中東呼吸症候群冠狀病毒

中東呼吸症候群冠狀病毒
	中東冠狀病毒負染電子顯微映像。病毒表面有刺狀突起物，此乃這一類病毒的典型特徵。
病毒分類
（未分級）：	病毒 Virus
域：	核糖病毒域 Riboviria
界：	正核糖病毒界 Orthornavirae
門：	小核糖病毒門 Pisuviricota
綱：	小南嵌套病毒綱 Pisoniviricetes
目：	套式病毒目 Nidovirales
科：	冠狀病毒科 Coronaviridae
屬：	乙型冠狀病毒屬 Betacoronavirus
種：	中東呼吸症候群冠狀病毒 Middle East respiratory; syndrome-related coronavirus

中東呼吸系統症候群冠狀病毒是導致中東呼吸系統症候群的病原體（英文縮寫：MERS-CoV 或代號：EMC/2012『HCoV-EMC/2012』）引起^[1]，有別於嚴重急性呼吸系統症候群冠狀病毒和普通傷風冠狀病毒。^[2]中東冠狀病毒具單鏈核糖核酸，為β冠狀病毒屬的新成員，按基因組區別被分為了甲、乙兩大系統發生分支；最早期的感染病例是由甲類病毒造成，與後來的不同。^[3]

中東冠狀病毒主要襲擊支氣管上的無纖毛上皮細胞。它能避開宿主體內的起始免疫反應，並阻止免疫細胞分泌干擾素。此向性在眾多呼吸系統病毒裡實屬獨特，因為其他病毒大多都襲擊纖毛上皮細胞。^[4]^[5]

傳播途徑

2010年至2013年間進行的一項研究，在310頭單峰駱駝的身上評估MERS的發病率，揭示出MERS冠狀病毒中和抗體在這些動物的血清中的滴度高^[6]。進一步對沙烏地單峰駱駝鼻拭子上的MERS冠狀病毒進行的研究測序，發現它們的序列與以前的人類測序隔離。從個別駱駝的身上還發現鼻咽處有一個以上的基因組變體^[7]。據報一名沙烏地男子給幾頭生病駱駝的鼻子敷藥後七天發病，後來他和一隻駱駝都被發現帶有相同的MERS冠狀病毒毒株。現在尚未明確病毒從駱駝傳播給人類的方法^[8]^[9]。世界衛生組織建議避免接觸駱駝，只吃全熟的駱駝肉，用巴氏法殺毒的駱駝奶，避免飲用駱駝尿。駱駝尿被認為是各種中東疾病的治療藥物^[10]。沙烏地農業部建議人們避免接觸駱駝，或是在接觸時佩戴呼吸面罩^[11]。有些人不聽政府的意見，親吻了駱駝以表蔑視^[12]。

有限的證據表明MERS冠狀病毒不會在人與人間持續傳播，無論是在家裡或是在醫院等衛生保健機構^[13]^[14]。大多數的傳播發生在「密切接觸醫療機構或居家危重病人的情況下」，並沒有症狀表明會傳播給無症狀感染者^[15]。群集範圍從1人到26人，平均數為2.7^[16]。

