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lessons for covid-19 immunity from other coronavirus infections.a key goal to controlling coronavirus disease 2019 (covid-19) is developing an effective vaccine. development of a vaccine requires knowledge of what constitutes a protective immune response and also features that might be pathogenic. protective and pathogenic aspects of the response to severe acute respiratory syndrome coronavirus 2 (sars-cov-2) are not well understood, partly because the virus has infected humans for only 6 months. however, insight into coronavirus immunity can be informed by ...202032717182
covid-19: a new turning point for dental practice.recent new zoonotic respiratory viruses have infected humans and led to severe acute respiratory syndrome: severe acute respiratory syndrome coronavirus (sars-cov), influenza a h5n1, influenza a h1n1 and middle east respiratory syndrome coronavirus (mers-cov). the first sars-cov outbreak took place in 2003, in guangdong, china. a decade later, another pathogenic coronavirus, mers-cov caused an endemic in middle eastern countries. the latest pandemic coronavirus infectious disease (covid-19) has ...202032696908
middle east respiratory syndrome coronavirus (mers-cov): state of the science.coronaviruses belong to a large family of viruses that can cause disease outbreaks ranging from the common cold to acute respiratory syndrome. since 2003, three zoonotic members of this family evolved to cross species barriers infecting humans and resulting in relatively high case fatality rates (cfr). compared to severe acute respiratory syndrome coronavirus (sars-cov, cfr = 10%) and pandemic severe acute respiratory syndrome coronavirus 2 (sars-cov-2, cfr = 6%), the middle east respiratory syn ...202032630780
covid-19: precautionary guidelines for ophthalmologists.several coronaviruses can infect humans, and the globally endemic human coronaviruses, hcov-229e (human coronavirus 229e), hcov-nl63 (human coronavirus nl63), and others, tend to cause mild respiratory diseases. the zoonotic middle east respiratory syndrome coronavirus (mers-cov) and severe acute respiratory syndrome coronavirus type1 (sars-cov-1) have high fatality rates. in december 2019, the world health organization (who) was notified by chinese authorities about an outbreak of pneumonia bef ...202032607305
covid-19 vaccines: "warp speed" needs mind melds, not warped minds.in this review, we address issues that relate to the rapid "warp speed" development of vaccines to counter the covid-19 pandemic. we review the antibody response that is triggered by severe acute respiratory syndrome coronavirus 2 (sars-cov-2) infection of humans and how it may inform vaccine research. the isolation and properties of neutralizing monoclonal antibodies from covid-19 patients provide additional information on what vaccines should try to elicit. the nature and longevity of the anti ...202032591466
characterization and noncovalent inhibition of the deubiquitinase and deisgylase activity of sars-cov-2 papain-like protease.severe acute respiratory syndrome coronavirus 2 (sars-cov-2), the causative agent for covid-19, is a novel human betacoronavirus that is rapidly spreading worldwide. the outbreak currently includes over 3.7 million cases and 260,000 fatalities. as a betacoronavirus, sars-cov-2 encodes for a papain-like protease (plpro) that is likely responsible for cleavage of the coronavirus (cov) viral polypeptide. the plpro is also responsible for suppression of host innate immune responses by virtue of its ...202032428392
human coronaviruses with emphasis on the covid-19 outbreak.human coronaviruses are known as respiratory pathogens mainly associated with a range of respiratory diseases. in the past 18 years, the beginning of severe acute respiratory syndrome human coronavirus (sars-hcov), middle east respiratory syndrome coronavirus (mers-cov) and now the (covid-19) have driven the hcov into the platform of the scientific community due to their high pathogenicity in humans. our study about the hcov has contributed extensively to the understanding of hcov pathogenesis i ...202032399479
characterization of a human monoclonal antibody generated from a b-cell specific for a prefusion-stabilized spike protein of middle east respiratory syndrome coronavirus.middle east respiratory syndrome coronavirus (mers-cov) causes severe respiratory infection and continues to infect humans, thereby contributing to a high mortality rate (34.3% in 2019). in the absence of an available licensed vaccine and antiviral agent, therapeutic human antibodies have been suggested as candidates for treatment. in this study, human monoclonal antibodies were isolated by sorting b cells from patient's pbmc cells with prefusion stabilized spike (s) probes and a direct immunogl ...202032384116
molecular evolution and structural mapping of n-terminal domain in spike gene of middle east respiratory syndrome coronavirus (mers-cov).the middle east respiratory syndrome coronavirus (mers-cov) is a lethal zoonotic pathogen circulating in the arabian peninsula since 2012. there is no vaccine for mers and anti-viral treatment is generally not applicable. we investigated the evolution of the mers-cov spike gene sequences and changes in viral loads over time from patients in saudi arabia from 2105-2017. all the mers-cov strains belonged to lineage 5, and showed high sequence homology (99.9%) to 2017 strains. recombination analysi ...202032370153
feasibility of known rna polymerase inhibitors as anti-sars-cov-2 drugs.coronaviruses (covs) are positive-stranded rna viruses that infect humans and animals. infection by covs such as hcov-229e, -nl63, -oc43 and -hku1 leads to the common cold, short lasting rhinitis, cough, sore throat and fever. however, covs such as severe acute respiratory syndrome coronavirus (sars-cov), middle east respiratory syndrome coronavirus (mers-cov), and the newest sars-cov-2 (the causative agent of covid-19) lead to severe and deadly diseases with mortality rates ranging between ~1 t ...202032357471
coronavirus (covid-19): a review of clinical features, diagnosis, and treatment.coronavirus (covid-19) is an enveloped rna virus that is diversely found in humans and wildlife. a total of six species have been identified to cause disease in humans. they are known to infect the neurological, respiratory, enteric, and hepatic systems. the past few decades have seen endemic outbreaks in the form of middle east respiratory syndrome coronavirus (mers-cov) and severe acute respiratory syndrome related coronavirus (sars-cov). yet again, we see the emergence of another outbreak due ...202032328367
composition and divergence of coronavirus spike proteins and host ace2 receptors predict potential intermediate hosts of sars-cov-2.from the beginning of 2002 and 2012, severe respiratory syndrome coronavirus (sars-cov) and middle east respiratory syndrome coronavirus (mers-cov) crossed the species barriers to infect humans, causing thousands of infections and hundreds of deaths, respectively. currently, a novel coronavirus (sars-cov-2), which has become the cause of the outbreak of coronavirus disease 2019 (covid-19), was discovered. until 18 february 2020, there were 72 533 confirmed covid-19 cases (including 10 644 severe ...202032100877
