Family Cluster of Middle East Respiratory Syndrome Coronavirus Infection

New England Journal of Medicine
June 27, 2013  Vol. 368 No. 26
http://www.nejm.org/toc/nejm/medical-journal

Brief Report: Family Cluster of Middle East Respiratory Syndrome Coronavirus Infections
Z.A. Memish, A.I. Zumla, R.F. Al-Hakeem, A.A. Al-Rabeeah, and G.M. Stephens

Abstract
A human coronavirus, called the Middle East respiratory syndrome coronavirus (MERS-CoV), was first identified in September 2012 in samples obtained from a Saudi Arabian businessman who died from acute respiratory failure. Since then, 49 cases of infections caused by MERS-CoV (previously called a novel coronavirus) with 26 deaths have been reported to date. In this report, we describe a family case cluster of MERS-CoV infection, including the clinical presentation, treatment outcomes, and household relationships of three young men who became ill with MERS-CoV infection after the hospitalization of an elderly male relative, who died of the disease. Twenty-four other family members living in the same household and 124 attending staff members at the hospitals did not become ill. MERS-CoV infection may cause a spectrum of clinical illness. Although an animal reservoir is suspected, none has been discovered. Meanwhile, global concern rests on the ability of MERS-CoV to cause major illness in close contacts of patients.