參考文獻

^ De Groot RJ; et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group. Journal of Virology. 2013-05-15, 87 (14): 7790–2. PMC 3700179 . PMID 23678167. doi:10.1128/JVI.01244-13.
^ ECDC Rapid Risk Assessment - Severe respiratory disease associated with a novel coronavirus (PDF). 2013-02-19 [08-06-2015]. （原始內容 (PDF)存檔於2013-05-31）.
^ MERS Coronaviruses in Dromedary Camels, Egypt. 06-2014 [08-06-2015]. （原始內容存檔於2014-03-08）.
^ Kindler, E.; Jónsdóttir, H. R.; Muth, D.; Hamming, O. J.; Hartmann, R.; Rodriguez, R.; Geffers, R.; Fouchier, R. A.; Drosten, C. Efficient Replication of the Novel Human Betacoronavirus EMC on Primary Human Epithelium Highlights Its Zoonotic Potential. MBio. 2013, 4 (1): e00611–12. PMC 3573664 . PMID 23422412. doi:10.1128/mBio.00611-12.
^ Raj, V. S.; Mou, H.; Smits, S. L.; Dekkers, D. H.; Müller, M. A.; Dijkman, R.; Muth, D.; Demmers, J. A.; Zaki, A. Dipeptidyl peptidase 4 is a functional receptor for the emerging human coronavirus-EMC. Nature. 03-2013, 495 (7440): 251–4. PMID 23486063. doi:10.1038/nature12005. 請檢查|date=中的日期值 (幫助)
^ Hemida, MG; et al. Middle East Respiratory Syndrome (MERS) coronavirus seroprevalence in domestic livestock in Saudi Arabia. Eurosurveillance. 2013-12-12, 18 (50) [2015-06-09]. （原始內容存檔於2015-04-24）.
^ Briese, T.; et al. Middle East Respiratory Syndrome Coronavirus Quasispecies That Include Homologues of Human Isolates Revealed through Whole-Genome Analysis and Virus Cultured from Dromedary Camels in Saudi Arabia. mBio. 2014-04-29 [2014-05-20]. doi:10.1128/mBio.01146-14. （原始內容存檔於2014-05-02）.
^ Gallagher, James. Camel infection 'led to Mers death'. BBC News. 2014-06-05 [2014-06-05]. （原始內容存檔於2014-06-05）.
^ Azhar, E. I.; et al. Evidence for Camel-to-Human Transmission of MERS Coronavirus. The New England Journal of Medicine. 2014-06-04 [2014-06-06]. doi:10.1056/NEJMoa1401505. （原始內容存檔於2014-06-06）.
^ WHO warns about camel products, contact over rising MERS concerns | CTV News. CTV News. 2014-05-10 [2014-05-22]. （原始內容存檔於2014-05-22）.
^ Mers virus: Saudis warned to wear masks near camels. BBC News. 2014-05-11 [2014-05-22]. （原始內容存檔於2014-05-19）.
^ Saudi Arabia: Farmers flout Mers warning by kissing camels. BBC News. 2014-05-13 [2014-05-22]. （原始內容存檔於2014-05-21）.
^ The Health Protection Agency (HPA) UK Novel Coronavirus Investigation team. State of Knowledge and Data Gaps of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Humans. Eurosurveillance. 2013-03-14 [2014-05-21]. doi:10.1371/currents.outbreaks.0bf719e352e7478f8ad85fa30127ddb8. （原始內容存檔於2014-05-21）.
^ Assiri, A.; et al. Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus. The New England Journal of Medicine. 2013-01-08 [2014-05-20]. doi:10.1056/NEJMoa1306742. （原始內容存檔於2014-06-10）.
^ Rapid advice note on home care for patients with Mi ddle East respiratory syndrome coronavirus (MERS-CoV) infecti on presenting with mild symptoms and management of contacts (PDF). WHO. 2013-08-08 [2014-05-21]. （原始內容存檔 (PDF)於2014-05-14）.
^ Cauchemez, S.; et al. Middle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility. The Lancet Infectious Diseases. January 2014 [2014-05-21]. doi:10.1016/S1473-3099(13)70304-9. （原始內容存檔於2015-09-24）.

外部連結

Emergence of the Middle East Respiratory Syndrome Coronavirus（頁面存檔備份，存於網際網路檔案館）
MERS-CoV Complete Genome（頁面存檔備份，存於網際網路檔案館）
Emerging viruses
Molecular Illustration of MERS-Coronavirus（頁面存檔備份，存於網際網路檔案館）
Philippines still MERS-CoV free – DOH（頁面存檔備份，存於網際網路檔案館）

參見

[deGroot-1] De Groot RJ; et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group. Journal of Virology. 2013-05-15, 87 (14): 7790–2. PMC 3700179 . PMID 23678167. doi:10.1128/JVI.01244-13.

[rapid-2] ECDC Rapid Risk Assessment - Severe respiratory disease associated with a novel coronavirus (PDF). 2013-02-19 [08-06-2015]. （原始內容 (PDF)存檔於2013-05-31）.

