Viral Shedding and Antibody Response in 37 Patients with Middle East Respiratory Syndrome Coronavirus Infection

Middle East respiratory syndrome coronavirus (MERS-CoV) causes isolated cases and outbreaks of severe respiratory disease.

This paper presents a study based on 37 adult patients infected with MERS-CoV. The aim was to assess the viral load (amount of virus) in the lower and upper respiratory tracts, blood, stool (faeces), and urine.

A minority of faeces (14.6%) and urine (2.4%) were found to contain measurable MERS-CoV RNA.

The authors discuss how this low frequency of MERS-CoV RNA in faeces is different to what was previously reported for SARFS-CoV. For SARS-CoV, the reported RNA prevalence in faecal samples was so high that testing of stool has been proposed as a reliable and sensitive way to routinely diagnose the disease. Furthermore, active replication in the gut with SARS-CoV virus isolation has been demonstrated.

In addition to the low frequency (14.6%) of detection and low RNA concentration of MERS-CoV in faecal samples, the authors reported no success in isolating infectious virus. Based on these data, they concluded that faecal excretion may not have played a relevant role for the spread of MERS-CoV, at least among the patients involved in this study.


Corman, V. M., Albarrak, A. M., Omrani, A. S., Albarrak, M. M., Farah, M. E., Almasri, M., Muth, D., Sieberg, A., Meyer, B., Assiri, A. M., Binger, T., Steinhagen, K., Lattwein, E., Al-Tawfiq, J., Müller, M. A., Drosten, C. and Memish, Z. A. (2015) Viral Shedding and Antibody Response in 37 Patients With Middle East Respiratory Syndrome Coronavirus Infection. Clin. Infect. Dis., 62(4), 477-483.

Published by Stuart Khan

Professor of Civil & Environmental Engineering, University of New South Wales

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