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Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Hajj Gatherings

  • Jaffar A. Al-TawfiqEmail author
  • Mamunur Rahman Malik
  • Ziad A. Memish
Living reference work entry

Abstract

Hajj, the Pilgrimage to the Holy City of Makkah, Saudi Arabia, is one of the largest mass gatherings in the World. Due to the overcrowding, there is a risk of the transmission of infectious diseases from person to person, especially the risk of respiratory diseases. Since the emergence of Middle East Respiratory Syndrome Coronavirus, there was a significant interest in the risk that this posed to the Hajj. So far, there had been systematic surveillance of the virus among returning Pilgrims and no cases were identified in relation to the Hajj. However, there were two reported MERS-CoV cases related to the mini-Hajj, Umrah, in May 2014. Continued surveillance and vigilance are required to monitor and evaluate the risk in the future.

Keywords

Hajj Pilgrimage Mass gathering MERS-CoV Middle east respiratory syndrome coronavirus 

References

  1. Aberle JH, Popow-Kraupp T, Kreidl P, Laferl H, Heinz FX, Aberle SW (2015) Influenza A and B viruses but not MERS-CoV in Hajj pilgrims, Austria, 2014. Emerg Infect Dis 21:726–727.  https://doi.org/10.3201/eid2104.141745CrossRefPubMedPubMedCentralGoogle Scholar
  2. Alfaraj SH, Al-Tawfiq JA, Alzahrani NA, Altwaijri TA, Memish ZA (2017a) The impact of co-infection of influenza A virus on the severity of Middle East respiratory syndrome coronavirus. J Infect 74:521–523.  https://doi.org/10.1016/j.jinf.2017.02.001CrossRefPubMedGoogle Scholar
  3. Alfaraj SH, Al-Tawfiq JA, Altuwaijri TA, Memish ZA (2017b) Middle East respiratory syndrome coronavirus and pulmonary tuberculosis coinfection: implications for infection control. Intervirology 60:53–55.  https://doi.org/10.1159/000477908CrossRefPubMedGoogle Scholar
  4. Alfaraj SH, Al-Tawfiq JA, Altuwaijri TA, Memish ZA (2018) Middle East respiratory syndrome coronavirus in pediatrics: a report of seven cases from Saudi Arabia. Front Med.  https://doi.org/10.1007/s11684-017-0603-yCrossRefGoogle Scholar
  5. Al-Abdallat MM, Rha B, Alqasrawi S, Payne DC, Iblan I, Binder AM et al (2017) Acute respiratory infections among returning Hajj pilgrims – Jordan, 2014. J Clin Virol 89:34–37.  https://doi.org/10.1016/j.jcv.2017.01.010CrossRefPubMedGoogle Scholar
  6. Al-Tawfiq JA, Auwaerter PG (2018) Healthcare-associated infections: the hallmark of the Middle East respiratory syndrome coronavirus (MERS-CoV) with review of the literature. J Hosp Infect.  https://doi.org/10.1016/j.jhin.2018.05.021CrossRefGoogle Scholar
  7. Al-Tawfiq JA, Gautret P (2018) Asymptomatic Middle East respiratory syndrome coronavirus (MERS-CoV) infection: extent and implications for infection control: a systematic review. Travel Med Infect Dis.  https://doi.org/10.1016/j.tmaid.2018.12.003CrossRefGoogle Scholar
  8. Al-Tawfiq JA, Hinedi K (2018) The calm before the storm: clinical observations of Middle East respiratory syndrome (MERS) patients. J Chemother.  https://doi.org/10.1080/1120009X.2018.1429236CrossRefGoogle Scholar
  9. Al-Tawfiq JA, Memish ZA (2012a) Mass gatherings and infectious diseases: prevention, detection, and control. Infect Dis Clin North Am 26:725–737.  https://doi.org/10.1016/j.idc.2012.05.005CrossRefPubMedGoogle Scholar
  10. Al-Tawfiq JA, Memish ZA (2012b) The Hajj: updated health hazards and current recommendations for 2012. Euro Surveill 17:20295PubMedGoogle Scholar
