Lack of detection of Middle East respiratory syndrome coronavirus in mild and severe respiratory infections in Catalonia, northeastern Spain
Identifieur interne : 000F35 ( Pmc/Corpus ); précédent : 000F34; suivant : 000F36Lack of detection of Middle East respiratory syndrome coronavirus in mild and severe respiratory infections in Catalonia, northeastern Spain
Auteurs : M. J. Martínez ; M. A. Marcos ; V. Gonzalo ; Y. Zboromyrska ; R. Isanta ; N. Torner ; A. Martinez ; M. Jané ; A. Mateu ; J. VilaSource :
- New Microbes and New Infections [ 2052-2975 ] ; 2014.
Abstract
Surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) was conducted to explore the possible introduction and circulation of this novel virus in Catalonia, northeastern Spain. Five hundred and sixty-three samples from mild and severe respiratory infections collected between January 2012 and April 2013 were screened using real-time RT-PCR. All samples were negative, suggesting that MERS-CoV is not circulating silently in Catalonia.
Url:
DOI: 10.1002/2052-2975.34
PubMed: 25356335
PubMed Central: 4184620
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PMC:4184620Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Lack of detection of Middle East respiratory syndrome coronavirus in mild and severe respiratory infections in Catalonia, northeastern Spain</title><author><name sortKey="Martinez, M J" sort="Martinez, M J" uniqKey="Martinez M" first="M. J." last="Martínez">M. J. Martínez</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Marcos, M A" sort="Marcos, M A" uniqKey="Marcos M" first="M. A." last="Marcos">M. A. Marcos</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Gonzalo, V" sort="Gonzalo, V" uniqKey="Gonzalo V" first="V." last="Gonzalo">V. Gonzalo</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Zboromyrska, Y" sort="Zboromyrska, Y" uniqKey="Zboromyrska Y" first="Y." last="Zboromyrska">Y. Zboromyrska</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Isanta, R" sort="Isanta, R" uniqKey="Isanta R" first="R." last="Isanta">R. Isanta</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Torner, N" sort="Torner, N" uniqKey="Torner N" first="N." last="Torner">N. Torner</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Martinez, A" sort="Martinez, A" uniqKey="Martinez A" first="A." last="Martinez">A. Martinez</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Jane, M" sort="Jane, M" uniqKey="Jane M" first="M." last="Jané">M. Jané</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Mateu, A" sort="Mateu, A" uniqKey="Mateu A" first="A." last="Mateu">A. Mateu</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Vila, J" sort="Vila, J" uniqKey="Vila J" first="J." last="Vila">J. Vila</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25356335</idno><idno type="pmc">4184620</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184620</idno><idno type="RBID">PMC:4184620</idno><idno type="doi">10.1002/2052-2975.34</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000F35</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F35</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Lack of detection of Middle East respiratory syndrome coronavirus in mild and severe respiratory infections in Catalonia, northeastern Spain</title><author><name sortKey="Martinez, M J" sort="Martinez, M J" uniqKey="Martinez M" first="M. J." last="Martínez">M. J. Martínez</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Marcos, M A" sort="Marcos, M A" uniqKey="Marcos M" first="M. A." last="Marcos">M. A. Marcos</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Gonzalo, V" sort="Gonzalo, V" uniqKey="Gonzalo V" first="V." last="Gonzalo">V. Gonzalo</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Zboromyrska, Y" sort="Zboromyrska, Y" uniqKey="Zboromyrska Y" first="Y." last="Zboromyrska">Y. Zboromyrska</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Isanta, R" sort="Isanta, R" uniqKey="Isanta R" first="R." last="Isanta">R. Isanta</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Torner, N" sort="Torner, N" uniqKey="Torner N" first="N." last="Torner">N. Torner</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Martinez, A" sort="Martinez, A" uniqKey="Martinez A" first="A." last="Martinez">A. Martinez</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Jane, M" sort="Jane, M" uniqKey="Jane M" first="M." last="Jané">M. Jané</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Mateu, A" sort="Mateu, A" uniqKey="Mateu A" first="A." last="Mateu">A. Mateu</name><affiliation><nlm:aff id="aff2">Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</nlm:aff></affiliation></author><author><name sortKey="Vila, J" sort="Vila, J" uniqKey="Vila J" first="J." last="Vila">J. Vila</name><affiliation><nlm:aff id="aff1">Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</nlm:aff></affiliation></author></analytic><series><title level="j">New Microbes and New Infections</title><idno type="eISSN">2052-2975</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) was conducted to explore the possible introduction and circulation of this novel virus in Catalonia, northeastern Spain. Five hundred and sixty-three samples from mild and severe respiratory infections collected between January 2012 and April 2013 were screened using real-time RT-PCR. All samples were negative, suggesting that MERS-CoV is not circulating silently in Catalonia.