Serveur d'exploration MERS

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Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE

Identifieur interne : 000669 ( Pmc/Checkpoint ); précédent : 000668; suivant : 000670

Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE

Auteurs : C. R. Paden [États-Unis] ; M. F. B. M. Yusof [Émirats arabes unis] ; Z. M. Al Hammadi [Émirats arabes unis] ; K. Queen [États-Unis] ; Y. Tao [États-Unis] ; Y. M. Eltahir [Émirats arabes unis] ; E. A. Elsayed [Émirats arabes unis] ; B. A. Marzoug [Émirats arabes unis] ; O. K. A. Bensalah [Émirats arabes unis] ; A. I. Khalafalla [Émirats arabes unis] ; M. Al Mulla [Émirats arabes unis] ; A. Khudhair [Émirats arabes unis] ; K. A. Elkheir [Émirats arabes unis] ; Z. B. Issa [Émirats arabes unis] ; K. Pradeep [Émirats arabes unis] ; F. N. Elsaleh [Émirats arabes unis] ; H. Imambaccus [Émirats arabes unis] ; J. Sasse [Émirats arabes unis] ; S. Weber [Émirats arabes unis] ; M. Shi [Australie] ; J. Zhang [États-Unis] ; Y. Li [États-Unis] ; H. Pham [États-Unis] ; L. Kim [États-Unis] ; A. J. Hall [États-Unis] ; S. I. Gerber [États-Unis] ; F. I. Al Hosani [Émirats arabes unis] ; S. Tong [États-Unis] ; S. S. M. Al Muhairi [Émirats arabes unis]

Source :

RBID : PMC:5893383

Abstract

Summary

Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, there have been a number of clusters of human-to-human transmission. These cases of human-to-human transmission involve close contact and have occurred primarily in healthcare settings, and they are suspected to result from repeated zoonotic introductions. In this study, we sequenced whole MERS-CoV genomes directly from respiratory samples collected from 23 confirmed MERS cases in the United Arab Emirates (UAE). These samples included cases from three nosocomial and three household clusters. The sequences were analysed for changes and relatedness with regard to the collected epidemiological data and other available MERS-CoV genomic data. Sequence analysis supports the epidemiological data within the clusters, and further, suggests that these clusters emerged independently. To understand how and when these clusters emerged, respiratory samples were taken from dromedary camels, a known host of MERS-CoV, in the same geographic regions as the human clusters. Middle East respiratory syndrome coronavirus genomes from six virus-positive animals were sequenced, and these genomes were nearly identical to those found in human patients from corresponding regions. These data demonstrate a genetic link for each of these clusters to a camel and support the hypothesis that human MERS-CoV diversity results from multiple zoonotic introductions.


Url:
DOI: 10.1111/zph.12435
PubMed: 29239118
PubMed Central: 5893383


Affiliations:


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PMC:5893383

Le document en format XML

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<name sortKey="Kim, L" sort="Kim, L" uniqKey="Kim L" first="L." last="Kim">L. Kim</name>
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<title xml:lang="en" level="a" type="main">Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE</title>
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<name sortKey="Tao, Y" sort="Tao, Y" uniqKey="Tao Y" first="Y." last="Tao">Y. Tao</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Eltahir, Y M" sort="Eltahir, Y M" uniqKey="Eltahir Y" first="Y. M." last="Eltahir">Y. M. Eltahir</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Abu Dhabi Food Control Authority, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Elsayed, E A" sort="Elsayed, E A" uniqKey="Elsayed E" first="E. A." last="Elsayed">E. A. Elsayed</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Abu Dhabi Food Control Authority, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Marzoug, B A" sort="Marzoug, B A" uniqKey="Marzoug B" first="B. A." last="Marzoug">B. A. Marzoug</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Abu Dhabi Food Control Authority, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
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</author>
<author>
<name sortKey="Bensalah, O K A" sort="Bensalah, O K A" uniqKey="Bensalah O" first="O. K. A." last="Bensalah">O. K. A. Bensalah</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Abu Dhabi Food Control Authority, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Khalafalla, A I" sort="Khalafalla, A I" uniqKey="Khalafalla A" first="A. I." last="Khalafalla">A. I. Khalafalla</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Abu Dhabi Food Control Authority, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Al Mulla, M" sort="Al Mulla, M" uniqKey="Al Mulla M" first="M." last="Al Mulla">M. Al Mulla</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
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</author>
<author>
<name sortKey="Khudhair, A" sort="Khudhair, A" uniqKey="Khudhair A" first="A." last="Khudhair">A. Khudhair</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Elkheir, K A" sort="Elkheir, K A" uniqKey="Elkheir K" first="K. A." last="Elkheir">K. A. Elkheir</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Issa, Z B" sort="Issa, Z B" uniqKey="Issa Z" first="Z. B." last="Issa">Z. B. Issa</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Pradeep, K" sort="Pradeep, K" uniqKey="Pradeep K" first="K." last="Pradeep">K. Pradeep</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Elsaleh, F N" sort="Elsaleh, F N" uniqKey="Elsaleh F" first="F. N." last="Elsaleh">F. N. Elsaleh</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Imambaccus, H" sort="Imambaccus, H" uniqKey="Imambaccus H" first="H." last="Imambaccus">H. Imambaccus</name>
<affiliation wicri:level="1">
<nlm:aff id="A5">Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Sheikh Khalifa Medical City, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Sasse, J" sort="Sasse, J" uniqKey="Sasse J" first="J." last="Sasse">J. Sasse</name>
<affiliation wicri:level="1">
<nlm:aff id="A5">Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Sheikh Khalifa Medical City, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
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</author>
<author>
<name sortKey="Weber, S" sort="Weber, S" uniqKey="Weber S" first="S." last="Weber">S. Weber</name>
<affiliation wicri:level="1">
<nlm:aff id="A5">Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Sheikh Khalifa Medical City, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
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</author>
<author>
<name sortKey="Shi, M" sort="Shi, M" uniqKey="Shi M" first="M." last="Shi">M. Shi</name>
<affiliation wicri:level="4">
<nlm:aff id="A6">The University of Sydney, Sydney, NSW, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>The University of Sydney, Sydney, NSW</wicri:regionArea>
<orgName type="university">Université de Sydney</orgName>
<placeName>
<settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
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</author>
<author>
<name sortKey="Zhang, J" sort="Zhang, J" uniqKey="Zhang J" first="J." last="Zhang">J. Zhang</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
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</author>
<author>
<name sortKey="Li, Y" sort="Li, Y" uniqKey="Li Y" first="Y." last="Li">Y. Li</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Pham, H" sort="Pham, H" uniqKey="Pham H" first="H." last="Pham">H. Pham</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Kim, L" sort="Kim, L" uniqKey="Kim L" first="L." last="Kim">L. Kim</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Hall, A J" sort="Hall, A J" uniqKey="Hall A" first="A. J." last="Hall">A. J. Hall</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Gerber, S I" sort="Gerber, S I" uniqKey="Gerber S" first="S. I." last="Gerber">S. I. Gerber</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Al Hosani, F I" sort="Al Hosani, F I" uniqKey="Al Hosani F" first="F. I." last="Al Hosani">F. I. Al Hosani</name>