  11. Al-Tawfiq JA, Memish ZA (2014a) Mass gathering medicine: 2014 Hajj and Umra preparation as a leading example. Int J Infect Dis 27:26–31CrossRefGoogle Scholar
  12. Al-Tawfiq JA, Memish ZA (2014b) Middle East respiratory syndrome coronavirus: epidemiology and disease control measures. Infect Drug Resist 7:281–287.  https://doi.org/10.2147/IDR.S51283CrossRefPubMedPubMedCentralGoogle Scholar
  13. Al-Tawfiq JA, Memish ZA (2015a) Potential risk for drug resistance globalization at the Hajj. Clin Microbiol Infect 21:109–114.  https://doi.org/10.1016/j.cmi.2014.11.013CrossRefPubMedGoogle Scholar
  14. Al-Tawfiq JAA, Memish ZAA (2015b) Managing MERS-CoV in the healthcare setting. Hosp Pract 43:158–163.  https://doi.org/10.1080/21548331.2015.1074029CrossRefGoogle Scholar
  15. Al-Tawfiq JA, Smallwood CAH, Arbuthnott KG, Malik MSK, Barbeschi M, Memish ZA (2013) Emerging respiratory and novel coronavirus 2012 infections and mass gatherings. East Mediterr Health J 19(Suppl 1):S48–S54CrossRefGoogle Scholar
  16. Al-Tawfiq JA, Hinedi K, Ghandour J, Khairalla H, Musleh S, Ujayli A et al (2014a) Middle East respiratory syndrome-coronavirus (MERS-CoV): a case-control study of hospitalized patients. Clin Infect Dis 59:160–165.  https://doi.org/10.1093/cid/ciu226CrossRefPubMedGoogle Scholar
  17. Al-Tawfiq JA, Zumla A, Memish ZA (2014b) Travel implications of emerging coronaviruses: SARS and MERS-CoV. Travel Med Infect Dis 12:422–428.  https://doi.org/10.1016/j.tmaid.2014.06.007CrossRefPubMedGoogle Scholar
  18. Al-Tawfiq JA, Kattan RF, Memish ZA (2016a) Middle East respiratory syndrome coronavirus disease is rare in children: an update from Saudi Arabia. World J Clin Pediatr 5:391–396.  https://doi.org/10.5409/wjcp.v5.i4.391CrossRefPubMedPubMedCentralGoogle Scholar
  19. Al-Tawfiq JA, Omrani AS, Memish ZA (2016b) Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns. Front Med 10:111.  https://doi.org/10.1007/s11684-016-0446-yCrossRefPubMedGoogle Scholar
  20. Al-Tawfiq JA, Gautret P, Benkouiten S, Memish ZA (2016c) Mass gatherings and the spread of respiratory infections. Lessons from the Hajj. Ann Am Thorac Soc 13:759–765.  https://doi.org/10.1513/AnnalsATS.201511-772FRCrossRefPubMedPubMedCentralGoogle Scholar
  21. Al-Tawfiq JA, Alfaraj SH, Altuwaijri TA, Memish ZA (2017) A cohort-study of patients suspected for MERS-CoV in a referral hospital in Saudi Arabia. J Infect 75:378–379.  https://doi.org/10.1016/j.jinf.2017.06.002CrossRefPubMedGoogle Scholar
  22. Annan A, Owusu M, Marfo KS, Larbi R, Sarpong FN, Adu-Sarkodie Y et al (2015) High prevalence of common respiratory viruses and no evidence of Middle East respiratory syndrome coronavirus in Hajj pilgrims returning to Ghana, 2013. Trop Med Int Health 20:807–812.  https://doi.org/10.1111/tmi.12482CrossRefPubMedGoogle Scholar
  23. Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A et al (2014) Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection. Ann Intern Med 160:389–397.  https://doi.org/10.7326/M13-2486CrossRefGoogle Scholar
  24. Assiri A, McGeer A, Perl TM, Price CS, Al Rabeeah AA, Cummings DAT et al (2013a) Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med 369:407–416.  https://doi.org/10.1056/NEJMoa1306742CrossRefPubMedPubMedCentralGoogle Scholar
  25. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A et al (2013b) Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis 13:752–761.  https://doi.org/10.1016/S1473-3099(13)70204-4CrossRefGoogle Scholar