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name></author><author><name sortKey="Osterhaus, Ad" uniqKey="Osterhaus A">AD Osterhaus</name></author><author><name sortKey="Fouchier, Ra" uniqKey="Fouchier R">RA Fouchier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Annan, A" uniqKey="Annan A">A Annan</name></author><author><name sortKey="Baldwin, Hj" uniqKey="Baldwin H">HJ Baldwin</name></author><author><name sortKey="Corman, Vm" uniqKey="Corman V">VM Corman</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author><author><name sortKey="Mcgeer, A" uniqKey="Mcgeer A">A McGeer</name></author><author><name sortKey="Perl, Tm" uniqKey="Perl T">TM Perl</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author><author><name sortKey="Zumla, Ai" uniqKey="Zumla A">AI Zumla</name></author><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Breban, R" uniqKey="Breban R">R Breban</name></author><author><name sortKey="Riou, J" uniqKey="Riou J">J Riou</name></author><author><name sortKey="Fontanet, A" uniqKey="Fontanet A">A Fontanet</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cauchemez, S" uniqKey="Cauchemez S">S Cauchemez</name></author><author><name sortKey="Fraser, C" uniqKey="Fraser C">C Fraser</name></author><author><name sortKey="Van Kerkhove, Md" uniqKey="Van Kerkhove M">MD Van Kerkhove</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coiras, Mt" uniqKey="Coiras M">MT Coiras</name></author><author><name sortKey="Aguilar, Jc" uniqKey="Aguilar J">JC Aguilar</name></author><author><name sortKey="Garcia, Ml" uniqKey="Garcia M">ML Garcia</name></author><author><name sortKey="Casas, I" uniqKey="Casas I">I Casas</name></author><author><name sortKey="Perez Brena, P" uniqKey="Perez Brena P">P Perez-Brena</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coiras, Mt" uniqKey="Coiras M">MT Coiras</name></author><author><name sortKey="Perez Brena, P" uniqKey="Perez Brena P">P Perez-Brena</name></author><author><name sortKey="Garcia, Ml" uniqKey="Garcia M">ML Garcia</name></author><author><name sortKey="Casas, I" uniqKey="Casas I">I Casas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Corman, Vm" uniqKey="Corman V">VM Corman</name></author><author><name sortKey="Eckerle, I" uniqKey="Eckerle I">I Eckerle</name></author><author><name sortKey="Bleicker, T" uniqKey="Bleicker T">T Bleicker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Souza Luna, Lk" uniqKey="De Souza Luna L">LK de Souza Luna</name></author><author><name sortKey="Heiser, V" uniqKey="Heiser V">V Heiser</name></author><author><name sortKey="Regamey, N" uniqKey="Regamey N">N Regamey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ricart, S" uniqKey="Ricart S">S Ricart</name></author><author><name sortKey="Garcia Garcia, Jj" uniqKey="Garcia Garcia J">JJ Garcia-Garcia</name></author><author><name sortKey="Anton, A" uniqKey="Anton A">A Anton</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">New Microbes New Infect</journal-id><journal-id journal-id-type="iso-abbrev">New Microbes New Infect</journal-id><journal-title-group><journal-title>New Microbes and New Infections</journal-title></journal-title-group><issn pub-type="epub">2052-2975</issn><publisher><publisher-name>European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25356335</article-id><article-id pub-id-type="pmc">4184620</article-id><article-id pub-id-type="publisher-id">S2052-2975(14)50044-3</article-id><article-id pub-id-type="doi">10.1002/2052-2975.34</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Lack of detection of Middle East respiratory syndrome coronavirus in mild and severe respiratory infections in Catalonia, northeastern Spain</article-title></title-group><contrib-group><contrib contrib-type="author" id="au10"><name><surname>Martínez</surname><given-names>M.J.</given-names></name><email>myoldi@clinic.ub.es</email><xref rid="aff1" ref-type="aff">a</xref><xref rid="cor1" ref-type="corresp">*</xref></contrib><contrib contrib-type="author" id="au20"><name><surname>Marcos</surname><given-names>M.A.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au30"><name><surname>Gonzalo</surname><given-names>V.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au40"><name><surname>Zboromyrska</surname><given-names>Y.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au50"><name><surname>Isanta</surname><given-names>R.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au60"><name><surname>Torner</surname><given-names>N.</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au70"><name><surname>Martinez</surname><given-names>A.</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au80"><name><surname>Jané</surname><given-names>M.</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au90"><name><surname>Mateu</surname><given-names>A.</given-names></name><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au100"><name><surname>Vila</surname><given-names>J.