The death toll from SARS-like MERS-CoV infection reaches 32 today as Saudi Arabia announces four more fatalities.

So far, worldwide 37 people have died of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) since September 2012, says the World Health Organization.

One of the latest fatalities in Saudi Arabia was a 2-year-old child. She had been hospitalized “suffering from chronic pulmonary disease”, according the Saudi Health Ministry.

The Saudi Health Ministry and the World Health Organization are becoming growingly concerned because Ramadan starts on July 9th, at the end of which approximately two million pilgrims from around the world will congregate in Mecca, the holy city. Ramadan occurs during the ninth month of the Muslim year, when the faithful fast during the daylight hours.

There is concern that pilgrims might carry the virus back to their own countries.

MERS-CoV is a member of the coronavirus family, which causes respiratory illnesses in mammals (including humans). Coronaviruses are quite common and are responsible for about one-in-three of all common colds.

MERS-CoV is a new coronavirus strain. It started infecting humans last year in the Middle East. It was initially identified in 2012 when an adult male in Saudi Arabia became ill with SARS-like symptoms. He died in June 2012.

Three months later, a Qatari man became ill with SARS-like symptoms after traveling to Saudi Arabia. He was airlifted to the United Kingdom for further treatment. Laboratory tests confirmed he was infected with MERS-CoV. Confirmed cases of MERS-CoV human infection and/or deaths have been reported in Saudi Arabia, Jordan, Qatar, the United Arab Emirates, France, Germany, Italy and Tunisia.

SARS (severe acute respiratory syndrome) is also a type of coronavirus. SARS spread around the globe in 2003, killing 800 people.

While SARS was much more human-transmissible than MERS-CoV appears to be, it was not as deadly. Sixty percent of humans who become infected with MERS-CoV die, compared to about 10% with SARS-CoV.

MERS-CoV is similar to SARS-CoV in that patients develop a serious lung infection, coughs, breathing problems and fever. However, with MERS-CoV there is also a serious risk of rapid kidney failure.

New research published in The Lancet identified some important differences between MERS-CoV and SARS-CoV.

According to researchers at the Erasmus Medical Center, Rotterdam, the Netherlands, MERS-CoV probably originated from bats, but nobody is sure.

Experts are concerned that MERS-CoV might be able to mutate and become more human-transmissible and spark a new pandemic. At the end of May 2013, Margaret Chan, Director of WHO warned that MERS-CoV is “a threat to the entire world”.

Scientists at the CDC (Centers for Disease Control and Prevention) say they are still waiting to test MERS-CoV samples, which are many months overdue in coming. According to the Calgary Herald, the samples have been delayed by long drawn-out negations for a material transfer agreement which Saudi authorities insist be signed first. The scientists say that it is highly unusual to ask for a materials transfer agreement when there is an ongoing investigation of an outbreak.

Written by Christian Nordqvist