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ARCHIVE MERS-CoV situation update

27 September 2017, 17:00 hours; Rome

The next update will be issued on 25 October 2017


Information provided herein is current as of the date of issue. Information added or changed since the last MERS-CoV situation update appears in red. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisatwion for Animal Health [OIE]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.



Situation: Middle East Respiratory Syndrome Coronavirus (MERS-CoV): zoonotic virus with pandemic potential.
Countries with known human cases1: Jordan, Saudi Arabia (KSA), Qatar, the United Arab Emirates (UAE), Oman, Kuwait, Yemen, United Kingdom*, France*, Germany*, Italy*, Tunisia*, Malaysia*, the Philippines*, the United States of America (USA)*, Egypt*, Lebanon*, the Netherlands*, Iran, Algeria*, Turkey*, Austria*, Greece*, Republic of Korea, China*, Thailand*, the Kingdom of Bahrain2.
Findings in humans: 2,091 cases confirmed; including 779 case fatalities (since September 2012)3.
Countries with published animal findings (serology and/or virology): Canary Islands, Egypt, Ethiopia, Iran, Jordan, Kenya, Kuwait, Mali, Morocco, Nigeria, Oman, Pakistan, Qatar, Saudi Arabia (KSA), Tunisia, United Arab Emirates.


1 Countries in order of first reported occurrence
2 (*) denotes cases with travel to/through the Middle East/Arabian Peninsula
3 For detailed information on human cases, please refer to WHO at


 Situation in animals

Map 1. MERS-CoV livestock field surveys by country*

Map of MERS-CoV livestock field surveys by country
Click to enlarge - *Note: Positive findings in Spain refer to samples taken in the Canary Islands.


 Situation in humans

  • Between 30 August and 27 September 2017, twelve (n=12) new human cases have been reported: ten (n=10) in Saudi Arabia, including eight fatalities (n=8), one (n=1) in Oman and one (n=1) in the United Arab Emirates.

Map 2. Global distribution of human cases of MERS-CoVMap of global distribution of human cases of MERS-CoV

Click to enlarge


Table 1. MERS-CoV cases in humans by country and dates of first and most recent observations




Cumulative number of confirmed MERS-CoV human cases

First observation

Last Observation

Middle East Saudi Arabia 1,721 13/06/2012 21/09/2017
United Arab Emirates 86 19/03/2013 11/08/2017
Jordan 26 02/04/2012 26/09/2015
Qatar 19 15/08/2013 14/05/2017
Oman 9 26/10/2013 09/08/2017
Iran (Islamic Republic of) 6 11/05/2014 18/03/2015
Kuwait 4 30/10/2013 08/09/2015
Lebanon 2 22/04/2014 08/06/2017
Yemen 1 17/03/2014 17/03/2014
Bahrain (the Kingdom of) 1 04/04/2016 04/04/2016
Europe United Kingdom 4 03/09/2012 05/02/2013
Germany 2 05/10/2012 07/03/2015
Netherlands 2 01/05/2014 05/05/2014
France 2 23/04/2013 27/04/2013
Austria 2 22/09/2014 08/09/2016
Turkey 1 25/09/2014 25/09/2014
Italy 1 25/05/2013 25/05/2013
Greece 1 08/04/2014 08/04/2014
Asia Republic of Korea 185 11/05/2015 02/07/2015
Philippines 3 15/04/2014 30/06/2015
Thailand 3 10/06/2015 25/07/2016
China 1 21/05/2015 21/05/2015
Malaysia 1 08/04/2014 08/04/2014
Americas United States of America 2 14/04/2014 01/05/2014
Africa Tunisia 3 01/05/2013 17/06/2013
Algeria 2 23/05/2014 23/05/2014
Egypt 1 22/04/2014 22/04/2014

Figure 1. Human epidemiological timeline (with cases reporting animal exposure in blue), by month of disease onset (since September 2012)

Human epidemiological timeline (with cases reporting animal exposure in blue), by month of disease onset
Click to enlarge

Figure 2. Breakdown of human MERS-CoV cases by potential source of exposure (in percent). Please note that while infection control improves in healthcare settings and history of animal contact is recorded more consistently in case investigations, the overall number of cases has decreased (see figure 1). The apparent increase in proportion of primary cases with animal exposure therefore should be interpreted in the overall context of a reduced human case count.

Breakdown of human MERS-CoV cases by potential source of exposure (in percent)
Click to enlarge