[3] MERS Coronaviruses in Dromedary Camels, Egypt. 06-2014 [08-06-2015]. （原始內容存檔於2014-03-08）.

[Kindler-2013-4] Kindler, E.; Jónsdóttir, H. R.; Muth, D.; Hamming, O. J.; Hartmann, R.; Rodriguez, R.; Geffers, R.; Fouchier, R. A.; Drosten, C. Efficient Replication of the Novel Human Betacoronavirus EMC on Primary Human Epithelium Highlights Its Zoonotic Potential. MBio. 2013, 4 (1): e00611–12. PMC 3573664 . PMID 23422412. doi:10.1128/mBio.00611-12.

[Raj-2013-5] Raj, V. S.; Mou, H.; Smits, S. L.; Dekkers, D. H.; Müller, M. A.; Dijkman, R.; Muth, D.; Demmers, J. A.; Zaki, A. Dipeptidyl peptidase 4 is a functional receptor for the emerging human coronavirus-EMC. Nature. 03-2013, 495 (7440): 251–4. PMID 23486063. doi:10.1038/nature12005. 請檢查|date=中的日期值 (幫助)

[Hemida12dec2013-6] Hemida, MG; et al. Middle East Respiratory Syndrome (MERS) coronavirus seroprevalence in domestic livestock in Saudi Arabia. Eurosurveillance. 2013-12-12, 18 (50) [2015-06-09]. （原始內容存檔於2015-04-24）.

[Briese29apr2014-7] Briese, T.; et al. Middle East Respiratory Syndrome Coronavirus Quasispecies That Include Homologues of Human Isolates Revealed through Whole-Genome Analysis and Virus Cultured from Dromedary Camels in Saudi Arabia. mBio. 2014-04-29 [2014-05-20]. doi:10.1128/mBio.01146-14. （原始內容存檔於2014-05-02）.

[BBC5jun2014-8] Gallagher, James. Camel infection 'led to Mers death'. BBC News. 2014-06-05 [2014-06-05]. （原始內容存檔於2014-06-05）.

[Azhar4jun2014-9] Azhar, E. I.; et al. Evidence for Camel-to-Human Transmission of MERS Coronavirus. The New England Journal of Medicine. 2014-06-04 [2014-06-06]. doi:10.1056/NEJMoa1401505. （原始內容存檔於2014-06-06）.

[CTV10may2014-10] WHO warns about camel products, contact over rising MERS concerns | CTV News. CTV News. 2014-05-10 [2014-05-22]. （原始內容存檔於2014-05-22）.

[BBC11may2014-11] Mers virus: Saudis warned to wear masks near camels. BBC News. 2014-05-11 [2014-05-22]. （原始內容存檔於2014-05-19）.

[BBC13may2014-12] Saudi Arabia: Farmers flout Mers warning by kissing camels. BBC News. 2014-05-13 [2014-05-22]. （原始內容存檔於2014-05-21）.

[HPA14mar2013-13] The Health Protection Agency (HPA) UK Novel Coronavirus Investigation team. State of Knowledge and Data Gaps of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Humans. Eurosurveillance. 2013-03-14 [2014-05-21]. doi:10.1371/currents.outbreaks.0bf719e352e7478f8ad85fa30127ddb8. （原始內容存檔於2014-05-21）.

[Assiri8jan2013-14] Assiri, A.; et al. Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus. The New England Journal of Medicine. 2013-01-08 [2014-05-20]. doi:10.1056/NEJMoa1306742. （原始內容存檔於2014-06-10）.

[WHO8aug2013-15] Rapid advice note on home care for patients with Mi ddle East respiratory syndrome coronavirus (MERS-CoV) infecti on presenting with mild symptoms and management of contacts (PDF). WHO. 2013-08-08 [2014-05-21]. （原始內容存檔 (PDF)於2014-05-14）.

[Cauchemez13nov2013-16] Cauchemez, S.; et al. Middle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility. The Lancet Infectious Diseases. January 2014 [2014-05-21]. doi:10.1016/S1473-3099(13)70304-9. （原始內容存檔於2015-09-24）.

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