<affiliation wicri:level="1">
<nlm:aff id="A4">Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Health Authority Abu Dhabi, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Tong, S" sort="Tong, S" uniqKey="Tong S" first="S." last="Tong">S. Tong</name>
<affiliation wicri:level="2">
<nlm:aff id="A1">Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Al Muhairi, S S M" sort="Al Muhairi, S S M" uniqKey="Al Muhairi S" first="S. S. M." last="Al Muhairi">S. S. M. Al Muhairi</name>
<affiliation wicri:level="1">
<nlm:aff id="A3">Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</nlm:aff>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Abu Dhabi Food Control Authority, Abu Dhabi</wicri:regionArea>
<wicri:noRegion>Abu Dhabi</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Zoonoses and public health</title>
<idno type="ISSN">1863-1959</idno>
<idno type="eISSN">1863-2378</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
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<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<title>Summary</title>
<p id="P1">Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, there have been a number of clusters of human-to-human transmission. These cases of human-to-human transmission involve close contact and have occurred primarily in healthcare settings, and they are suspected to result from repeated zoonotic introductions. In this study, we sequenced whole MERS-CoV genomes directly from respiratory samples collected from 23 confirmed MERS cases in the United Arab Emirates (UAE). These samples included cases from three nosocomial and three household clusters. The sequences were analysed for changes and relatedness with regard to the collected epidemiological data and other available MERS-CoV genomic data. Sequence analysis supports the epidemiological data within the clusters, and further, suggests that these clusters emerged independently. To understand how and when these clusters emerged, respiratory samples were taken from dromedary camels, a known host of MERS-CoV, in the same geographic regions as the human clusters. Middle East respiratory syndrome coronavirus genomes from six virus-positive animals were sequenced, and these genomes were nearly identical to those found in human patients from corresponding regions. These data demonstrate a genetic link for each of these clusters to a camel and support the hypothesis that human MERS-CoV diversity results from multiple zoonotic introductions.</p>
</div>
</front>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">101300786</journal-id>
<journal-id journal-id-type="pubmed-jr-id">33328</journal-id>
<journal-id journal-id-type="nlm-ta">Zoonoses Public Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Zoonoses Public Health</journal-id>
<journal-title-group>
<journal-title>Zoonoses and public health</journal-title>
</journal-title-group>
<issn pub-type="ppub">1863-1959</issn>
<issn pub-type="epub">1863-2378</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">29239118</article-id>
<article-id pub-id-type="pmc">5893383</article-id>
<article-id pub-id-type="doi">10.1111/zph.12435</article-id>
<article-id pub-id-type="manuscript">HHSPA939333</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Paden</surname>
<given-names>C. R.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref rid="FN2" ref-type="author-notes">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Yusof</surname>
<given-names>M. F. B. M.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref rid="FN2" ref-type="author-notes">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Al Hammadi</surname>
<given-names>Z. M.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref rid="FN2" ref-type="author-notes">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Queen</surname>
<given-names>K.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref rid="FN2" ref-type="author-notes">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tao</surname>
<given-names>Y.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Eltahir</surname>
<given-names>Y. M.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Elsayed</surname>
<given-names>E. A.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Marzoug</surname>
<given-names>B. A.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bensalah</surname>
<given-names>O. K. A.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Khalafalla</surname>
<given-names>A. I.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Al Mulla</surname>
<given-names>M.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Khudhair</surname>
<given-names>A.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Elkheir</surname>