safety and immunogenicity of a candidate middle east respiratory syndrome coronavirus viral-vectored vaccine: a dose-escalation, open-label, non-randomised, uncontrolled, phase 1 trial.cases of middle east respiratory syndrome coronavirus (mers-cov) infection continue to rise in the arabian peninsula 7 years after it was first described in saudi arabia. mers-cov poses a significant risk to public health security because of an absence of currently available effective countermeasures. we aimed to assess the safety and immunogenicity of the candidate simian adenovirus-vectored vaccine expressing the full-length spike surface glycoprotein, chadox1 mers, in humans.202032325038
coronavirus infections in children including covid-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children.coronaviruses (covs) are a large family of enveloped, single-stranded, zoonotic rna viruses. four covs commonly circulate among humans: hcov2-229e, -hku1, -nl63 and -oc43. however, covs can rapidly mutate and recombine leading to novel covs that can spread from animals to humans. the novel covs severe acute respiratory syndrome coronavirus (sars-cov) emerged in 2002 and middle east respiratory syndrome coronavirus (mers-cov) in 2012. the 2019 novel coronavirus (sars-cov-2) is currently causing a ...202032310621
[replication and transmission mechanisms of highly pathogenic human coronaviruses].the three known human highly pathogenic coronaviruses are severe acute respiratory syndrome coronavirus (sars-cov), middle east respiratory syndrome coronavirus, (mers-cov), and severe acute respiratory syndrome coronavirus 2 (sars-cov-2). human highly pathogenic coronaviruses are composed of non-structural proteins, structural proteins and accessory proteins. viral particles recognize host receptors via spike glycoprotein (s protein), enter host cells by membrane fusion, replicate in host cells ...202032298055
susceptibility to sars, mers, and covid-19 from animal health perspective.viruses are having great time as they seem to have bogged humans down. severe acute respiratory syndrome (sars), middle east respiratory syndrome (mers), and novel coronavirus (covid-19) are the three major coronaviruses of present-day global human and animal health concern. covid-19 caused by sars-cov-2 is identified as the newest disease, presumably of bat origin. different theories on the evolution of viruses are in circulation, yet there is no denying the fact that the animal source is the s ...202032821661
genomic determinants of pathogenicity in sars-cov-2 and other human coronaviruses.severe acute respiratory syndrome coronavirus 2 (sars-cov-2) poses an immediate, major threat to public health across the globe. here we report an in-depth molecular analysis to reconstruct the evolutionary origins of the enhanced pathogenicity of sars-cov-2 and other coronaviruses that are severe human pathogens. using integrated comparative genomics and machine learning techniques, we identify key genomic features that differentiate sars-cov-2 and the viruses behind the two previous deadly cor ...202032522874
role of probiotics to combat viral infections with emphasis on covid-19.interspecies transmissions of viruses between animals and humans may result in unpredictable pathogenic potential and new transmissible diseases. this mechanism has recently been exemplified by the discovery of new pathogenic viruses, such as the novel severe acute respiratory syndrome corona virus-2 (sars-cov-2) pandemic, middle-east respiratory syndrome-coronavirus epidemic in saudi arabia, and the deadly outbreak of ebola in west africa. the. sars-cov-2 causes coronavirus disease-19 (covid-19 ...202032813065
genomic sequencing and analysis of eight camel-derived middle east respiratory syndrome coronavirus (mers-cov) isolates in saudi arabia.middle east respiratory syndrome coronavirus (mers-cov) causes severe respiratory illness in humans; the second-largest and most deadly outbreak to date occurred in saudi arabia. the dromedary camel is considered a possible host of the virus and also to act as a reservoir, transmitting the virus to humans. here, we studied evolutionary relationships for 31 complete genomes of betacoronaviruses, including eight newly sequenced mers-cov genomes isolated from dromedary camels in saudi arabia. throu ...202032503352
coronaviruses and sars-cov-2coronaviruses (covs) cause a broad spectrum of diseases in domestic and wild animals, poultry, and rodents, ranging from mild to severe enteric, respiratory, and systemic disease, and also cause the common cold or pneumonia in humans. seven coronavirus species are known to cause human infection, 4 of which, hcov 229e, hcov nl63, hcov hku1 and hcov oc43, typically cause cold symptoms in immunocompetent individuals. the others namely sars-cov (severe acute respiratory syndrome coronavirus), mers-c ...202032293832
subunit vaccines against emerging pathogenic human coronaviruses.seven coronaviruses (covs) have been isolated from humans so far. among them, three emerging pathogenic covs, including severe acute respiratory syndrome coronavirus (sars-cov), middle east respiratory syndrome coronavirus (mers-cov), and a newly identified cov (2019-ncov), once caused or continue to cause severe infections in humans, posing significant threats to global public health. sars-cov infection in humans (with about 10% case fatality rate) was first reported from china in 2002, while m ...202032265848
covid-19 infection: origin, transmission, and characteristics of human coronaviruses.the coronavirus disease 19 (covid-19) is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2), which emerged in wuhan, china and spread around the world. genomic analysis revealed that sars-cov-2 is phylogenetically related to severe acute respiratory syndrome-like (sars-like) bat viruses, therefore bats could be the possible primary reservoir. the intermediate source of origin and transfer to humans is not known, however, t ...202032257431
emergence of a novel coronavirus, severe acute respiratory syndrome coronavirus 2: biology and therapeutic options.the new decade of the 21st century (2020) started with the emergence of a novel coronavirus known as sars-cov-2 that caused an epidemic of coronavirus disease (covid-19) in wuhan, china. it is the third highly pathogenic and transmissible coronavirus after severe acute respiratory syndrome coronavirus (sars-cov) and middle east respiratory syndrome coronavirus (mers-cov) emerged in humans. the source of origin, transmission to humans, and mechanisms associated with the pathogenicity of sars-cov- ...202032161092
increased pathogenicity and virulence of middle east respiratory syndrome coronavirus clade b in vitro and in vivo.middle east respiratory syndrome coronavirus (mers-cov) causes severe acute respiratory disease in humans. mers-cov strains from early epidemic clade a and contemporary epidemic clade b have not been phenotypically characterized to compare their abilities to infect cells and mice. we isolated the clade b mers-cov chinagd01 strain from a patient infected during the south korean mers outbreak in 2015 and compared the phylogenetics and pathogenicity of mers-cov emc/2012 (clade a) and chinagd01 (cla ...202032434886
ca2+ ions promote fusion of middle east respiratory syndrome coronavirus with host cells and increase infectivity.fusion with, and subsequent entry into, the host cell is one of the critical steps in the life cycle of enveloped viruses. for middle east respiratory syndrome coronavirus (mers-cov), the spike (s) protein is the main determinant of viral entry. proteolytic cleavage of the s protein exposes its fusion peptide (fp), which initiates the process of membrane fusion. previous studies on the related severe acute respiratory syndrome coronavirus (sars-cov) fp have shown that calcium ions (ca2+) play an ...202032295925
