia: Demographic, clinical and survival data METHODS: A retrospective study was conducted of all confirmed MERS-CoV infections from March 2014 to May 2014 at two tertiary care hospitals in Al-Madinah region (Saudi Arabia). Epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) was expanded after exploring the large hospital outbreak in Al-Hasa, Saudi Arabia [2] . We obtained data about demographic characteristics, clinical presentation, laboratory results, diagnosis, incubation period, smoking history, comorbidities, and history of contact with camels or MERS-CoV positive patients in regions within the Madinah area. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection doi = 10.1016/j.jegh.2016.05.002 id = cord-316194-jnw8gr7e author = Sifuentes, Monica title = Chapter 61 Disorders of the Ear date = 2005-12-31 keywords = AOM; ear; middle summary = Children differ from adults in that complications are more likely to occur from AOM than chronic ear disease and often are the result of delayed treatment. Children with AOM usually have fluid present in the mastoid air cells because of the direct connection with the middle ear ( Fig. 61-1) . The most common suppurative intracranial complication of OM and mastoiditis is bacterial meningitis, although its incidence has decreased dramatically since the advent of antibiotic therapy for acute infections and routine immunization against Haemophilus influenzae type B. Therapeutic goals for infants and young children with OM are to treat acute infections appropriately and prevent recurrent and chronic middle ear disease, reducing the morbidity and mortality associated with intratemporal and intracranial complications. Children with uncomplicated AOM generally have a favorable outcome depending on their age at diagnosis, frequency of infections, and length of time for fluid in the middle ear to resolve. doi = 10.1016/b978-0-323-01199-0.50066-9 id = cord-341795-zbqfs77n author = Sikkema, R. S. title = Global status of Middle East respiratory syndrome coronavirus in dromedary camels: a systematic review date = 2019-02-21 keywords = East; MERS; Middle summary = This systematic review aims to compile and analyse all published data on MERS-coronavirus (CoV) in the global camel population to provide an overview of current knowledge on the distribution, spread and risk factors of infections in dromedary camels. In the field surveys included in this review, MERS-CoV RNA has been described in rectal swab samples, although other field studies report negative results [3, [22] [23] [24] and when viral RNA can be detected, the positivity rate of rectal swabs is lower compared with nasal swab samples [19, [25] [26] [27] . Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study Longitudinal study of Middle East respiratory syndrome coronavirus infection in dromedary camel herds in Saudi Arabia Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels doi = 10.1017/s095026881800345x id = cord-283586-o8m6xdra author = Spanakis, Nikolaos title = Virological and serological analysis of a recent Middle East respiratory syndrome coronavirus infection case on a triple combination antiviral regimen date = 2014-12-31 keywords = East; MERS; Middle summary = Abstract Serological, molecular and phylogenetic analyses of a recently imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Greece are reported. Although MERS-CoV remained detectable in the respiratory tract secretions of the patient until the fourth week of illness, viraemia was last detected 2 days after initiation of triple combination therapy with pegylated interferon, ribavirin and lopinavir/ritonavir, administered from Day 13 of illness. An upsurge of Middle East respiratory syndrome coronavirus (MERS-CoV) infection has been recently described in countries of the Arabian Peninsula resulting in exported cases from these countries to the European Union [1] . Published reports propose the use of known antivirals based on extrapolation of data from: (i) the severe acute respiratory syndrome (SARS) epidemic that was also associated with the circulation of a novel coronavirus; (ii) in vitro data; (iii) animal experimental infections and therapy data; and (iv) limited clinical data for actual MERS-CoV infections [2] [3] [4] . doi = 10.1016/j.ijantimicag.2014.07.026 id = cord-017731-xzfo5jjq author = Todd, Ewen C. D. title = Foodborne Disease in the Middle East date = 2016-11-25 keywords = East; Egypt; Iraq; Lebanon; Middle; Ministry; Pakistan; Qatar; Salmonella; Turkey; country; egyptian; food; outbreak summary = Food safety is a concern worldwide and according to the World Health Organization, developing countries are probably more at risk of foodborne illness because many of these, including those in the Middle East, have limited disease surveillance and prevention and control strategies. Like many other parts of the developing world, foodborne disease surveillance is limited and outbreaks are most often reported through the Press but with insufficient detail to determine the etiological agents and the factors contributing to the outbreaks, leading to speculation to the cause by those interested or responsible for food prevention and control. Thus, the main foodborne disease issues are with homemade, restaurant and street food, where isolated claims of illness are followed up by inspections and possible punitive action by public health agencies responsible for food safety. doi = 10.1007/978-3-319-48920-9_17 id = cord-022046-q1exf47s author = Toosy, Arshad Haroon title = An Overview of Middle East Respiratory Syndrome in the Middle East date = 2018-09-28 keywords = East; MERS; Middle summary = Middle East respiratory syndrome (MERS) is an emerging infectious zoonotic disease caused by a novel coronavirus (CoV). 