<given-names>K. A.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Issa</surname>
<given-names>Z. B.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pradeep</surname>
<given-names>K.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Elsaleh</surname>
<given-names>F. N.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Imambaccus</surname>
<given-names>H.</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sasse</surname>
<given-names>J.</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Weber</surname>
<given-names>S.</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Shi</surname>
<given-names>M.</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Zhang</surname>
<given-names>J.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Y.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pham</surname>
<given-names>H.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kim</surname>
<given-names>L.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hall</surname>
<given-names>A. J.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gerber</surname>
<given-names>S. I.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Al Hosani</surname>
<given-names>F. I.</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
<xref rid="FN3" ref-type="author-notes">#</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tong</surname>
<given-names>S.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref rid="FN3" ref-type="author-notes">#</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Al Muhairi</surname>
<given-names>S. S. M.</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref rid="FN3" ref-type="author-notes">#</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA</aff>
<aff id="A2">
<label>2</label>
Oak Ridge Institute for Science Education, Oak Ridge, TN, USA</aff>
<aff id="A3">
<label>3</label>
Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates</aff>
<aff id="A4">
<label>4</label>
Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates</aff>
<aff id="A5">
<label>5</label>
Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates</aff>
<aff id="A6">
<label>6</label>
The University of Sydney, Sydney, NSW, Australia</aff>
<author-notes>
<corresp id="FN1">Correspondence: Suxiang Tong, CDC, Atlanta, GA, USA.
<email>sot1@cdc.gov</email>
</corresp>
<fn id="FN2" fn-type="equal">
<label>*</label>
<p>These authors contributed equally to this article.</p>
</fn>
<fn id="FN3">
<label>#</label>
<p>These authors are co-principal investigators.</p>
</fn>
<fn id="FN4">
<p>
<bold>ORCID</bold>
</p>
<p>
<italic>C. R. Paden</italic>
<ext-link ext-link-type="uri" xlink:href="http://orcid.org/0000-0001-8701-8948">http://orcid.org/0000-0001-8701-8948</ext-link>
</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>3</day>
<month>2</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>13</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="ppub">
<month>5</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>01</day>
<month>5</month>
<year>2019</year>
</pub-date>
<volume>65</volume>
<issue>3</issue>
<fpage>322</fpage>
<lpage>333</lpage>
<pmc-comment>elocation-id from pubmed: 10.1111/zph.12435</pmc-comment>
<permissions>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">
<license-p>This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</license-p>
</license>
</permissions>
<abstract>
<title>Summary</title>
<p id="P1">Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, there have been a number of clusters of human-to-human transmission. These cases of human-to-human transmission involve close contact and have occurred primarily in healthcare settings, and they are suspected to result from repeated zoonotic introductions. In this study, we sequenced whole MERS-CoV genomes directly from respiratory samples collected from 23 confirmed MERS cases in the United Arab Emirates (UAE). These samples included cases from three nosocomial and three household clusters. The sequences were analysed for changes and relatedness with regard to the collected epidemiological data and other available MERS-CoV genomic data. Sequence analysis supports the epidemiological data within the clusters, and further, suggests that these clusters emerged independently. To understand how and when these clusters emerged, respiratory samples were taken from dromedary camels, a known host of MERS-CoV, in the same geographic regions as the human clusters. Middle East respiratory syndrome coronavirus genomes from six virus-positive animals were sequenced, and these genomes were nearly identical to those found in human patients from corresponding regions. These data demonstrate a genetic link for each of these clusters to a camel and support the hypothesis that human MERS-CoV diversity results from multiple zoonotic introductions.</p>
</abstract>
<kwd-group>
<kwd>dromedary camel</kwd>
<kwd>epidemiology</kwd>
<kwd>genomics</kwd>
<kwd>middle east respiratory syndrome</kwd>
<kwd>viral pathogens</kwd>
<kwd>zoonoses</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="F1" orientation="portrait" position="float">