single-dose, intranasal immunization with recombinant parainfluenza virus 5 expressing middle east respiratory syndrome coronavirus (mers-cov) spike protein protects mice from fatal mers-cov infection.middle east respiratory syndrome coronavirus (mers-cov) can cause severe and fatal acute respiratory disease in humans and remains endemic in the middle east since first being identified in 2012. there are currently no approved vaccines or therapies available for mers-cov. in this study, we evaluated parainfluenza virus 5 (piv5)-based vaccine expressing the mers-cov envelope spike protein (piv5/mers-s) in a human dpp4 knockin c57bl/6 congenic mouse model (hdpp4 ki). following a single-dose intra ...202032265331
replication of severe acute respiratory syndrome coronavirus 2 in human respiratory epithelium.currently, there are four seasonal coronaviruses associated with relatively mild respiratory tract disease in humans. however, there is also a plethora of animal coronaviruses which have the potential to cross the species border. this regularly results in the emergence of new viruses in humans. in 2002, severe acute respiratory syndrome coronavirus (sars-cov) emerged and rapidly disappeared in may 2003. in 2012, middle east respiratory syndrome coronavirus (mers-cov) was identified as a possible ...202032434888
middle east respiratory syndrome coronavirus (mers-cov) seropositive camel handlers in kenya.middle east respiratory syndrome (mers) is a respiratory disease caused by a zoonotic coronavirus (mers-cov). camel handlers, including slaughterhouse workers and herders, are at risk of acquiring mers-cov infections. however, there is limited evidence of infections among camel handlers in africa. the purpose of this study was to determine the presence of antibodies to mers-cov in high-risk groups in kenya. sera collected from 93 camel handlers, 58 slaughterhouse workers and 35 camel herders, we ...202032260186
covid-19: the outbreak caused by a new coronavirus.before the severe acute respiratory syndrome outbreak in 2003, coronaviruses (covs) were not considered to be highly pathogenic to humans. however, it was this epidemic that highlighted this group of viruses and included them among the causative agents of emerging epidemic diseases. in addition, in 2012, another new cov responsible for the middle east respiratory syndrome was identified. both infections were considered a threat to global health security. at present, the third epidemic caused by ...202032226003
a tug-of-war between severe acute respiratory syndrome coronavirus 2 and host antiviral defence: lessons from other pathogenic viruses.world health organization has declared the ongoing outbreak of coronavirus disease 2019 (covid-19) a public health emergency of international concern. the virus was named severe acute respiratory syndrome coronavirus 2 (sars-cov-2) by the international committee on taxonomy of viruses. human infection with sars-cov-2 leads to a wide range of clinical manifestations ranging from asymptomatic, mild, moderate to severe. the severe cases present with pneumonia, which can progress to acute respirator ...202032172672
a review of coronavirus disease-2019 (covid-19).there is a new public health crises threatening the world with the emergence and spread of 2019 novel coronavirus (2019-ncov) or the severe acute respiratory syndrome coronavirus 2 (sars-cov-2). the virus originated in bats and was transmitted to humans through yet unknown intermediary animals in wuhan, hubei province, china in december 2019. there have been around 96,000 reported cases of coronavirus disease 2019 (covid-2019) and 3300 reported deaths to date (05/03/2020). the disease is transmi ...202032166607
zoonotic implications of camel diseases in iran.approximately 60% of all human pathogens and 75% of emerging infectious diseases are zoonotic (of animal origin). camel zoonotic diseases can be encountered in all camel-rearing countries. in this article, all studies carried out on camel zoonotic diseases in iran are reviewed to show the importance of camels for public health in this country. more than 900 published documents were systematically searched to find relevant studies from 1,890 until late 2018. the collected articles were classified ...202032160657
from four-way linking to a one health platform in egypt: institutionalisation of a multidisciplinary and multisectoral one health system.the convergence of humans, animals and our shared environment results in a dynamic in which the health of each group is inextricably linked. taking into account the fact that the majority of emerging pathogens (e.g. highly pathogenic avian influenza [hpai], severe acute respiratory syndrome coronavirus, nipah virus, middle east respiratory syndrome coronavirus) are zoonotic diseases, egypt has established a national one health coordination mechanism. the primary purpose of this mechanism is to p ...201931564724
identification of a novel betacoronavirus (merbecovirus) in amur hedgehogs from china.while dromedaries are the immediate animal source of middle east respiratory syndrome (mers) epidemic, viruses related to mers coronavirus (mers-cov) have also been found in bats as well as hedgehogs. to elucidate the evolution of mers-cov-related viruses and their interspecies transmission pathway, samples were collected from different mammals in china. a novel coronavirus related to mers-cov, erinaceus amurensis hedgehog coronavirus hku31 (ea-hedcov hku31), was identified from two amur hedgeho ...201931653070
probing the effects of pyrimidine functional group switches on acyclic fleximer analogues for antiviral activity.due to their ability to inhibit viral dna or rna replication, nucleoside analogues have been used for decades as potent antiviral therapeutics. however, one of the major limitations of nucleoside analogues is the development of antiviral resistance. in that regard, flexible nucleoside analogues known as "fleximers" have garnered attention over the years due to their ability to survey different amino acids in enzyme binding sites, thus overcoming the potential development of antiviral resistance. ...201931480658
identification of 6'-β-fluoro-homoaristeromycin as a potent inhibitor of chikungunya virus replication.we have reported on aristeromycin (1) and 6'-fluorinated-aristeromycin analogues (2), which are active against rna viruses such as middle east respiratory syndrome coronavirus (mers-cov), severe acute respiratory syndrome coronavirus (sars-cov), zika virus (zikv), and chikungunya virus (chikv). however, these exhibit substantial cytotoxicity. as this cytotoxicity may be attributed to 5'-phosphorylation, we designed and synthesized one-carbon homologated 6'-fluorinated-aristeromycin analogues. th ...201931841728
potential intermediate hosts for coronavirus transmission: no evidence of clade 2c coronaviruses in domestic livestock from ghana.the emergence of middle east respiratory syndrome coronavirus (mers-cov), nearly a decade ago with worldwide distribution, was believed to be of zoonotic origin from bats with dromedary camels as intermediate hosts. there is a likelihood of other domestic livestock serving as intermediate hosts for this virus. the presence of coronaviruses, closely related to mers-cov in ghanaian bats, presented the opportunity to test the hypothesis of transmissibility of this virus through domestic livestock s ...201930744201
