A-Z Index × Submit A-Z Index × Submit A-Z Index Search Dropdown × Submit Facebook Twitter LinkedIn Syndicate Emerging Infectious Disease journal ISSN: 1080-6059 Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.
Middle East respiratory syndrome coronavirus (MERS-CoV) is a persistent zoonotic and epidemic threat. We analyzed 807 publicly available human- and camel-derived MERS-CoV genomes collected during 2012–2024 to assess global genomic surveillance. Most sequences originated from Saudi Arabia and the United Arab Emirates. Major gaps in surveillance persist across Africa and South and Central Asia despite large camel populations, active trade, and evidence of viral circulation. Phylogenetic analysis confirmed predominance of clade B in the Arabian Peninsula and clade C in East Africa, consistent with regional patterns. We identified uneven sampling, incomplete metadata, and long delays between sample collection and public sequence submission, often spanning years. Those limitations reduce the value of genomic data for timely situational awareness. Integrating genomic with population and trade data supports timelier, more representative, and coordinated One Health surveillance for MERS-CoV but reveals major blind spots.
Middle East respiratory syndrome coronavirus (MERS-CoV) was first detected in humans in 2012 ( 1 ). Saudi Arabia has recorded 84% of the 2,617 laboratory-confirmed human cases reported to the World Health Organization (WHO) as of May 2025 ( 2 ). Although limited human-to-human transmission has been documented within healthcare settings and in communities, most human infections are linked directly or indirectly to contact with infected dromedary camels, the main animal reservoir ( 3 ). In camels, infection is usually asymptomatic or mild ( 4 ), whereas infected humans can suffer severe respiratory illness and a crude case-fatality ratio of ≈37% ( 5 ). More than a decade after its discovery, MERS-CoV remains a public health concern because of its epidemic and pandemic potential, severe clinical outcomes, and the absence of licensed vaccines or therapeutics ( 6 ).
MERS-CoV belongs to the Merbecovirus subgenus within the genus Betacoronavirus , which also includes severe acute respiratory syndrome coronavirus (SARS-CoV), which caused the SARS epidemic in 2002–2003, and SARS-CoV-2, responsible for the COVID-19 pandemic ( 7 ). Three major clades within the MERS-CoV phylogeny have been identified, clades A, B and C, which differ in their geographic distribution and ecology. Differences in the clades phenotypic properties are still being investigated ( 8 ). Understanding MERS-CoV genetic diversity therefore remains necessary for situational awareness, interpretation of transmission patterns, and future preparedness planning ( 9 , 10 ).
Genomic epidemiology has become a critical component of pathogen surveillance, enabling the description of pathogen diversity, the contextualization of outbreaks, and identifying changes in circulating lineages over time ( 11 ). However, the utility of genomic surveillance depends not only on the existence of and access to sequence data but also on how representative, timely, and well annotated those data are. Recent reviews have documented major MERS-CoV surveillance and research gaps, such as incomplete virologic and serologic evidence in dromedary populatio…