<label>FIGURE 1</label>
<caption>
<p>Geographic distribution of human and camel cases in the UAE, 2013–2014. Map of the United Arab Emirates showing approximate location of each sequenced human MERS case, as well as the location of the Middle East respiratory syndrome coronavirus (MERS-CoV)-positive camels sampled in this study. Each marker represents an individual case sequenced in this study. Arrows represent the importation of cases to the indicated location. [Colour figure can be viewed at wileyonlinelibrary.com]</p>
</caption>
<graphic xlink:href="nihms939333f1"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float">
<label>FIGURE 2</label>
<caption>
<p>Summary of cases sequenced from the UAE 2013–2014 clusters. Each Middle East respiratory syndrome coronavirus (MERS-CoV) genome sequenced from the UAE clusters is shown as a circle. Filled circles represent those human samples where full MERS-CoV genome sequence was obtained, stripe-filled circles represent where only S and N gene sequences were obtained. Triangles represent associated MERS cases where no sequence was obtained. Cases are plotted along a timeline corresponding with the index case infection date, and those associated with frequent exposure to camels are in the shaded region. Camels that were directly implicated in a cluster are connected by a solid arrow. Human cases where the sequence indicates that there is significant similarity to a camel are connected by a dashed arrow. [Colour figure can be viewed at wileyonlinelibrary.com]</p>
</caption>
<graphic xlink:href="nihms939333f2"></graphic>
</fig>
<fig id="F3" orientation="portrait" position="float">
<label>FIGURE 3</label>
<caption>
<p>Genome alignment and Single nucleotide polymorphism (SNPs) within UAE cases. (a) Full genome sequences or (b) S gene nucleotide sequences from the 2013–2014 UAE Middle East respiratory syndrome coronavirus clusters, sporadic cases and camels were aligned with parsnp, using Human betacoronavirus 2c EMC/2012 (GenBank JX869059) as a reference sequence. Gingr was used to visualize SNPs, compared to the reference genome. Each vertical bar in the graph represents a single SNP. Asterisks in S gene alignment represent amino acid changes</p>
</caption>
<graphic xlink:href="nihms939333f3"></graphic>
</fig>
<fig id="F4" orientation="portrait" position="float">
<label>FIGURE 4</label>
<caption>
<p>PhyML tree analysis of Middle East respiratory syndrome coronavirus (MERS-CoV) genome sequences. Maximum likelihood tree 97 MERS-CoV genomes, generated using PhyML. The trees include sequences from the 2013–2014 UAE clusters as well as camel-derived viruses sequenced in this study and representative sequences from GenBank. The lineages described in Sabir et al. are indicated. The clusters described in the paper are highlighted in coloured boxes. [Colour figure can be viewed at wileyonlinelibrary.com]</p>
</caption>
<graphic xlink:href="nihms939333f4"></graphic>
</fig>
<fig id="F5" orientation="portrait" position="float">
<label>FIGURE 5</label>
<caption>
<p>BEAST time-scaled tree of Middle East respiratory syndrome coronavirus (MERS-CoV) cases. After filtering recombinant MERS-CoV genomes using RDP, the remaining genomes were analysed using BEAST to understand divergence times between the various human cases and between the human and camel cases. Node A shows a divergence between a camel virus and the 2014_008-associated cluster (Healthcare- associated clusters III and HH C) virus that occurred separately, but concurrent, with the divergence at Node C, between a camel virus and human case 2014_XXX. Likewise, the divergence of the 2014_002 virus from a camel virus happened at Node B, separately and later than the other two examples. The clusters described in the paper are highlighted in coloured boxes. [Colour figure can be viewed at wileyonlinelibrary. com]</p>
</caption>
<graphic xlink:href="nihms939333f5"></graphic>
</fig>
<table-wrap id="T1" position="float" orientation="landscape">
<label>TABLE 1</label>
<caption>
<p>Summary of 23 Middle East respiratory syndrome coronavirus clinical samples sequenced and submitted to GenBank</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left" rowspan="1" colspan="1">Cluster</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Case</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Type</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Sample collection date</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Sequence Type</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">GenBank accession</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Distance to index (nucleotide)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" rowspan="3" colspan="1">Healthcare-associated clusters (HCA) I (Abu Dhabi)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013_002</td>