 Recent publications

  • Li YKhalafalla AIPaden CRYusof MFEltahir YM, Al Hammadi ZM, Tao YQueen KHosani FAGerber SIHall AJAl Muhairi STong S.  Identification of diverse viruses in upper respiratory samples in dromedary camels from United Arab Emirates. PLoS One. 2017 Sep 13;12(9):e0184718. doi: 10.1371/journal.pone.0184718. [reference] Metagenomic sequencing analysis was performed on nasopharyngeal swab samples from 108 MERS-CoV-positive dromedary camels from a live animal market in Abu Dhabi, United Arab Emirates. A total of five potentially novel virus species or strains were identified. Co-infection of at least two recently identified camel coronaviruses was detected in 92.6% of the camels in the study. This study provides a comprehensive survey of viruses in the virome of upper respiratory samples in camels that have extensive contact with the human population.
  • Al-Osail AMAl-Wazzah MJ. The history and epidemiology of Middle East respiratory syndrome corona virus. Multidiscip Respir Med. 2017 Aug 7;12:20. doi: 10.1186/s40248-017-0101-8. [reference] This review describes the history and epidemiology of this novel virus. Studies of the genetics and molecular mechanisms of this virus are expected to facilitate the development of vaccines in the future.
  • Vergara-Alert JRaj VSMuñoz MAbad FXCordón IHaagmans BLBensaid ASegalés J. Middle East respiratory syndrome coronavirus experimental transmission using a pig model. Transbound Emerg Dis. 2017 Oct;64(5):1342-1345. doi: 10.1111/tbed.12668. [reference] This study explored pig-to-pig MERS-CoV transmission experimentally. Virus was present in nasal swabs of infected animals, and limited amounts of viral RNA, but no infectious virus were detected in the direct contact pigs. The role of pigs as reservoir is probably negligible, although it deserves further confirmation.
  • Rabaan AA. Middle East respiratory syndrome coronavirus: five years later. Expert Rev Respir Med. 2017 Aug 21:1-12. doi: 10.1080/17476348.2017.1367288. [reference] This review presents an overview of MERS-CoV within the last five years, with a particular emphasis on the key areas of human transmission, infection control and prevention, and therapies and vaccines



  • A FAO-OIE-WHO tripartite meeting was held in Geneva, 25-27 September 2017 [reference]. Representatives from Ministries of Health and Ministries of Agriculture in affected and at risk countries, MERS-CoV subject-matter experts and researchers, funders, industrial partners and representatives from FAO, OIE and WHO attended. The specific objectives of this meeting were to (i) summarize and communicate research progress made, with a focus on new research and knowledge gained; (ii) improve coordination and communication between animal health and public health sectors in outbreak preparedness and response, active surveillance and technical issues of disease control and prevention, and (iii) to review and update previous recommendations based on latest scientific evidence. [#tackleMERS]
  • In close collaboration with OIE and WHO, monitoring the situation / inter-agency teleconferences;
  • Analysing available data, including results from surveillance in camels and advanced characterization of the virus;
  • Providing technical assistance and guidance to countries to improve understanding of the disease situation and help filling existing gaps in epidemiological knowledge;
  • Supporting national laboratories to develop capacity in serology and PCR diagnostic for MERS-CoV, quality assurance and quality control and biosafety, and establish national sample banks;
  • Keeping a dialogue between the scientific community and the field to ensure needs and gaps are addressed;
  • Assist in developing communication strategies to ensure appropriate information reaches the public on MERS-CoV and avoid possible negative impacts of the crisis on the livestock industry.

Country-level actions


  • Longitudinal surveillance (cohort study) is ongoing at Soysambu Ranch in Nakuru County. Nine rounds of sampling have been conducted. Testing is ongoing at the country’s Central Veterinary Laboratories (CVL). 
  • Longitudinal surveillance (repeat cross sectional studies) ongoing in Isiolo County; four rounds of sampling have been conducted so far and testing is ongoing at CVL.
  • Kenya shipped 2,240 nasal swabs to the Institute of Virology, Charité – Universitätsmedizin Berlin, Germany for molecular analysis. These include 59 nasals swabs from other species (sheep, donkey, cattle and cattle).


  • Camel and livestock sample collection and laboratory testing for MERS-CoV is underway on samples collected in Somali, Afar, and Borena regions.
  • The first phase of MERS CoV cross-sectional surveillance has been finalized with an overall sero-prevalence of 70.8% in camels.
  • In depth value chain and production systems studies are underway.


  • Both longitudinal and cross sectional surveillance are lightly delayed but will start soon.
  • For the cross sectional surveillance, samples will be collected form 46 villages and stored at the Animal Health Research Institute (AHRI) lab to be analysed up on receiving kits and reagents.
  • The first round of longitudinal surveillance (repeated cross sectional), will last for 2 weeks. The National Research Centre (NRC) team in collaboration with General Organization for Veterinary Services (GOVS) will collect samples from different nodes along camel value chain in Egypt.

Press Releases

  • 25-27 September 2017: FAO-OIE-WHO Global Technical Meeting on MERS-CoV [#tackleMERS]
  • 13-14 December 2016: FAO inter-regional training workshop: “Analysis of camel value chains and human behaviours in view of MERS-CoV surveillance”.
  • 7 November 2016: FAO_ECTAD Egypt trains Laboratory staff from Animal Health Research Institute (AHRI) and the National Research Center (NRC) on lab tests for (MERS-CoV).
  • 30 March 2016: Launching of the “Reference Centre and Network on camel diseases” for the Gulf and neighbouring countries. (in Arabic)
  • 28 January 2016: FAO pushes for a road map to control and contain zoonotic diseases.
  • 21 to 22 January 2016: Technical Meeting: Understanding MERS-CoV at the animal-human interface at FAO-HQ in Rome, Italy.
  • 20 October 2015: U.S. backs FAO efforts to combat global animal disease threats with $87 million.
  • 27 April 2015: Stepping up efforts for a better understanding of MERS at the human-animal interface.

 Important links