4 Surveillance of DCs in KSA has shown that MERS-CoV clade B has been enzootic in the camel population in Arabia Genetic deep sequencing methods (i.e., high-throughput sequencing) have been readily available to researchers since the disease was first reported. 8 Nevertheless, given the prevalence of MERS-CoV infection in the Middle East''s DC population and due to the potential for spillover to the human population in direct contact with DCs, the development of a vaccine for use in DCs may be feasible. Middle East respiratory syndrome coronavirus (MERS-CoV): animal to human interaction Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia Detection of the Middle East respiratory syndrome coronavirus genome in an air sample originating from a camel barn owned by an infected patient doi = 10.1016/b978-0-323-55228-8.00042-4 id = cord-349643-jtx7ni9b author = Uyeki, Timothy M. title = Development of Medical Countermeasures to Middle East Respiratory Syndrome Coronavirus date = 2016-07-17 keywords = CoV; East; MERS; Middle summary = Preclinical development of and research on potential Middle East respiratory syndrome coronavirus (MERS-CoV) medical countermeasures remain preliminary; advancements are needed before most countermeasures are ready to be tested in human clinical trials. Research priorities include standardization of animal models and virus stocks for studying disease pathogenesis and efficacy of medical countermeasures; development of MERS-CoV diagnostics; improved access to nonhuman primates to support preclinical research; studies to better understand and control MERS-CoV disease, including vaccination studies in camels; and development of a standardized clinical trial protocol. F rom September 2012 through April 27, 2016, a total of 1,728 laboratory-confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) infections, leading to 624 deaths (36% case-fatality proportion), had been reported to the World Health Organization (WHO) (1) . Prophylaxis with a Middle East respiratory syndrome coronavirus (MERS-CoV)-specific human monoclonal antibody protects rabbits from MERS-CoV infection doi = 10.3201/eid2207.160022 id = cord-275602-cog4nma0 author = Watkins, Kevin title = Emerging Infectious Diseases: a Review date = 2018-06-22 keywords = East; Middle; RNA; disease; virus summary = SUMMARY: In addition to the aforementioned pathogens, the Severe Acute Respiratory Syndrome, Middle East Respiratory Syndrome, Nipah virus, New Delhi metallo-ß-lactamase-1 Enterobacteriaceae, Rift Valley Fever virus, and Crimean-Congo Hemorrhagic Fever virus are reviewed. In 1992, an expert committee that produced the Institute of Medicine report on emerging infections defined them as "new, reemerging, or drug-resistant infections whose incidence in humans has increased within the past two decades or whose incidence threatens to increase in the near future." Additionally, six major contributors to these diseases were presented and included changes in human demographics and behavior, advances in technology and changes in industry practices, economic development and changes in land-use patterns, dramatic increases in volume and speed of international travel and commerce, microbial adaptation and change, and breakdown of public health capacity [1] . The World Health Organization has prioritized a number of infectious diseases as requiring urgent need for research and development given the concern for potential of severe outbreaks. doi = 10.1007/s40138-018-0162-9 id = cord-306004-amv0los1 author = Widagdo, W. title = Host Determinants of MERS-CoV Transmission and Pathogenesis date = 2019-03-19 keywords = DPP4; East; MERS; Middle summary = doi = 10.3390/v11030280 id = cord-309621-6jj19xpr author = Yu, Pin title = Comparative pathology of rhesus macaque and common marmoset animal models with Middle East respiratory syndrome coronavirus date = 2017-02-24 keywords = East; Fig; MERS; Middle summary = The main histopathological findings in the lungs of rhesus macaques and common marmosets were varying degrees of pulmonary lesions, including pneumonia, pulmonary oedema, haemorrhage, degeneration and necrosis of the pneumocytes and bronchial epithelial cells, and inflammatory cell infiltration. Although there have been several studies in animal models on the pathogenic mechanisms of MERS-CoV infection, little is known about the comparative pathology and inflammatory cell response in rhesus macaques or common marmosets infected with this virus. Pathological findings in the rhesus macaque tissues HE stained tissues from rhesus macaques experimentally infected with MERS-CoV demonstrate that MERS-CoV induces lesions that are primarily observed in the lungs, with varying degrees of inflammation, interstitial pneumonia (Fig 1A) , pulmonary oedema (Fig 1B) , haemorrhaging, degeneration and necrosis of pneumocytes and bronchial epithelial cells (Fig 1C) , and the infiltration of inflammatory cells. Using immunohistochemical techniques and an ISH analysis, we confirmed that MERS-CoV protein and viral RNA were distributed in the lungs of rhesus macaques and common marmosets and that they were primarily located