<td align="left" valign="top" rowspan="1" colspan="1">Index</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Jul 10</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581684</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2013_003</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Jul 12</td>
<td align="left" valign="top" rowspan="1" colspan="1">S/N</td>
<td align="left" valign="top" rowspan="1" colspan="1">S: KY673146;
<break></break>
N: KY673143</td>
<td align="left" valign="top" rowspan="1" colspan="1">0
<xref rid="TFN1" ref-type="table-fn">a</xref>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2013_004</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Jul 12</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581685</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Other (Oman)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013_007</td>
<td align="left" valign="top" rowspan="1" colspan="1">Sporadic</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Oct 12</td>
<td align="left" valign="top" rowspan="1" colspan="1">S/N</td>
<td align="left" valign="top" rowspan="1" colspan="1">S: KP236092
<break></break>
N: KP236093</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="2" colspan="1">HH A (Abu Dhabi)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013_008</td>
<td align="left" valign="top" rowspan="1" colspan="1">Index</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Nov 24</td>
<td align="left" valign="top" rowspan="1" colspan="1">S/N</td>
<td align="left" valign="top" rowspan="1" colspan="1">N: KY673144</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2013_009</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Nov 25</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209312</td>
<td align="left" valign="top" rowspan="1" colspan="1">0
<xref rid="TFN1" ref-type="table-fn">a</xref>
</td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">HH B (Dubai/Abu Dhabi)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013_011</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2013 Dec 23</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581687</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">HCA II (Western Region)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_002</td>
<td align="left" valign="top" rowspan="1" colspan="1">Index</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Mar 16</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209310</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4" colspan="1">HH C (Al Ain)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_008
<xref rid="TFN2" ref-type="table-fn">b</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Index</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 09</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209306</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_009</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 10</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581686</td>
<td align="left" valign="top" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_011</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 10</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581688</td>
<td align="left" valign="top" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_015</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 10</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581689</td>
<td align="left" valign="top" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="10" colspan="1">HCA III (Al Ain)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_008
<xref rid="TFN2" ref-type="table-fn">b</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">Index</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 09</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209306</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_016</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 12</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209308</td>
<td align="left" valign="top" rowspan="1" colspan="1">3</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_017</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 12</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581690</td>
<td align="left" valign="top" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_018</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 12</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209307</td>
<td align="left" valign="top" rowspan="1" colspan="1">2</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_023</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 14</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581691</td>
<td align="left" valign="top" rowspan="1" colspan="1">0</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_025</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 15</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581692</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_026</td>
<td align="left" valign="top" rowspan="1" colspan="1">Tertiary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 15</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209313</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_030</td>