</given-names></name><xref rid="aff1" ref-type="aff">a</xref></contrib></contrib-group><aff id="aff1"><label>a</label>Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain</aff><aff id="aff2"><label>b</label>Generalitat of Catalonia, Public Health Agency of Catalonia, Barcelona, Spain</aff><author-notes><corresp id="cor1"><label>*</label><bold>Corresponding author:</bold> M. J. Martínez, Department of Clinical Microbiology, Hospital Clinic, Barcelona Centre for International Health Research, Barcelona, Spain <email>myoldi@clinic.ub.es</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>16</day><month>12</month><year>2014</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>1</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>16</day><month>12</month><year>2014</year></pub-date><volume>2</volume><pmc-comment>1 </pmc-comment>
<fpage>27</fpage><lpage>28</lpage><history><date date-type="received"><day>19</day><month>9</month><year>2013</year></date><date date-type="rev-recd"><day>10</day><month>12</month><year>2013</year></date><date date-type="accepted"><day>13</day><month>12</month><year>2013</year></date></history><permissions><copyright-statement>Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd.</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>European Society of Clinical Microbiology and Infectious Diseases</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="ceab10"><p>Surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) was conducted to explore the possible introduction and circulation of this novel virus in Catalonia, northeastern Spain. Five hundred and sixty-three samples from mild and severe respiratory infections collected between January 2012 and April 2013 were screened using real-time RT-PCR. All samples were negative, suggesting that MERS-CoV is not circulating silently in Catalonia.</p></abstract><kwd-group id="cekeyws10"><title>Keywords</title><kwd>MERS-CoV</kwd><kwd>northeastern Spain</kwd><kwd>respiratory infections</kwd></kwd-group></article-meta></front><body><p id="para10">In June 2012, a patient with a severe respiratory infection was admitted to a hospital in Saudi Arabia. Known respiratory pathogens were ruled out as aetiological agents of the syndrome and the patient died of progressive respiratory and renal failure. Respiratory samples were further analysed, which resulted in the identification of a novel betacoronavirus: Middle East respiratory syndrome coronavirus (MERS-CoV) [<xref rid="bib1" ref-type="bibr">1</xref>]. As of 12 September 2013, a total of 114 laboratory-confirmed cases of MERS-CoV infection, including 54 deaths, have been reported (<ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/don/2013_09_07/en/index.html" id="interrefs10">http://www.who.int/csr/don/2013_09_07/en/index.html</ext-link>). MERS-CoV is related to bat coronaviruses [<xref rid="bib2" ref-type="bibr">2</xref>], although the animal reservoir has not been identified and the virus has been only isolated in humans. The severity of the infections and the ability of the virus to be transmitted person to person [<xref rid="bib3" ref-type="bibr">3</xref>, <xref rid="bib4" ref-type="bibr">4</xref>] raised international concerns about the possible spread and potential impact of the novel virus on human health. Asymptomatic or mild cases of MERS-CoV have been described [<xref rid="bib3" ref-type="bibr">3</xref>, <xref rid="bib5" ref-type="bibr">5</xref>], as well as cases of co-infection by MERS-CoV with other respiratory pathogens (<ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_investigation_guideline_Jul13.pdf" id="interrefs20">http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_investigation_guideline_Jul13.pdf</ext-link>). Two recent studies assessed the transmission potential of the virus by mathematical modelling using currently existing data. Although the estimation of the inter-human transmissibility suggests that the virus is currently unlikely to cause a pandemic [<xref rid="bib6" ref-type="bibr">6</xref>], it was also indicated that more than half of the symptomatic human cases would remain undetected [<xref rid="bib7" ref-type="bibr">7</xref>].</p><p id="para20">Although most cases have been identified in Saudi Arabia, imported cases in European countries have also been reported. All imported cases had a travel history to the Middle East and therefore current recommendations for investigation of MERS-CoV cases include residence in or history of travel to Middle Eastern countries (<ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_investigation_guideline_Jul13.pdf" id="interrefs30">http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_investigation_guideline_Jul13.pdf</ext-link>). However, the fact that the virus can be transmitted person to person and also cause mild disease could potentially result in unnoticed importation and circulation of the virus in other parts of the world apart from the identified geographical areas. Direct traffic from the Barcelona international airport includes 30 weekly flights to the Middle East, accounting for more than 600 000 passengers in 2012 (<ext-link ext-link-type="uri" xlink:href="http://www.bcnair-route.com/index.php/en/intercontinental-flights" id="interrefs40">http://www.bcnair-route.com/index.php/en/intercontinental-flights</ext-link>). To explore whether MERS-CoV could have been introduced into our region and be circulating at a certain level, we screened respiratory samples from both mild and severe cases of acute respiratory infection, independently of the travel history of the patients.