Middle east respiratory syndrome coronavirus (MERS-CoV): An underestimated betacoronavirus with pandemic potential.

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic beta coronavirus identified in 2012 that circulates in dromedary camels and occasionally infects humans. Although community spread is limited, the disease shows a high case fatality rate near 36 percent and has caused hospital outbreaks such as the 2015 South Korea event. The viral spike binds the DPP4 (CD26) receptor, enabling entry into airway epithelial and selected immune cells, while accessory proteins suppress early innate immunity. Genetic studies indicate continuing evolution with clades A, B, and C across the Arabian Peninsula and Africa. Human infection is linked to camel contact, farm exposure, or raw camel products, with secondary spread mainly in healthcare settings. Diagnosis uses rRT-PCR and serology; treatment is supportive, and vaccines and antivirals are under study. A One Health approach is vital for surveillance, early detection, and control.