Virological and serological analysis of a recent Middle East respiratory syndrome coronavirus infection case on a triple combination antiviral regimen - PubMed (original) (raw)

Case Reports

Virological and serological analysis of a recent Middle East respiratory syndrome coronavirus infection case on a triple combination antiviral regimen

Nikolaos Spanakis et al. Int J Antimicrob Agents. 2014 Dec.

Abstract

Serological, molecular and phylogenetic analyses of a recently imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Greece are reported. Although MERS-CoV remained detectable in the respiratory tract secretions of the patient until the fourth week of illness, viraemia was last detected 2 days after initiation of triple combination therapy with pegylated interferon, ribavirin and lopinavir/ritonavir, administered from Day 13 of illness. Phylogenetic analysis of the virus showed close similarity with other human MERS-CoVs from the recent Jeddah outbreak in Saudi Arabia. Immunoglobulin G (IgG) titres peaked 3 weeks after the onset of illness, whilst IgM levels remained constantly elevated during the follow-up period (second to fifth week of illness). Serological testing confirmed by virus neutralisation assay detected an additional case that was a close contact of the patient.

Keywords: Antiviral treatment; Coronavirus; MERS; MERS-CoV; Phylogeny; Serology.

Copyright © 2014. Published by Elsevier B.V.

PubMed Disclaimer

Figures

Fig. 1

Fig. 1

Time course of symptoms, medication, and molecular and serological findings of the Middle East respiratory syndrome coronavirus (MERS-CoV)-infected patient. IIF, indirect immunofluorescence.

Fig. 2

Fig. 2

Phylogenetic tree of the Middle East respiratory syndrome coronavirus (MERS-CoV) from the Greek patient. Nucleotide sequences of 3-kb concatenated sequences of representative MERS-CoVs were analysed and a phylogenetic tree was constructed by the PhyML method. Values at the branches show the result of the approximate likelihood ratio, with values of <0.70 not depicted.

Similar articles

Cited by

References

    1. European Centre for Disease Prevention and Control . ECDC; 2 July 2014. Epidemiological update: Middle East respiratory syndrome coronavirus (MERS-CoV) http://www.ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.asp... [accessed 9 September 2014]
    1. Al-Tawfiq J.A., Memish Z.A. What are our pharmacotherapeutic options for MERS-CoV? Expert Rev Clin Pharmacol. 2014;7:235–238. - PubMed
    1. Al-Tawfiq J.A., Momattin H., Dib J., Memish Z.A. Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study. Int J Infect Dis. 2014;20:42–46. - PMC - PubMed
    1. Momattin H., Mohammed K., Zumla A., Memish Z.A., Al-Tawfiq J.A. Therapeutic options for Middle East respiratory syndrome coronavirus (MERS-CoV)—possible lessons from a systematic review of SARS-CoV therapy. Int J Infect Dis. 2013;17:e792–e798. - PMC - PubMed
    1. Clinical Decision Making Tool for Treatment of MERS-CoV v.1.1, 29 July, 2013. Public Health England. http://webarchive.nationalarchives.gov.uk/20140714084352/http://www.hpa.... [accessed 11 September 2014].

Publication types

MeSH terms

Substances

LinkOut - more resources