中東呼吸器症候群（MERS）コロナウイルス感染症

抄録

From March 2012 to October 2013, 145 cases including 62 deaths of Middle East respiratory syndrome (MERS) have been identified in 9 countries (Saudi Arabia, UAE, Qatar, Jordan, France, Germany, Italy, Tunisia, and UK). Recent studies say, while MERS appears to be more deadly in those it infects, it also seems to be less contagious than severe acute respiratory syndrome (SARS) in 2003. All primary cases were connected to the Arabian Peninsula, and nearly half of the cases died due to severe lung inflammation. Nosocomial transmission was implied in 26 percent of the cases. Human-to-human-transmission was considered the likely source of infection in hospital. From these cases, the median incubation period was estimated as 5.2 days (95 percent confidence interval 2 to 15 days). At the same time, some asymptomatic or mildly symptomatic cases have been reported. All MERS-positive cases were diagnosed by using real-time RT-PCR targeting upE and Orf1a genes of MERS-CoV. Specimens were taken from the upper or the lower respiratory tract and blood. Even though over a year has passed since the emergence of the 1st case, many questions on the origin and transmission patterns of the disease remain. The pathogen of MERS belongs to the lineage C of the beta coronaviruses (CoV), which are genetically similar to various coronaviruses detected in bats in Africa and Europe. And two studies suggest dromedary camels in Oman, the Canary Islands and Egypt may have been infected with the virus or a MERS-CoV-like virus in the past. However, human cases have not been detected in these areas. With the Hajj, the Muslim pilgrimage to Mecca in Saudi Arabia, taking place in October 2013 and attracting 3 million visitors, international public health efforts to mitigate and possibly contain this outbreak need to be reinforced. On alert for a possible pandemic, we prepared the PCR system, and shared it to 74 locations of prefectural public health institutes and quarantines in Japan.