Health officials have expressed concern that the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) could become a major public health threat, according to an article being published in Annals of Internal Medicine.

Since September 2012, 163 infections have been reported to the World Health Organization (WHO), including 71 deaths. The severity of symptoms, high fatality rate, and ease of transmission resemble the infection caused by severe acute respiratory syndrome coronavirus (SARS-CoV) but data on MERS-CoV-infected critically ill patients are limited.

Researchers studied 12 patients with confirmed or probable MERS-CoV in three intensive care units at two tertiary hospitals in Saudi Arabia. They found that all of the critically ill patients had underlying comorbidities, developed acute respiratory failure characterized by severe hypoxemia, had high severity of illness, and had high incidence of extra-pulmonary manifestations, and a high mortality rate. The researchers noted that all of the MERS-CoV patients had underlying chronic comorbidities, which strongly suggests that patients with such comorbidities are susceptible hosts for MERS-CoV. While transmission to health care workers appeared to be low, human-to-human transmission can occur with unprotected exposure.

The authors suggest an urgent collaborative study to examine therapeutic options to treat MERS-CoV, as the disease has the potential to become a worldwide public health threat. The authors of an accompanying editorial cite lessons learned from SARS-CoV and agree that scientific transparency and collaboration is needed to effectively protect populations from MERS-CoV.