Title: Human MERS-CoV cases are falling but pose an ongoing pandemic threat
Authors: Subissi L, Otieno J, Shah A, Abu-Raddad L, Agrawal A, Mehairi A, Albarraq A, Barakat A, Bashir I, Caly L, Chand M, Drosten C, Faria N, Fowotade A, von Gottberg A, Haagmans B, Huang B, Kindrachuk J, Koopmans M, Korber B, Leo Y, Mbala-Kingebeni P, Melhem N, Munster V, Ngere I, Njenga M, de Oliveira T, Palacios G, Peiris M, Rambaut A, Resende P, Saha S, Suzuki T, Yadav P, von Dobschuetz S, Azhar E, Van Kerkhove M.
Journal: Nature Health, : (2026)
Abstract
Human cases of Middle East respiratory syndrome coronavirus (MERS-CoV) have declined in recent years, but continued surveillance and research is needed to understand this trend and mitigate future zoonotic threats.
Since its emergence in 2012, MERS-CoV has remained an endemic zoonotic pathogen in the Arabian Peninsula; most human cases come from the Kingdom of Saudi Arabia (KSA), where dromedary camels serve as the primary reservoir1. MERS-CoV can be classified by sequence analysis into three clades (clades A, B and C), each of which branches into more granular lineages that are continuing to evolve2. In addition to these lineages, circulating recombinant forms have emerged; there is limited knowledge on how the observed genomic diversity translates to specific viral traits3. To date, over 2,600 laboratory-confirmed human cases have been reported globally, with a crude case–fatality ratio of approximately 37%. MERS-CoV spreads in strikingly different ways across regions. In Africa, clade C dominates, but human Middle East respiratory syndrome (MERS) has so far not been officially reported — although there is increasing evidence that human infection is taking place4. In the Middle East, clade B drives frequent camel-to-human MERS-CoV infections, which intensify during calving season. Although laboratory evidence suggests clade differences in relation to virulence and infectivity, it remains unclear why these patterns diverge.
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Citation: Subissi L, Otieno J, Shah A, Abu-Raddad L, Agrawal A, Mehairi A, Albarraq A, Barakat A, Bashir I, Caly L, Chand M, Drosten C, Faria N, Fowotade A, von Gottberg A, Haagmans B, Huang B, Kindrachuk J, Koopmans M, Korber B, Leo Y, Mbala-Kingebeni P, Melhem N, Munster V, Ngere I, Njenga M, de Oliveira T, Palacios G, Peiris M, Rambaut A, Resende P, Saha S, Suzuki T, Yadav P, von Dobschuetz S, Azhar E, Van Kerkhove M. Human MERS-CoV cases are falling but pose an ongoing pandemic threat Nature Health, : (2026).