some one health based control strategies for the middle east respiratory syndrome coronavirus.the middle east respiratory syndrome coronavirus (mers-cov) presents an ideal example for developing one health concepts. dromedary camels are the principal reservoir for the virus. infected camels shed the virus in body secretions, particularly nasal discharges. mers-cov has the potential to remain active in the environment for some time under optimum conditions of temperature and humidity. this shedding sustains the virus in endemic communities and thus contact with camels is considered a majo ...201931485476
detection of mers-cov antigen on formalin-fixed paraffin-embedded nasal tissue of alpacas by immunohistochemistry using human monoclonal antibodies directed against different epitopes of the spike protein.middle east respiratory syndrome (mers) represents an important respiratory disease accompanied by lethal outcome in one third of human patients. in recent years, several investigators developed protective antibodies which could be used as prophylaxis in prospective human epidemics. in the current study, eight human monoclonal antibodies (mabs) with neutralizing and non-neutralizing capabilities, directed against different epitopes of the mers-coronavirus (mers-cov) spike (mers-s) protein, were ...201931526954
global status of middle east respiratory syndrome coronavirus in dromedary camels: a systematic review.dromedary camels have been shown to be the main reservoir for human middle east respiratory syndrome (mers) infections. this systematic review aims to compile and analyse all published data on mers-coronavirus (cov) in the global camel population to provide an overview of current knowledge on the distribution, spread and risk factors of infections in dromedary camels. we included original research articles containing laboratory evidence of mers-cov infections in dromedary camels in the field fro ...201930869000
middle east respiratory coronavirus (mers-cov) spike (s) protein vesicular stomatitis virus pseudoparticle neutralization assays offer a reliable alternative to the conventional neutralization assay in human seroepidemiological studies.middle east respiratory syndrome coronavirus (mers-cov) is a novel zoonotic coronavirus that was identified in 2012. mers-cov infection in humans can result in an acute, severe respiratory disease and in some cases multi-organ failure; the global mortality rate is approximately 35 %. the mers-cov spike (s) protein is a major target for neutralizing antibodies in infected patients. the mers-cov microneutralization test (mnt) is the gold standard method for demonstrating prior infection. however, ...201932974558
risk factors for fatal middle east respiratory syndrome coronavirus infections in saudi arabia: analysis of the who line list, 2013-2018.objectives. to explore complex associations among demographic factors, risk factors, health care, and fatality rates of middle east respiratory syndrome coronavirus (mers-cov) in the kingdom of saudi arabia.methods. we based this study on analysis of a publicly accessible line listing of 1256 mers-cov cases (2013 to october 2018) available on the world health organization's web site. for analyses of demographic factors (e.g., age, gender), access to health care, promptness of laboratory services ...201931318592
a rapid scoping review of middle east respiratory syndrome coronavirus in animal hosts.middle east respiratory syndrome coronavirus (mers-cov) is an emerging zoonotic pathogen discovered in 2012. the purpose of this scoping review was to summarize the empirical evidence for mers-cov in animals in order to map knowledge gaps and to extract data for modelling disease transmission in dromedary camels. a review protocol was developed a priori, and a systematic search, data extraction and summary were conducted using the arksey and o'malley framework. ninety-nine publications were iden ...201930421581
knowledge and practices regarding middle east respiratory syndrome coronavirus among camel handlers in a slaughterhouse, kenya, 2015.dromedary camels are implicated as reservoirs for the zoonotic transmission of middle east respiratory syndrome coronavirus (mers-cov) with the respiratory route thought to be the main mode of transmission. knowledge and practices regarding mers among herders, traders and slaughterhouse workers were assessed at athi-river slaughterhouse, kenya. questionnaires were administered, and a check list was used to collect information on hygiene practices among slaughterhouse workers. of 22 persons, all ...201930238634
global status of middle east respiratory syndrome coronavirus in dromedary camels: a systematic review - corrigendum. 201931364519
diversity of dromedary camel coronavirus hku23 in african camels revealed multiple recombination events among closely related betacoronaviruses of the subgenus embecovirus.genetic recombination has frequently been observed in coronaviruses. here, we sequenced multiple complete genomes of dromedary camel coronavirus hku23 (dccov-hku23) from nigeria, morocco, and ethiopia and identified several genomic positions indicative of cross-species virus recombination events among other betacoronaviruses of the subgenus embecovirus (clade a beta-covs). recombinant fragments of a rabbit coronavirus (rbcov-hku14) were identified at the hemagglutinin esterase gene position. hom ...201931534035
enzootic patterns of middle east respiratory syndrome coronavirus in imported african and local arabian dromedary camels: a prospective genomic study.the middle east respiratory syndrome coronavirus (mers-cov) is a lethal zoonotic pathogen endemic to the arabian peninsula. dromedary camels are a likely source of infection and the virus probably originated in africa. we studied the genetic diversity, geographical structure, infection prevalence, and age-associated prevalence among camels at the largest entry port of camels from africa into the arabian peninsula.201931843456
a systematic review of mers-cov seroprevalence and rna prevalence in dromedary camels: implications for animal vaccination.human infection with middle east respiratory syndrome coronavirus (mers-cov) is driven by recurring dromedary-to-human spill-over events, leading decision-makers to consider dromedary vaccination. dromedary vaccine candidates in the development pipeline are showing hopeful results, but gaps in our understanding of the epidemiology of mers-cov in dromedaries must be addressed to design and evaluate potential vaccination strategies. we aim to bring together existing measures of mers-cov infection ...201931201040
bactrian camels shed large quantities of middle east respiratory syndrome coronavirus (mers-cov) after experimental infection.in 2012, middle east respiratory syndrome coronavirus (mers-cov) emerged. to date, more than 2300 cases have been reported, with an approximate case fatality rate of 35%. epidemiological investigations identified dromedary camels as the source of mers-cov zoonotic transmission and evidence of mers-cov circulation has been observed throughout the original range of distribution. other new-world camelids, alpacas and llamas, are also susceptible to mers-cov infection. currently, it is unknown wheth ...201931119984
