First MERS Autopsy Reveals Critical Information

Ebola and now Zika are two viruses that have monopolized headlines for two years. But the Middle East respiratory syndrome is a potentially deadly contagion also on the radar of health officials worldwide. Some 1,500 people have been infected, and more than 500 have been killed.

But little research has been done on the affliction. Now the first published results of a MERS autopsy have been published in The American journal of Pathology [1], allowing for further exploration into the contagion.

The 45-year-old man had worked in a storage room at a paramedic station in the United Arab Emirates in April 2014, according to the autopsy. The man had no direct exposure to camels, a known vector of the disease, or even any direct patient-care duties.

But between April 2 and April 10 of that year, he deteriorated quickly. A fever, runny nose and cough rapidly led to death. On the final day, he was treated with 100 mg of the hydrocortisone steroids every eight hours.

The man’s death was agonizing. The main damage was inflicted on the lungs – and also where the transmission may have originated.

“Infection of bronchial submucosal glands is a likely source of viral shedding in respiratory secretions leading to human-to-human transmissions,” said Sherif Zaki, lead investigator, and Chief of the Infectious Diseases Pathology Branch at the CDC in Atlanta.

Notably absent were signs of acute renal failure, and signs of the infection in the brain. Together, the findings suggest treating the illness directly in the lungs first.

The autopsy was performed 10 days after the man’s death.

“The long interval between the emergence of this dangerous disease three years ago and the first autopsy reminds us of the lost opportunity that the decline of the performance of autopsies, particularly research-oriented post-mortem examinations in the United States represents,” said David H. Walker, director of the University of Texas Medical Branch Center for Biodefense and Emerging Infectious Diseases.

Thailand confirmed a case in their country on Jan. 26, the second such case of a traveler in their country, according to the World Health Organization [2].

South Korea isolated hundreds of people last summer [3] due to cases among travelers.

MERS-CoV was first identified in 2012 in Saudi Arabia, where three-quarters of the cases have originated, according to the CDC. The coronavirus is from the same disease group that caused the 2003 outbreak of Severe Acute Respiratory Syndrome, or SARS, in China.