<td align="left" valign="top" rowspan="1" colspan="1">Secondary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 16</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209309</td>
<td align="left" valign="top" rowspan="1" colspan="1">0</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_033</td>
<td align="left" valign="top" rowspan="1" colspan="1">Tertiary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 20</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KP209311</td>
<td align="left" valign="top" rowspan="1" colspan="1">0</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2014_045</td>
<td align="left" valign="top" rowspan="1" colspan="1">Tertiary</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 25</td>
<td align="left" valign="top" rowspan="1" colspan="1">S/N</td>
<td align="left" valign="top" rowspan="1" colspan="1">S: KY673147;
<break></break>
N: KY673145</td>
<td align="left" valign="top" rowspan="1" colspan="1">0
<xref rid="TFN1" ref-type="table-fn">a</xref>
</td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Other (Jeddah, Kingdom of Saudi Arabia)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_032</td>
<td align="left" valign="top" rowspan="1" colspan="1">Sporadic</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Apr 20</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581693</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="7" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Other</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_XXX</td>
<td align="left" valign="top" rowspan="1" colspan="1">Unknown</td>
<td align="left" valign="top" rowspan="1" colspan="1">Unknown</td>
<td align="left" valign="top" rowspan="1" colspan="1">Genome</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581694</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="TFN1">
<label>a</label>
<p>Sequences compared are not full genomes.</p>
</fn>
<fn id="TFN2">
<label>b</label>
<p>2014_008 is the index patient for both HH C and HCA III.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" position="float" orientation="landscape">
<label>TABLE 2</label>
<caption>
<p>Summary of Middle East respiratory syndrome coronavirus genomes sequenced from UAE camels</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="bottom" align="left" rowspan="1" colspan="1">Region</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Sample ID</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Sample date</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Closest human case</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">Distancefrom human (nucleotide)</th>
<th valign="bottom" align="left" rowspan="1" colspan="1">GenBank accession</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" rowspan="3" colspan="1">Kingdom of Saudi Arabia Border</td>
<td align="left" valign="top" rowspan="1" colspan="1">1B-A</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 May 28</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_XXX</td>
<td align="left" valign="top" rowspan="1" colspan="1">8</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581695</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">2B-E
<xref rid="TFN3" ref-type="table-fn">a</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 May 28</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581699</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">1H-F
<xref rid="TFN3" ref-type="table-fn">a</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 May 28</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581698</td>
</tr>
<tr>
<td colspan="6" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="2" colspan="1">Al Ain</td>
<td align="left" valign="top" rowspan="1" colspan="1">3B-C
<xref rid="TFN4" ref-type="table-fn">b</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Feb 17</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_008, 011, 030, 033</td>
<td align="left" valign="top" rowspan="1" colspan="1">7</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581700</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">1H-D
<xref rid="TFN4" ref-type="table-fn">b</xref>
</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Feb 17</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581697</td>
</tr>
<tr>
<td colspan="6" align="left" valign="bottom" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Western Region</td>
<td align="left" valign="top" rowspan="1" colspan="1">1H-B</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014 Mar 11</td>
<td align="left" valign="top" rowspan="1" colspan="1">2014_002</td>
<td align="left" valign="top" rowspan="1" colspan="1">3</td>
<td align="left" valign="top" rowspan="1" colspan="1">KY581696</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="TFN3">
<label>a</label>
<p>These sequences are identical to each other.</p>
</fn>
<fn id="TFN4">
<label>b</label>