qatar experience on one health approach for middle-east respiratory syndrome coronavirus, 2012-2017: a viewpoint.the emergence of the middle east respiratory syndrome corona virus (mers-cov) in the middle east in 2012 was associated with an overwhelming uncertainty about its epidemiological and clinical characteristics. once dromedary camels (camelus dromedarius) was found to be the natural reservoir of the virus, the public health systems across the arabian peninsula encountered an unprecedented pressure to control its transmission. this view point describes how the one health approach was used in qatar t ...201931011617
a review of asymptomatic and subclinical middle east respiratory syndrome coronavirus infections.the epidemiology of middle east respiratory syndrome coronavirus (mers-cov) since 2012 has been largely characterized by recurrent zoonotic spillover from dromedary camels followed by limited human-to-human transmission, predominantly in health-care settings. the full extent of infection of mers-cov is not clear, nor is the extent and/or role of asymptomatic infections in transmission. we conducted a review of molecular and serological investigations through pubmed and embase from september 2012 ...201931781765
evaluation of serological assays available in a biosafety level 2 laboratory and their application for survey of middle east respiratory syndrome coronavirus among livestock in ethiopia.a serological survey of middle east respiratory syndrome coronavirus (mers-cov) was conducted among dromedary camels and herbivorous animals sharing the same pasturage in ethiopia. the pseudotyped vesicular stomatitis virus coated with the spike protein of mers-cov was used in virus neutralization (vn) tests performed in a biosafety level (bsl)-2 laboratory. the results were similar to those obtained from the vn test using live mers-cov and were more sensitive than the elisa performed using synt ...201931685722
force of infection of middle east respiratory syndrome in dromedary camels in kenya.middle east respiratory syndrome coronavirus (mers-cov) is a zoonotic disease transmitted from dromedary camels to people, which can result in outbreaks with human-to-human transmission. because it is a subclinical infection in camels, epidemiological measures other than prevalence are challenging to assess. this study estimated the force of infection (foi) of mers-cov in camel populations from age-stratified serological data. a cross-sectional study of mers-cov was conducted in kenya from july ...201931547888
middle east respiratory syndrome coronavirus (mers-cov): a review.as a novel coronavirus first reported by saudi arabia in 2012, the middle east respiratory syndrome coronavirus (mers-cov) is responsible for an acute human respiratory syndrome. the virus, of 2c beta-cov lineage, expresses the dipeptidyl peptidase 4 (dpp4) receptor and is densely endemic in dromedary camels of east africa and the arabian peninsula. mers-cov is zoonotic but human-to-human transmission is also possible. surveillance and phylogenetic researches indicate mers-cov to be closely asso ...201931119115
middle east respiratory syndrome coronavirus (mers-cov) in dromedary camels in africa and middle east.: dromedary camels are the natural reservoirs of the middle east respiratory syndrome coronavirus (mers-cov). camels are mostly bred in east african countries then exported into africa and middle east for consumption. to understand the distribution of mers-cov among camels in north africa and the middle east, we conducted surveillance in egypt, senegal, tunisia, uganda, jordan, saudi arabia, and iraq. we also performed longitudinal studies of three camel herds in egypt and jordan to elucidate me ...201931387326
serological evidence of mers-cov and hku8-related cov co-infection in kenyan camels.dromedary camels are important reservoir hosts of various coronaviruses, including middle east respiratory syndrome coronavirus (mers-cov) that cause human infections. cov genomes regularly undergo recombination during infection as observed in bat sars-related covs. here we report for the first time that only a small proportion of mers-cov receptor-binding domain positive (rbd) of spike protein positive camel sera in kenya were also seropositive to mers-cov nucleocapsid (np). in contrast, many o ...201931645223
middle east respiratory syndrome coronavirus in dromedaries in ethiopia is antigenically different from the middle east isolate emc.middle east respiratory syndrome (mers) is an emerging respiratory disease caused by the mers coronavirus (mers-cov). mers has been endemic to saudi arabia since 2012. the reservoir of mers-cov is the dromedary camel, suggesting that mers is primarily a zoonotic disease. mers-cov is common in dromedaries throughout the middle east, north africa, and east africa as evidenced by neutralizing antibodies against mers-cov; however, human cases have remained limited to the middle east. to better under ...201931275264
mers-cov in camels but not camel handlers, sudan, 2015 and 2017.we tested samples collected from camels, camel workers, and other animals in sudan and qatar in 2015 and 2017 for evidence of middle east respiratory syndrome coronavirus (mers-cov) infection. mers-cov antibodies were abundant in sudan camels, but we found no evidence of mers-cov infection in camel workers, other livestock, or bats.201931742534
immune responses to middle east respiratory syndrome coronavirus during the acute and convalescent phases of human infection.an understanding of immune responses against the middle east respiratory syndrome (mers) is important for the development of treatments and preventive measures. here, we investigated the spectrum of immune responses occurring in patients with mers during the early period of infection.201930060038
mers coronavirus outbreak: implications for emerging viral infections.in september 2012, a novel coronavirus was isolated from a patient who died in saudi arabia after presenting with acute respiratory distress and acute kidney injury. analysis revealed the disease to be due to a novel virus which was named middle east respiratory coronavirus (mers-cov). there have been several mers-cov hospital outbreaks in ksa, continuing to the present day, and the disease has a mortality rate in excess of 35%. since 2012, the world health organization has been informed of 2220 ...201930413355
towards a solution to mers: protective human monoclonal antibodies targeting different domains and functions of the mers-coronavirus spike glycoprotein.the middle-east respiratory syndrome coronavirus (mers-cov) is a zoonotic virus that causes severe and often fatal respiratory disease in humans. efforts to develop antibody-based therapies have focused on neutralizing antibodies that target the receptor binding domain of the viral spike protein thereby blocking receptor binding. here, we developed a set of human monoclonal antibodies that target functionally distinct domains of the mers-cov spike protein. these antibodies belong to six distinct ...201930938227
middle east respiratory syndrome coronavirus infection in non-camelid domestic mammals.dromedary camels are natural host of the middle east respiratory syndrome coronavirus (mers-cov). however, there are limited studies of mers-cov infection of other domestic mammals exposed to infected dromedaries. we expanded our surveillance among camels in egypt, tunisia, and senegal to include other domestic mammalian species in contact with infected camels. a total of 820 sera and 823 nasal swabs from cattle, sheep, goats, donkeys, buffaloes, mules, and horses were collected. swabs were test ...201930866764