</p><p id="para30">The acute respiratory infections surveillance programme in Catalonia, PIDIRAC (daily information system for acute respiratory infections in Catalonia), performs surveillance during the influenza activity season from October to May (<ext-link ext-link-type="uri" xlink:href="http://www.gencat.cat/temes/cat/salut.htm" id="interrefs50">http://www.gencat.cat/temes/cat/salut.htm</ext-link>). This surveillance system is based on 38 sentinel primary-care centres in which physicians collect nasopharyngeal swabs from patients with acute respiratory infections as well as 11 sentinel hospitals that report cases of severe confirmed influenza virus infection admitted to their facility. Samples from the primary-care centres were screened at our laboratory for respiratory viruses using multiplex nested RT-PCR assays [<xref rid="bib8" ref-type="bibr">8</xref>, <xref rid="bib9" ref-type="bibr">9</xref>] that allow detection of influenza viruses A, B and C, respiratory syncytial virus, parainfluenza viruses 1–4, adenoviruses, human coronaviruses 229E and OC43, rhinoviruses and enteroviruses. This surveillance network provides timely information about the circulation of respiratory viruses in our region and carries out virological surveillance for the European Influenza Surveillance Network (EISN). For our study, we selected cases of mild respiratory infections attending the primary-care centres as well as patients with severe febrile respiratory syndromes admitted to our hospital who underwent bronchoalveolar lavage. A total of 563 samples from 563 corresponding patients were tested, from which 195 were collected between January 2012 and June 2012 and 368 between July 2012 and April 2013. We selected 304 nasopharyngeal swab samples from the surveillance network that were negative for respiratory viruses and 39 bronchoalveolar lavage samples that were negative for standard microbiological tests. Given that co-infections with other respiratory pathogens have been detected in patients with MERS-CoV infection, 200 nasopharyngeal swab samples in which a respiratory virus was identified and 20 bronchoalveolar lavage samples in which a respiratory pathogen was identified were also tested. The following viruses were detected among the positive nasopharyngeal samples: influenza viruses (51.8%), respiratory syncytial virus (17.4%), mixed viral infections (16.5%), adenoviruses (4.8%), coronaviruses (3.7%), parainfluenza viruses (3.4%) and enteroviruses (2%). Among the positive bronchoalveolar lavage samples for respiratory pathogens, 35% were positive for bacteria, 25% were positive for viruses, 20% were positive for fungi and 20% were mixed infections. RNA extraction of the respiratory samples was performed using an automated system (QiaSymphony; Qiagen, Hilden, Germany). A recently published real-time RT-PCR protocol for MERS-CoV [<xref rid="bib10" ref-type="bibr">10</xref>] was implemented in our laboratory, and evaluated using an <italic>in vitro</italic> transcribed RNA kindly provided by C. Drosten through the European Virus Archive platform (<ext-link ext-link-type="uri" xlink:href="http://www.european-virus-archive.com" id="interrefs60">http://www.european-virus-archive.com</ext-link>). The sensitivity of the assay in our hands was similar to that described by Corman <italic>et al</italic>. [<xref rid="bib10" ref-type="bibr">10</xref>] (five RNA copies per reaction). In addition, we established a generic coronavirus RT-PCR as a confirmatory assay [<xref rid="bib11" ref-type="bibr">11</xref>]. This protocol further identifies the coronavirus species by sequencing of the PCR product. This assay was evaluated with samples containing 229E and OC43 human coronaviruses previously detected at our laboratory [<xref rid="bib12" ref-type="bibr">12</xref>]. All 563 respiratory samples tested were negative for the MERS-CoV using the real-time RT-PCR protocol.</p><p id="para40">The emergence of MERS-CoV represents a public health concern, although the virus does not seem to be as efficiently transmissible between people as the severe acute respiratory syndrome coronavirus. Many questions regarding the epidemiology of the virus remain unanswered, highlighting the importance of continued surveillance and research on MERS-CoV. To our knowledge, this is the first exploratory study of MERS-CoV in the general population using already established sentinel networks. Data obtained through active surveillance for MERS-CoV may be helpful for the global monitoring of the virus. 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2014.</p></fn></fn-group></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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