in the pneumocytes and inflammatory cells. doi = 10.1371/journal.pone.0172093 id = cord-314651-e4uaw5fy author = Zhao, Guangyu title = Multi-Organ Damage in Human Dipeptidyl Peptidase 4 Transgenic Mice Infected with Middle East Respiratory Syndrome-Coronavirus date = 2015-12-23 keywords = East; Fig; MERS; Middle summary = After intranasal inoculation with MERS-CoV, the mice rapidly developed severe pneumonia and multi-organ damage, with viral replication being detected in the lungs on day 5 and in the lungs, kidneys and brains on day 9 post-infection. To assess viral replication and histopathologic damage following MERS-CoV infection, mice were euthanized with overdose inhalational carbon dioxide, and tissues included lungs, kidneys, livers, spleens, intestines and brains were harvested on indicated time points. Although a transgenic mouse model expressing human DPP4 was also established, and its immune response was studied after infection with MERS-CoV [16] , the transgenic mice in the study died on day 6 with only progressive pneumonia and mild perivascular cuffing in brain, and no neurological disorder or other multi-organ damage was observed. doi = 10.1371/journal.pone.0145561 id = cord-352527-eeyqh9nc author = Zhou, Yusen title = Advances in MERS-CoV Vaccines and Therapeutics Based on the Receptor-Binding Domain date = 2019-01-14 keywords = East; MERS; Middle; RBD summary = A number of MERS vaccines have been developed based on viral RBD, including nanoparticles, virus-like particles (VLPs), and recombinant proteins, and their protective efficacy has been evaluated in animal models, including mice with adenovirus 5 (Ad5)-directed expression of human DPP4 (Ad5/hDPP4), hDPP4-transgenic (hDPP4-Tg) mice, and non-human primates (NHPs) [88] [89] [90] [91] [92] [93] [94] . Receptor usage of a novel bat lineage C Betacoronavirus reveals evolution of Middle East respiratory syndrome-related coronavirus spike proteins for human dipeptidyl peptidase 4 binding Recombinant receptor-binding domains of multiple Middle East respiratory syndrome coronaviruses (MERS-CoVs) induce cross-neutralizing antibodies against divergent human and camel MERS-CoVs and antibody escape mutants A conformation-dependent neutralizing monoclonal antibody specifically targeting receptor-binding domain in Middle East respiratory syndrome coronavirus spike protein A novel nanobody targeting Middle East respiratory syndrome coronavirus (MERS-CoV) receptor-binding domain has potent cross-neutralizing activity and protective efficacy against MERS-CoV doi = 10.3390/v11010060 id = cord-260518-mswb3q67 author = Zumla, Alimuddin title = Taking forward a ‘One Health’ approach for turning the tide against the Middle East respiratory syndrome coronavirus and other zoonotic pathogens with epidemic potential date = 2016-06-15 keywords = East; Health; MERS; Middle summary = Since the Kingdom of Saudi Arabia is host to millions of pilgrims each year travelling from all continents, 29 tackling the threat of MERS and other infectious diseases with epidemic potential will require enhanced closer cooperation between those who provide human health, animal health, and environmental health services, locally, nationally, regionally, and internationally: the Middle Eastern, European, African, Asian, and American governments, veterinary groups, the WHO, the Food and Agriculture Organization (FAO), the African Union, the United Nations International Children''s Emergency Fund (UNICEF), The World Bank, Office International des Epizooties (OIE), CDC, Public Health England, the newly formed Africa CDC, and funding agencies among others. The persistence of MERS-CoV 4 years since its first discovery has created major opportunities for each of the Middle Eastern and African countries to take leadership of the ''One Health'' approach with a view to bringing this under regional and global umbrellas, to tackle new emerging and re-emerging infectious diseases with epidemic potential. doi = 10.1016/j.ijid.2016.06.012 id = cord-319877-izn315hb author = de Wit, Emmie title = SARS and MERS: recent insights into emerging coronaviruses date = 2016-06-27 keywords = CoV; East; MERS; Middle; SARS; respiratory summary = doi = 10.1038/nrmicro.2016.81 id = cord-332952-d5l60cgc author = nan title = MERS: Progress on the global response, remaining challenges and the way forward date = 2018-09-17 keywords = East; MERS; Middle summary = Typical of an emerging zoonosis, Middle East respiratory syndrome coronavirus (MERS-CoV) has an animal reservoir, i.e. dromedary camels in which the virus causes little to no disease (Mohd et al., 2016) . For example, studies of respiratory pathogens (Yu et al., 2007; Tran et al., 2012; Thompson et al., 2013) and MERS-CoV conducted in the Middle East (Assiri et al., 2013; Oboho et al., 2015; Hunter et al., 2016; Balkhy et al., 2016) and the Republic of Korea (Bin et al., 2016; Kim et al., 2016a Kim et al., , 2016b Nam et al., 2017) illustrate that aerosol-generating procedures and non-invasive ventilation, combined with inappropriate infection prevention and control practices and lack of adherence to standard practices had an important role in facilitating human-to-human transmission in health care settings. The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study Sero-prevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) specific antibodies in dromedary camels in Tabuk, Saudi Arabia doi = 10.1016/j.antiviral.2018.09.002