molecular identification of betacoronavirus in bats from sardinia (italy): first detection and phylogeny.bats may be natural reservoirs for a large variety of emerging viruses, including mammalian coronaviruses (cov). the recent emergence of severe acute respiratory syndrome-associated coronavirus (sars-cov) and middle east respiratory syndrome coronavirus (mers-cov) in humans, with evidence that these viruses may have their ancestry in bats, highlights the importance of virus surveillance in bat populations. here, we report the identification and molecular characterization of a bat β-coronavirus, ...201930426315
modulation of the immune response by middle east respiratory syndrome coronavirus.coronavirus (cov) infections are commonly associated with respiratory and enteric disease in humans and animals. in 2012, a new human disease called middle east respiratory syndrome (mers) emerged in the middle east. mers was caused by a virus that was originally called human coronavirus-erasmus medical center/2012 but was later renamed as middle east respiratory syndrome coronavirus (mers-cov). mers-cov causes high fever, cough, acute respiratory tract infection, and multiorgan dysfunction that ...201930146782
lack of middle east respiratory syndrome coronavirus transmission in rabbits.middle east respiratory syndrome coronavirus (mers-cov) transmission from dromedaries to humans has resulted in major outbreaks in the middle east. although some other livestock animal species have been shown to be susceptible to mers-cov, it is not fully understood why the spread of the virus in these animal species has not been observed in the field. in this study, we used rabbits to further characterize the transmission potential of mers-cov. in line with the presence of mers-cov receptor in ...201931022948
effect of fc fusion on folding and immunogenicity of middle east respiratory syndrome coronavirus spike protein.middle east respiratory syndrome coronavirus (mers-cov) induces severe respiratory impairment with a reported mortality rate of ~36% in humans. the absence of clinically available mers-cov vaccines and treatments to date has resulted in uncontrolled incidence and propagation of the virus. in vaccine design, fusion with the igg fc domain is reported to increase the immunogenicity of various vaccine antigens. however, limited reports have documented the potential negative effects of fc fusion on v ...201930982320
antagonism of dsrna-induced innate immune pathways by ns4a and ns4b accessory proteins during mers coronavirus infection.middle east respiratory syndrome coronavirus (mers-cov) was first identified in 2012 as a novel etiological agent of severe respiratory disease in humans. as during infection by other viruses, host sensing of viral double-stranded rna (dsrna) induces several antiviral pathways. these include interferon (ifn), oligoadenylate synthetase (oas)-rnase l, and protein kinase r (pkr). coronaviruses, including mers-cov, potently suppress the activation of these pathways, inducing only modest host respons ...201930914508
host determinants of mers-cov transmission and pathogenesis.middle east respiratory syndrome coronavirus (mers-cov) is a zoonotic pathogen that causes respiratory infection in humans, ranging from asymptomatic to severe pneumonia. in dromedary camels, the virus only causes a mild infection but it spreads efficiently between animals. differences in the behavior of the virus observed between individuals, as well as between humans and dromedary camels, highlight the role of host factors in mers-cov pathogenesis and transmission. one of these host factors, t ...201930893947
interferon regulatory factor 3-mediated signaling limits middle-east respiratory syndrome (mers) coronavirus propagation in cells from an insectivorous bat.insectivorous bats are speculated to be ancestral hosts of middle-east respiratory syndrome (mers) coronavirus (cov). mers-cov causes disease in humans with thirty-five percent fatality, and has evolved proteins that counteract human antiviral responses. since bats experimentally infected with mers-cov do not develop signs of disease, we tested the hypothesis that mers-cov would replicate less efficiently in bat cells than in human cells because of its inability to subvert antiviral responses in ...201930781790
a case-crossover analysis of the impact of weather on primary cases of middle east respiratory syndrome.middle east respiratory syndrome coronavirus (mers-cov) is endemic in dromedary camels in the arabian peninsula, and zoonotic transmission to people is a sporadic event. in the absence of epidemiological data on the reservoir species, patterns of zoonotic transmission have largely been approximated from primary human cases. this study aimed to identify meteorological factors that may increase the risk of primary mers infections in humans.201930717685
what have we learned about middle east respiratory syndrome coronavirus emergence in humans? a systematic literature review.middle east respiratory syndrome coronavirus (mers-cov) was first identified in humans in 2012. a systematic literature review was conducted to synthesize current knowledge and identify critical knowledge gaps.201930676269
from sars to mers, thrusting coronaviruses into the spotlight.coronaviruses (covs) have formerly been regarded as relatively harmless respiratory pathogens to humans. however, two outbreaks of severe respiratory tract infection, caused by the severe acute respiratory syndrome coronavirus (sars-cov) and the middle east respiratory syndrome coronavirus (mers-cov), as a result of zoonotic covs crossing the species barrier, caused high pathogenicity and mortality rates in human populations. this brought covs global attention and highlighted the importance of c ...201930646565
molecular pathogenesis of middle east respiratory syndrome (mers) coronavirus.middle east respiratory syndrome coronavirus (mers-cov) emerged in 2012 and is listed in the world health organization's blueprint of priority diseases that need immediate research. camels are reservoirs of this virus, and the virus spills over into humans through direct contact with camels. human-to-human transmission and travel-associated cases have been identified as well. limited studies have characterized the molecular pathogenesis of mers-cov. most studies have used ectopic expression of v ...201932226718
middle east respiratory syndrome coronavirus-encoded accessory proteins impair mda5-and tbk1-mediated activation of nf-κb.middle east respiratory syndrome coronavirus (mers-cov) is a newly emerging coronavirus which is zoonotic from bats and camels. its infection in humans can be fatal especially in patients with preexisting conditions due to smoking and chronic obstructive pulmonary disease (copd). among the 25 proteins encoded by mers-cov, 5 accessory proteins seem to be involved in viral evasion of the host immune responses. here we report that orf4a, orf4b, and orf8b proteins, alone or in combination, effective ...201931434175