  26. Atabani SF, Wilson S, Overton-Lewis C, Workman J, Kidd IM, Petersen E et al (2016) Active screening and surveillance in the United Kingdom for Middle East respiratory syndrome coronavirus in returning travellers and pilgrims from the Middle East: a prospective descriptive study for the period 2013–2015. Int J Infect Dis 47:10–14.  https://doi.org/10.1016/j.ijid.2016.04.016CrossRefPubMedGoogle Scholar
  27. Baharoon S, Al-Jahdali H, Al Hashmi J, Memish ZA, Ahmed QA (2009) Severe sepsis and septic shock at the Hajj: etiologies and outcomes. Travel Med Infect Dis 7:247–252.  https://doi.org/10.1016/j.tmaid.2008.09.002CrossRefPubMedGoogle Scholar
  28. Barasheed O, Rashid H, Alfelali M, Tashani M, Azeem M, Bokhary H et al (2014) Viral respiratory infections among Hajj pilgrims in 2013. Virol Sin 29:364–371.  https://doi.org/10.1007/s12250-014-3507-xCrossRefPubMedGoogle Scholar
  29. Benkouiten S, Charrel R, Belhouchat K, Drali T, Nougairede A, Salez N et al (2014) Respiratory viruses and bacteria among pilgrims during the 2013 Hajj. Emerg Infect Dis 20:1821–1827.  https://doi.org/10.3201/eid2011.140600CrossRefPubMedPubMedCentralGoogle Scholar
  30. Corman VM, Ithete NL, Richards LR, Schoeman MC, Preiser W, Drosten C et al (2014) Rooting the phylogenetic tree of MERS-coronavirus by characterization of a conspecific virus from an African Bat. J Virol 88:11297–11303.  https://doi.org/10.1128/JVI.01498-14CrossRefPubMedPubMedCentralGoogle Scholar
  31. Cotten M, Watson SJ, Kellam P, Al-Rabeeah AA, Makhdoom HQ, Assiri A et al (2013) Transmission and evolution of the Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive genomic study. Lancet 382:1993–2002.  https://doi.org/10.1016/S0140-6736(13)61887-5CrossRefPubMedPubMedCentralGoogle Scholar
  32. Cotten M, Watson SJ, Zumla AI, Makhdoom HQ, Palser AL, Ong SH et al (2014) Spread, circulation, and evolution of the Middle East respiratory syndrome coronavirus. MBio 5:pii: e01062–13.  https://doi.org/10.1128/mBio.01062-13CrossRefGoogle Scholar
  33. Fanoy EB, van der Sande MA, Kraaij-Dirkzwager M, Dirksen K, Jonges M, van der Hoek W et al (2014) Travel-related MERS-CoV cases: an assessment of exposures and risk factors in a group of Dutch travellers returning from the Kingdom of Saudi Arabia, May 2014. Emerg Themes Epidemiol 11:16.  https://doi.org/10.1186/1742-7622-11-16CrossRefPubMedPubMedCentralGoogle Scholar
  34. Gardner LM, Rey D, Heywood AE, Toms R, Wood J, Travis Waller S et al (2014) A scenario-based evaluation of the Middle East respiratory syndrome coronavirus and the Hajj. Risk Anal 34:1391–1400.  https://doi.org/10.1111/risa.12253CrossRefPubMedPubMedCentralGoogle Scholar
  35. Gautret P, Charrel R, Belhouchat K, Drali T, Benkouiten S, Nougairede A et al (2013) Lack of nasal carriage of novel corona virus (HCoV-EMC) in French Hajj pilgrims returning from the Hajj 2012, despite a high rate of respiratory symptoms. Clin Microbiol Infect 19:E315–E317.  https://doi.org/10.1111/1469-0691.12174CrossRefPubMedGoogle Scholar
  36. Gautret P, Charrel R, Benkouiten S, Belhouchat K, Nougairede A, Drali T et al (2014) Lack of MERS coronavirus but prevalence of influenza virus in French pilgrims after 2013 Hajj. Emerg Infect Dis 20:728–730.  https://doi.org/10.3201/eid2004.131708CrossRefPubMedPubMedCentralGoogle Scholar
  37. Gautret P, Benkouiten S, Al-Tawfiq JA, Memish ZA (2016a) Hajj-associated viral respiratory infections: a systematic review. Travel Med Infect Dis 14:92–109.  https://doi.org/10.1016/j.tmaid.2015.12.008CrossRefPubMedGoogle Scholar
