PRESENTER : Dr.

AISHIYA
MODERATOR: DR. VARSHA .A
SINGH

ii

INTRODUCTION

Not been seen in humans before

It was first reported in 2012 in

saudia arabia.

A INTENSE PROBLEM

By the end of Dec 2014, WHO reported

>900 cases of MERS.
>300 deaths(>30% ).
Casefatality ratio (CFR) - around 40%

VIRUS CLASSIFICATION

GROUP

ORDER

FAMILY

SUBFAMILY

SPECIES

BALTIMORE
1971
David Baltimore , Nobel Prize
CLASSIFICATION

Seven groups
Depending on a combination of
nucleic acid(DNAorRNA),
strandedness (single or double)
Sense (+/-)
method ofreplication.
Groups designated by Roman numerals.

The Baltimore Classification of viruses is based on

the method of viralmRNAsynthesis

GENUS
Human Corona viruses were first classifies in mid 1960s
ALPHA CoV
DELTA

GAMMA CoV

Human coronavirus 229E

CoV
Human coronavirus NL63

BETA CoV

Human coronavirus OC43

Human coronavirus HKU1
SARS-Cov
MERS-Cov

These 6 coronaviruses known to affect humans currently.

MERS-COV
Group:Group IV ((+)ssRNA)
Order:Nidovirales
Family:Coronaviridae
Subfamily:Coronavirinae
Genus:Betacoronavirus
Species:MERS-CoV
MERS CoV was named by the corona virus study
group of the international committee on

STRUCTURE OF MERSCOV

MERS-COV STRUCTURE

PROTEIN

NON-STRUCTURAL

STRUCTURAL

LIPID

MEMBRANE(
M)
SPIKE(S)
SMALL
ENVELOPE(E)

(+)SSRN
A

Intracelullar budding

Attachement to
host

Ion
channel

MERS-CoV particles as
seen negative stain
electron microscopy .
Virions contains
characteristic club-like
projections emanating
from the viral

RESISTANCE OF MERSCOV
HEAT

DRY
HEAT

48 hours at
20 C

HUMIDI
TY
MOIST
HEAT
Unpasteurised
camel milk

40% relative
humidity

SENSITIVITY
HEAT

RADIATIO
NS
UV Light

DRY
HEAT
Higher
temperatur

MOIST
HEAT
Pasteurised
camel milk

CHEMICA
LS
Lipid
solvents
Nonionising
detergents
Oxidising
agents

HUMIDI
TY
Higher level of
humidity

PATHOGENESI
S

S protein, HE protein
Receptors ( DPP4 )
Virus enters the host cell
RNA Polymerase
(-)ssRna which acts as template
Small sub-genomic positive RNAs which are used to synthezise all other proteins
Within ER , virions particles ( Protein N , protein M , RNA) are assembled and
encased with its membrane
Transported by Golgi vesicle to the cell membrane.
Exocytosed into the extracellular space

DPP4(Dipeptid
yl peptidase4)

Liver
Colon
Kidney
Testis
Lymph
node
Cerebral
cortex
Salivary
gland

TRANSMISSION

 Zoonotic disease
Origin - Bats
Major reservoir - Camels

BATS
CAMELS

BABOONS

HUMANS

PALM TREE

PATHOGENESIS

Route of entry
Mainly Respiratory route.

Incubation period
Generally less than one week
But can be as long as 14 days
(214 days).

PATHOGENESIS
PATHOGENESIS

CoV binds with DPP4

Vascular endothelial cells

Dissemination

IMMUNOPATHOGENESIS

Activate monocyte derived macrophage and

macrophage
Proinflammatory cytokines

Severe inflammation
& tissue damage

Immune cell
sequestration

SIGNS AND SYMPTOMS

Fever
Cough
Shortness of breath
Severe pneumonia presenting
as ARDS
Septic shock
Multi organ failure
Gastro intestinal symptoms like diarrhoea
Coinfections with bacteria and with other
respiratory viruses including
para influenza, rhinovirus, influenza A & B,
pneumococcus , and ventilatorassociated
pneumonia

HIGH RISK GROUP

Acute respiratory infection.
Indications of pulmonary parenchymal
disease.
Residents of Middle East.
Direct contact with CAMEL.
Health care worker.
Family members.

LABORATORY
DIAGNOSIS

SAMPLES TO BE
Sputum COLLECTED

Endotracheal aspirate
Bronchoalveolar lavage
Nasopharyngeal aspirate or combined
nasopharyngeal and oropharyngeal swab
Body fluids such as blood, urine and stool

LABORATORY TESTING
MOLECULAR
TESTING

SEROLOGICAL
TESTING

PCR
Screening
test
ELISA

confirmat
ory test
IFA

Neutralizing
membrane

TREATMENT
Symptomatic treatment
severe cases- support vital organ
functions.
Currently- no vaccine
U.S. National Institutes of Health
-developing vaccine.