sensitive and specific detection of low-level antibody responses in mild middle east respiratory syndrome coronavirus infections.middle east respiratory syndrome coronavirus (mers-cov) infections in humans can cause asymptomatic to fatal lower respiratory lung disease. despite posing a probable risk for virus transmission, asymptomatic to mild infections can go unnoticed; a lack of seroconversion among some pcr-confirmed cases has been reported. we found that a mers-cov spike s1 protein-based elisa, routinely used in surveillance studies, showed low sensitivity in detecting infections among pcr-confirmed patients with mil ...201931423970
comparison of serologic assays for middle east respiratory syndrome coronavirus.middle east respiratory syndrome coronavirus (mers-cov) was detected in humans in 2012. since then, sporadic outbreaks with primary transmission through dromedary camels to humans and outbreaks in healthcare settings have shown that mers-cov continues to pose a threat to human health. several serologic assays for mers-cov have been developed globally. we describe a collaborative study to investigate the comparability of serologic assays for mers-cov and assess any benefit associated with the int ...201931423969
origin and evolution of pathogenic coronaviruses.severe acute respiratory syndrome coronavirus (sars-cov) and middle east respiratory syndrome coronavirus (mers-cov) are two highly transmissible and pathogenic viruses that emerged in humans at the beginning of the 21st century. both viruses likely originated in bats, and genetically diverse coronaviruses that are related to sars-cov and mers-cov were discovered in bats worldwide. in this review, we summarize the current knowledge on the origin and evolution of these two pathogenic coronaviruse ...201930531947
a novel bacterium-like particle vaccine displaying the mers-cov receptor-binding domain induces specific mucosal and systemic immune responses in mice.middle east respiratory syndrome coronavirus (mers-cov), a new coronavirus that has been causing severe and fatal acute respiratory illnesses in humans since its outbreak in 2012, has raised public fear worldwide. the development of prophylactics and therapeutics is urgently needed to prevent and control mers-cov infections. in this study, a bacterium (lactococcus lactis)-like particle (blp) vaccine displaying the mers-cov receptor-binding domain (rbd) was developed, and gram-positive enhancer m ...201931470645
[coronaviruses as the cause of respiratory infections].there are six human pathogenic coronaviruses (cov), which mainly cause infections of the respiratory system. in everyday clinical practice, it is helpful to know the relevance and characteristics of these pathogens.201931455974
spike proteins of novel mers-coronavirus isolates from north- and west-african dromedary camels mediate robust viral entry into human target cells.the highly pathogenic middle east respiratory syndrome (mers)-related coronavirus (cov) is transmitted from dromedary camels, the natural reservoir, to humans. for at present unclear reasons, mers cases have so far only been observed in the arabian peninsula, although mers-cov also circulates in african dromedary camels. a recent study showed that mers-cov found in north/west- (morocco) and west-african (burkina faso and nigeria) dromedary camels are genetically distinct from arabian viruses and ...201931357164
mers coronavirus: an emerging zoonotic virus.middle east respiratory syndrome coronavirus (mers-cov) is an emerging virus that was first reported in humans in june 2012 [...].201931331035
a recombinant influenza a/h1n1 carrying a short immunogenic peptide of mers-cov as bivalent vaccine in balb/c mice.middle east respiratory syndrome coronavirus (mers-cov) became a global human health threat since its first documentation in humans in 2012. an efficient vaccine for the prophylaxis of humans in hotspots of the infection (e.g., saudi arabia) is necessary but no commercial vaccines are yet approved. in this study, a chimeric dna construct was designed to encode an influenza a/h1n1 na protein which is flanking immunogenic amino acids (aa) 736-761 of mers-cov spike protein. using the generated chim ...201931810359
efficacy of an adjuvanted middle east respiratory syndrome coronavirus spike protein vaccine in dromedary camels and alpacas.mers-cov is present in dromedary camels throughout the middle east and africa. dromedary camels are the primary zoonotic reservoir for human infections. interruption of the zoonotic transmission chain from camels to humans, therefore, may be an effective strategy to control the ongoing mers-cov outbreak. here we show that vaccination with an adjuvanted mers-cov spike protein subunit vaccine confers complete protection from mers-cov disease in alpaca and results in reduced and delayed viral shedd ...201930832356
overview of current therapeutics and novel candidates against influenza, respiratory syncytial virus, and middle east respiratory syndrome coronavirus infections.emergence and re-emergence of respiratory virus infections represent a significant threat to global public health, as they occur seasonally and less frequently (such as in the case of influenza virus) as pandemic infections. some of these viruses have been in the human population for centuries and others had recently emerged as a public health problem. influenza viruses have been affecting the human population for a long time now; however, their ability to rapidly evolve through antigenic drift ...201931275265
an updated roadmap for mers-cov research and product development: focus on diagnostics.diagnostics play a central role in the early detection and control of outbreaks and can enable a more nuanced understanding of the disease kinetics and risk factors for the middle east respiratory syndrome-coronavirus (mers-cov), one of the high-priority pathogens identified by the who. in this review we identified sources for molecular and serological diagnostic tests used in mers-cov detection, case management and outbreak investigations, as well as surveillance for humans and animals (camels) ...201930815285
species-specific colocalization of middle east respiratory syndrome coronavirus attachment and entry receptors.middle east respiratory syndrome coronavirus (mers-cov) uses the s1b domain of its spike protein to bind to dipeptidyl peptidase 4 (dpp4), its functional receptor, and its s1a domain to bind to sialic acids. the tissue localization of dpp4 in humans, bats, camelids, pigs, and rabbits generally correlates with mers-cov tropism, highlighting the role of dpp4 in virus pathogenesis and transmission. however, mers-cov s1a does not indiscriminately bind to all α2,3-sialic acids, and the species-specif ...201931167913
single intranasal immunization with chimpanzee adenovirus-based vaccine induces sustained and protective immunity against mers-cov infection.the recently identified middle east respiratory syndrome coronavirus (mers-cov) causes severe and fatal acute respiratory illness in humans. however, no approved prophylactic and therapeutic interventions are currently available. the mers-cov envelope spike protein serves as a crucial target for neutralizing antibodies and vaccine development, as it plays a critical role in mediating viral entry through interactions with the cellular receptor, dipeptidyl peptidase 4 (dpp4). here, we constructed ...201931130102