  38. Gautret P, Benkouiten S, Al-Tawfiq JA, Memish ZA (2016b) The spectrum of respiratory pathogens among returning Hajj pilgrims: myths and reality. Int J Infect Dis 47:83–85.  https://doi.org/10.1016/j.ijid.2016.01.013CrossRefPubMedGoogle Scholar
  39. Griffiths K, Charrel R, Lagier J-C, Nougairede A, Simon F, Parola P et al (2016) Infections in symptomatic travelers returning from the Arabian peninsula to France: a retrospective cross-sectional study. Travel Med Infect Dis 14:414–416.  https://doi.org/10.1016/j.tmaid.2016.05.002CrossRefPubMedGoogle Scholar
  40. Guery B, Poissy J, el Mansouf L, Séjourné C, Ettahar N, Lemaire X et al (2013) Clinical features and viral diagnosis of two cases of infection with Middle East respiratory syndrome coronavirus: a report of nosocomial transmission. Lancet 381:2265–2272.  https://doi.org/10.1016/S0140-6736(13)60982-4CrossRefPubMedGoogle Scholar
  41. Hijawi B, Abdallat M, Sayaydeh A, Alqasrawi S, Haddadin A, Jaarour N et al (2013) Novel coronavirus infections in Jordan, April 2012: epidemiological findings from a retrospective investigation. East Mediterr Health J 19(Suppl 1):S12–S18CrossRefGoogle Scholar
  42. Ithete NL, Stoffberg S, Corman VM, Cottontail VM, Richards LR, Schoeman MC et al (2013) Close relative of human Middle East respiratory syndrome coronavirus in bat, South Africa. Emerg Infect Dis 19:1697–1699.  https://doi.org/10.3201/eid1910.130946CrossRefPubMedPubMedCentralGoogle Scholar
  43. Kandeel A, Deming M, Elkreem EA, El-Refay S, Afifi S, Abukela M et al (2011) Pandemic (H1N1) 2009 and Hajj Pilgrims who received predeparture vaccination, Egypt. Emerg Infect Dis 17:1266–1268.  https://doi.org/10.3201/eid1707.101484CrossRefPubMedPubMedCentralGoogle Scholar
  44. Ki M (2015) 2015 MERS outbreak in Korea: hospital-to-hospital transmission. Epidemiol Health 37:e2015033.  https://doi.org/10.4178/epih/e2015033CrossRefPubMedPubMedCentralGoogle Scholar
  45. Kim Y, Lee S, Chu C, Choe S, Hong S, Shin Y (2016) The characteristics of Middle Eastern respiratory syndrome coronavirus transmission dynamics in South Korea. Osong Public Health Res Perspect 7:49–55.  https://doi.org/10.1016/j.phrp.2016.01.001CrossRefPubMedPubMedCentralGoogle Scholar
  46. Korea Centers for Disease Control and Prevention (2015) Middle East respiratory syndrome coronavirus outbreak in the Republic of Korea, 2015. Osong Public Health Res Perspect 6:269–278.  https://doi.org/10.1016/j.phrp.2015.08.006CrossRefPubMedCentralGoogle Scholar
  47. Koul PA, Mir H, Saha S, Chadha MS, Potdar V, Widdowson M-A et al (2017) Influenza not MERS CoV among returning Hajj and Umrah pilgrims with respiratory illness, Kashmir, north India, 2014–15. Travel Med Infect Dis 15:45–47.  https://doi.org/10.1016/j.tmaid.2016.12.002CrossRefPubMedGoogle Scholar
  48. Kraaij-Dirkzwager M, Timen A, Dirksen K, Gelinck L, Leyten E, Groeneveld P et al (2014) Middle East respiratory syndrome coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014. Euro Surveill 19:pii: 20817CrossRefGoogle Scholar
  49. Lessler J, Rodriguez-Barraquer I, Cummings DA, Garske T, Van Kerkhove M, Mills H et al (2014) Estimating potential incidence of MERS-CoV associated with Hajj pilgrims to Saudi Arabia, 2014. PLoS Curr 6:1–18.  https://doi.org/10.1371/currents.outbreaks.c5c9c9abd636164a9b6fd4dbda974369CrossRefGoogle Scholar
  50. Ma X, Liu F, Liu L, Zhang L, Lu M, Abudukadeer A et al (2017) No MERS-CoV but positive influenza viruses in returning Hajj pilgrims, China, 2013–2015. BMC Infect Dis 17:715.  https://doi.org/10.1186/s12879-017-2791-0CrossRefPubMedPubMedCentralGoogle Scholar
