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Spike Q833R and ORF8b L6Q Define MERS Transmission
Recombinomics Commentary 21:00
May 8, 2014

The recently released sequences from the MERS cases in Jeddah and Mecca match the three earlier sequences from cases in Jeddah.  Eight genetic changes define the novel sub-clade.  Included in the polymorphisms is a change in the Spike protein, Q833R, which has not been reported in any prior MERS sequence.  Similarly, another non-synonymous change, L6Q in open reading frame, ORF8b, is in all six human sequences, but not in any previously described MERS sequence.
The presence of both of these polymorphisms in all six human cases from four hospitals in two cities (Jeddah and Mecca) signal clonal expansion due to widespread MERS human transmission.

Although clonal expansion has been seen in cases linked to a nosocomial outbreak, such as the Al Hasa outbreak a year ago in eastern Saudi Arabia, the presence of the same sequence in multiple cases in multiple hospitals in two different cities raises serious pandemic concerns.

Moreover, these 9 markers are in six of six sequences from these two cities, strongly suggesting the 25 partial S gene sequences from 25 other Jeddah patients will also match these six cases, further supporting widespread human transmission.

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