structures of mers-cov spike glycoprotein in complex with sialoside attachment receptors.the middle east respiratory syndrome coronavirus (mers-cov) causes severe and often lethal respiratory illness in humans, and no vaccines or specific treatments are available. infections are initiated via binding of the mers-cov spike (s) glycoprotein to sialosides and dipeptidyl-peptidase 4 (the attachment and entry receptors, respectively). to understand mers-cov engagement of sialylated receptors, we determined the cryo-em structures of s in complex with 5-n-acetyl neuraminic acid, 5-n-glycol ...201931792450
middle east respiratory syndrome coronavirus (mers-cov) neutralising antibodies in a high-risk human population, morocco, november 2017 to january 2018.backgroundmiddle east respiratory syndrome coronavirus (mers-cov) remains a major concern for global public health. dromedaries are the source of human zoonotic infection. mers-cov is enzootic among dromedaries on the arabian peninsula, the middle east and in africa. over 70% of infected dromedaries are found in africa. however, all known zoonotic cases of mers have occurred in the arabian peninsula with none being reported in africa.aimwe aimed to investigate serological evidence of mers-cov in ...201931796154
structural insights into coronavirus entry.coronaviruses (covs) have caused outbreaks of deadly pneumonia in humans since the beginning of the 21st century. the severe acute respiratory syndrome coronavirus (sars-cov) emerged in 2002 and was responsible for an epidemic that spread to five continents with a fatality rate of 10% before being contained in 2003 (with additional cases reported in 2004). the middle-east respiratory syndrome coronavirus (mers-cov) emerged in the arabian peninsula in 2012 and has caused recurrent outbreaks in hu ...201931522710
peptide presentation by bat mhc class i provides new insight into the antiviral immunity of bats.bats harbor many zoonotic viruses, including highly pathogenic viruses of humans and other mammals, but they are typically asymptomatic in bats. to further understand the antiviral immunity of bats, we screened and identified a series of bat major histocompatibility complex (mhc) i ptal-n*01:01-binding peptides derived from four different bat-borne viruses, i.e., hendra virus (hev), ebola virus (ebov), middle east respiratory syndrome coronavirus (mers-cov), and h17n10 influenza-like virus. the ...201931498797
middle east respiratory syndrome coronavirus and the one health concept.middle east respiratory syndrome coronavirus (mers-cov) is one of the major threats to the healthcare systems in some countries, especially in the arabian peninsula. mers-cov is considered an ideal example of the one health concept. this is due to the animals, especially dromedary camels, play important roles in the transmission and sustainability of the virus, and the virus can be transmitted through aerosols of infected patients into the environment. however, there is some debate regarding the ...201931497405
a database of geopositioned middle east respiratory syndrome coronavirus occurrences.as a world health organization research and development blueprint priority pathogen, there is a need to better understand the geographic distribution of middle east respiratory syndrome coronavirus (mers-cov) and its potential to infect mammals and humans. this database documents cases of mers-cov globally, with specific attention paid to zoonotic transmission. an initial literature search was conducted in pubmed, web of science, and scopus; after screening articles according to the inclusion/ex ...201931836720
blocking transmission of middle east respiratory syndrome coronavirus (mers-cov) in llamas by vaccination with a recombinant spike protein.the ongoing middle east respiratory syndrome coronavirus (mers-cov) outbreaks pose a worldwide public health threat. blocking mers-cov zoonotic transmission from dromedary camels, the animal reservoir, could potentially reduce the number of primary human cases. here we report mers-cov transmission from experimentally infected llamas to naïve animals. directly inoculated llamas shed virus for at least 6 days and could infect all in-contact naïve animals 4-5 days after exposure. with the aim to bl ...201931711379
cepi: driving progress toward epidemic preparedness and response.the coalition for epidemic preparedness innovations (cepi) was formed in the aftermath of the 2014-2015 ebola outbreak in west africa to support the development of vaccines that could improve the world's preparedness against outbreaks of epidemic infectious diseases. since its launch in 2017, cepi has mobilized more than us$750 million to support its mission to develop vaccines against agents such as lassa virus, middle east respiratory syndrome coronavirus, and nipah virus, as well as several r ...201931673694
the middle east respiratory syndrome (mers).the middle east respiratory syndrome (mers) is a novel lethal zoonotic disease of humans caused by the mers coronavirus (mers-cov). although mers is endemic to the middle east, travelers have exported mers-cov on return to their home countries. clinical manifestations range from mild to severe acute respiratory disease and death. the elderly, immunocompromised, and those with chronic comorbid liver, lung, and hepatic conditions have a high mortality rate. there is no specific treatment. person-t ...201931668197
middle east respiratory syndrome coronavirus-encoded orf8b inhibits rig-i-like receptors in a differential mechanism.middle east respiratory syndrome coronavirus (mers-cov) belongs to the beta coronavirus subfamily and causes severe morbidity and mortality in humans especially when infected patients have underlying diseases such chronic obstructive pulmonary disease (copd). previously, we demonstrated that mers-cov-encoded orf8b strongly inhibits mda5- and rig-i-mediated induction of the interferon beta (ifn-β) promoter activities. here, we report that orf8b seem to regulate mda5 or rig-i differentially as pro ...201931838791
recombinant adenoviral vaccine encoding the spike 1 subunit of the middle east respiratory syndrome coronavirus elicits strong humoral and cellular immune responses in mice.middle east respiratory syndrome coronavirus (mers-cov) has rapidly spread throughout the middle east since its discovery in 2012. the virus poses a significant global public health threat with potentially devastating effects. in this study, a recombinant adenoviral-based vaccine encoding the spike 1 (s1) subunit of the mers-cov genome was constructed, and its humoral, and cellular immune responses were evaluated in mice.201931849416
the characteristics of hdpp4 transgenic mice subjected to aerosol mers coronavirus infection via an animal nose-only exposure device.middle east respiratory syndrome coronavirus (mers-cov), which is not fully understood in regard to certain transmission routes and pathogenesis and lacks specific therapeutics and vaccines, poses a global threat to public health.201931942559
the hajj 2019 vaccine requirements and possible new challenges.each year millions of pilgrims perform the annual hajj from more than 180 countries around the world. this is one of the largest mass gathering events and may result in the occurrence and spread of infectious diseases. as such, there are mandatory vaccinations for the pilgrims such as meningococcal vaccines. the 2019 annual hajj will take place during august 8-13, 2019. thus, we review the recommended and mandated vaccinations for the 2019 hajj and umrah. the mandatory vaccines required to secur ...201931529930
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