  51. Memish ZA (2010) The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims. Euro Surveill 15:19671PubMedGoogle Scholar
  52. Memish ZA, Assiri AM, Hussain R, Alomar I, Stephens G (2012) Detection of respiratory viruses among pilgrims in Saudi Arabia during the time of a declared influenza A(H1N1) pandemic. J Travel Med 19:15–21.  https://doi.org/10.1111/j.1708-8305.2011.00575.xCrossRefPubMedGoogle Scholar
  53. Memish ZA, Zumla AI, Al-Hakeem RF, Al-Rabeeah AA, Stephens GM (2013a) Family cluster of Middle East respiratory syndrome coronavirus infections. N Engl J Med 368:2487–2494.  https://doi.org/10.1056/NEJMoa1303729CrossRefPubMedGoogle Scholar
  54. Memish ZA, Zumla A, Al-Tawfiq JA (2013b) How great is the risk of Middle East respiratory syndrome coronavirus to the global population? Expert Rev Anti Infect Ther 11:979–981.  https://doi.org/10.1586/14787210.2013.836965CrossRefPubMedGoogle Scholar
  55. Memish ZA, Zumla A, Alhakeem RF, Assiri A, Turkestani A, Al Harby KD et al (2014a) Hajj: infectious disease surveillance and control. Lancet 383:2073–2082.  https://doi.org/10.1016/S0140-6736(14)60381-0CrossRefPubMedGoogle Scholar
  56. Memish ZAZA, Al-Tawfiq JAJA, Assiri A, Alrabiah FAFA, Al Hajjar S, Albarrak A et al (2014b) Middle East respiratory syndrome coronavirus disease in children. Pediatr Infect Dis J 33: 904–906.  https://doi.org/10.1097/INF.0000000000000325CrossRefPubMedGoogle Scholar
  57. Memish ZAZA, Al-Tawfiq JAJA, Makhdoom HQHQ, Assiri A, Alhakeem RFRF, Albarrak A et al (2014c) Respiratory tract samples, viral load, and genome fraction yield in patients with Middle East respiratory syndrome. J Infect Dis 210:1590–1594.  https://doi.org/10.1093/infdis/jiu292CrossRefPubMedGoogle Scholar
  58. Memish ZA, Almasri M, Turkestani A, Al-Shangiti AM, Yezli S (2014d) Etiology of severe community-acquired pneumonia during the 2013 Hajj-part of the MERS-CoV surveillance program. Int J Infect Dis 25:186–190.  https://doi.org/10.1016/j.ijid.2014.06.003CrossRefPubMedGoogle Scholar
  59. Memish ZA, Assiri A, Almasri M, Alhakeem RF, Turkestani A, Al Rabeeah AA et al (2014e) Prevalence of MERS-CoV nasal carriage and compliance with the Saudi health recommendations among pilgrims attending the 2013 Hajj. J Infect Dis 210:1067–1072.  https://doi.org/10.1093/infdis/jiu150CrossRefPubMedGoogle Scholar
  60. Memish ZA, Assiri A, Turkestani A, Yezli S, Al Masri M, Charrel R et al (2015) Mass gathering and globalization of respiratory pathogens during the 2013 Hajj. Clin Microbiol Infect 21:571.e1–571.e8.  https://doi.org/10.1016/j.cmi.2015.02.008CrossRefGoogle Scholar
  61. Pavli A, Tsiodras S, Maltezou HC (2014) Middle East respiratory syndrome coronavirus (MERS-CoV): prevention in travelers. Travel Med Infect Dis 12:602–608.  https://doi.org/10.1016/j.tmaid.2014.10.006CrossRefPubMedGoogle Scholar
  62. Pebody RG, Chand MA, Thomas HL, Green HK, Boddington NL, Carvalho C et al (2012) The United Kingdom public health response to an imported laboratory confirmed case of a novel coronavirus in September 2012. Euro Surveill 17:20292CrossRefGoogle Scholar
  63. Penttinen PM, Kaasik-Aaslav K, Friaux A, Donachie A, Sudre B, Amato-Gauci AJ et al (2013) Taking stock of the first 133 MERS coronavirus cases globally-is the epidemic changing? Eurosurveillance 18(39): pii: 20596Google Scholar
  64. ProMed (2013) Novel coronavirus – Eastern Mediterranean (03): Saudi comment, 12 February 2013. http://promedmail.org/post/20130326.1603038