<p>These sequences are identical to each other.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<boxed-text id="BX1" position="float" orientation="portrait">
<caption>
<title>Impacts</title>
</caption>
<list list-type="bullet" id="L1">
<list-item>
<p id="P26">Middle East respiratory syndrome coronavirus (MERS-CoV) is an important human pathogen with a high mortality rate that emerged from a zoonotic reservoir and has been transmitted between humans.</p>
</list-item>
<list-item>
<p id="P27">This study shows the close genetic relationship between the MERS-CoV virus genome sequences transmitted within outbreak clusters in the United Arab Emirates, which will aid in future epidemiological studies.</p>
</list-item>
<list-item>
<p id="P28">Camels are an important reservoir of MERS-CoV; in this study, MERS-CoVs sampled from UAE camels are sequenced and they demonstrate that the outbreak viruses emerged repeatedly from the animal reservoir.</p>
</list-item>
</list>
</boxed-text>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Émirats arabes unis</li>
<li>États-Unis</li>
</country>
<region>
<li>Géorgie (États-Unis)</li>
<li>Nouvelle-Galles du Sud</li>
<li>Tennessee</li>
</region>
<settlement>
<li>Sydney</li>
</settlement>
<orgName>
<li>Université de Sydney</li>
</orgName>
</list>
<tree>
<country name="États-Unis">
<region name="Géorgie (États-Unis)">
<name sortKey="Paden, C R" sort="Paden, C R" uniqKey="Paden C" first="C. R." last="Paden">C. R. Paden</name>
</region>
<name sortKey="Gerber, S I" sort="Gerber, S I" uniqKey="Gerber S" first="S. I." last="Gerber">S. I. Gerber</name>
<name sortKey="Hall, A J" sort="Hall, A J" uniqKey="Hall A" first="A. J." last="Hall">A. J. Hall</name>
<name sortKey="Kim, L" sort="Kim, L" uniqKey="Kim L" first="L." last="Kim">L. Kim</name>
<name sortKey="Li, Y" sort="Li, Y" uniqKey="Li Y" first="Y." last="Li">Y. Li</name>
<name sortKey="Paden, C R" sort="Paden, C R" uniqKey="Paden C" first="C. R." last="Paden">C. R. Paden</name>
<name sortKey="Pham, H" sort="Pham, H" uniqKey="Pham H" first="H." last="Pham">H. Pham</name>
<name sortKey="Queen, K" sort="Queen, K" uniqKey="Queen K" first="K." last="Queen">K. Queen</name>
<name sortKey="Queen, K" sort="Queen, K" uniqKey="Queen K" first="K." last="Queen">K. Queen</name>
<name sortKey="Tao, Y" sort="Tao, Y" uniqKey="Tao Y" first="Y." last="Tao">Y. Tao</name>
<name sortKey="Tong, S" sort="Tong, S" uniqKey="Tong S" first="S." last="Tong">S. Tong</name>
<name sortKey="Zhang, J" sort="Zhang, J" uniqKey="Zhang J" first="J." last="Zhang">J. Zhang</name>
</country>
<country name="Émirats arabes unis">
<noRegion>
<name sortKey="Yusof, M F B M" sort="Yusof, M F B M" uniqKey="Yusof M" first="M. F. B. M." last="Yusof">M. F. B. M. Yusof</name>
</noRegion>
<name sortKey="Al Hammadi, Z M" sort="Al Hammadi, Z M" uniqKey="Al Hammadi Z" first="Z. M." last="Al Hammadi">Z. M. Al Hammadi</name>
<name sortKey="Al Hosani, F I" sort="Al Hosani, F I" uniqKey="Al Hosani F" first="F. I." last="Al Hosani">F. I. Al Hosani</name>
<name sortKey="Al Muhairi, S S M" sort="Al Muhairi, S S M" uniqKey="Al Muhairi S" first="S. S. M." last="Al Muhairi">S. S. M. Al Muhairi</name>
<name sortKey="Al Mulla, M" sort="Al Mulla, M" uniqKey="Al Mulla M" first="M." last="Al Mulla">M. Al Mulla</name>
<name sortKey="Bensalah, O K A" sort="Bensalah, O K A" uniqKey="Bensalah O" first="O. K. A." last="Bensalah">O. K. A. Bensalah</name>
<name sortKey="Elkheir, K A" sort="Elkheir, K A" uniqKey="Elkheir K" first="K. A." last="Elkheir">K. A. Elkheir</name>
<name sortKey="Elsaleh, F N" sort="Elsaleh, F N" uniqKey="Elsaleh F" first="F. N." last="Elsaleh">F. N. Elsaleh</name>
<name sortKey="Elsayed, E A" sort="Elsayed, E A" uniqKey="Elsayed E" first="E. A." last="Elsayed">E. A. Elsayed</name>
<name sortKey="Eltahir, Y M" sort="Eltahir, Y M" uniqKey="Eltahir Y" first="Y. M." last="Eltahir">Y. M. Eltahir</name>
<name sortKey="Imambaccus, H" sort="Imambaccus, H" uniqKey="Imambaccus H" first="H." last="Imambaccus">H. Imambaccus</name>
<name sortKey="Issa, Z B" sort="Issa, Z B" uniqKey="Issa Z" first="Z. B." last="Issa">Z. B. Issa</name>
<name sortKey="Khalafalla, A I" sort="Khalafalla, A I" uniqKey="Khalafalla A" first="A. I." last="Khalafalla">A. I. Khalafalla</name>
<name sortKey="Khudhair, A" sort="Khudhair, A" uniqKey="Khudhair A" first="A." last="Khudhair">A. Khudhair</name>
<name sortKey="Marzoug, B A" sort="Marzoug, B A" uniqKey="Marzoug B" first="B. A." last="Marzoug">B. A. Marzoug</name>
<name sortKey="Pradeep, K" sort="Pradeep, K" uniqKey="Pradeep K" first="K." last="Pradeep">K. Pradeep</name>
<name sortKey="Sasse, J" sort="Sasse, J" uniqKey="Sasse J" first="J." last="Sasse">J. Sasse</name>
<name sortKey="Weber, S" sort="Weber, S" uniqKey="Weber S" first="S." last="Weber">S. Weber</name>
</country>
<country name="Australie">
<region name="Nouvelle-Galles du Sud">
<name sortKey="Shi, M" sort="Shi, M" uniqKey="Shi M" first="M." last="Shi">M. Shi</name>
</region>
</country>
</tree>
</affiliations>
</record>

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