  65. ProMed (2014a) MERS-CoV – Eastern Mediterranean (73): Saudi Arabia, Algeria, Jordan, WHO, RFI. http://www.promedmail.org/post/20140601.2512766. Accessed 11 Nov 2016
  66. ProMed (2014b) MERS-CoV (01): Bangladesh, KSA, Algeria, UAE, Iran, WHO, RFI Archive Number: 20140616.2541707. http://www.promedmail.org/post/20140616.2541707
  67. ProMed (n.d.) MERS-CoV – Eastern Mediterranean (80): S Arabia, Iran, Algeria, Tunisia. http://promedmail.chip.org/pipermail/promed/2014-June/004423.html
  68. Rashid H, Shafi S, Haworth E, El Bashir H, Memish ZA, Sudhanva M et al (2008) Viral respiratory infections at the Hajj: comparison between UK and Saudi pilgrims. Clin Microbiol Infect 14:569–574.  https://doi.org/10.1111/j.1469-0691.2008.01987.xCrossRefPubMedGoogle Scholar
  69. Refaey S, Amin MM, Roguski K, Azziz-Baumgartner E, Uyeki TM, Labib M et al (2016) Cross-sectional survey and surveillance for influenza viruses and MERS-CoV among Egyptian pilgrims returning from Hajj during 2012–2015. Influenza Other Respir Viruses.  https://doi.org/10.1111/irv.12429CrossRefGoogle Scholar
  70. Sridhar S, Brouqui P, Parola P, Gautret P (2015) Imported cases of Middle East respiratory syndrome: an update. Travel Med Infect Dis 13:106–109.  https://doi.org/10.1016/j.tmaid.2014.11.006CrossRefPubMedGoogle Scholar
  71. Thabet F, Chehab M, Bafaqih H, Al Mohaimeed S (2015) Middle East respiratory syndrome coronavirus in children. Saudi Med J 36:484–486.  https://doi.org/10.15537/smj.2015.4.10243CrossRefPubMedPubMedCentralGoogle Scholar
  72. van Boheemen S, de Graaf M, Lauber C, Bestebroer TM, Raj VS, Zaki AM et al (2012) Genomic characterization of a newly discovered coronavirus associated with acute respiratory distress syndrome in humans. MBio 3:pii: e00473–12.  https://doi.org/10.1128/mBio.00473-12CrossRefGoogle Scholar
  73. World Health Organization (2013) WHO guidelines for investigation of cases of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV). http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_investigation_guideline_Jul13.pdf. Accessed 17 Jan 2017
  74. World Health Organization (2015) Laboratory testing for Middle East respiratory syndrome coronavirus (MERS-CoV). http://apps.who.int/iris/bitstream/10665/176982/1/WHO_MERS_LAB_15.1_eng.pdf?ua=1. Accessed 20 Dec 2016
  75. Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM (2012) Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 367: 1814–1820.  https://doi.org/10.1056/NEJMoa1211721CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jaffar A. Al-Tawfiq
    • 1
    • 2
    • 3
    Email author
  • Mamunur Rahman Malik
    • 4
  • Ziad A. Memish
    • 5
    • 6
    • 7
  1. 1.Specialty Internal Medicine and Quality DepartmentJohns Hopkins Aramco HealthcareDhahranSaudi Arabia
  2. 2.Indiana University School of MedicineIndianapolisUSA
  3. 3.Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Eastern Mediterranean Regional Office of WHOCairoEgypt
  5. 5.College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
  6. 6.Infectious Diseases Division, Department of MedicinePrince Mohamed Bin Abdulaziz Hospital (“PMAH”), Ministry of HealthRiyadhSaudi Arabia
  7. 7.Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaUSA

Section editors and affiliations

  • Harunor Rashid
  • Ziad A. Memish
    • 1
    • 2
    • 3
  1. 1.Infectious Diseases Division, Department of MedicinePrince Mohammed Bin Abdulaziz hospitalRiyadhKingdom of Saudi Arabia
  2. 2.Ministry of HealthRiyadhSaudi Arabia
  3. 3.Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaUSA

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