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CDC Generates MERS Sequences from Suspect Serum
Recombinomics Commentary 20:45
May 21, 2014

AUTHORS   Abroug,F., Slim,A., BenSalah,A., Ouanes-Besbes,L., Hadj   Kacem,M.-A., Dachraoui,F., Ouanes,I., Zorraga,M., Ghawar,W., Lu,X.,     Tao,Y., Paden,C., Caidi,H., Miao,C., Gerber,S.I. and Al-Hajri,M.M.  CONSRTM   WHO-GOARN MERS-CoV International Investigation Team
TITLE     A family cluster of MERS-CoV infection in Tunisia imported from the  Middle East
JOURNAL   Unpublished
REFERENCE   2  (bases 1 to 4062)
AUTHORS   Lu,X., Slim,A. and Erdman,D.D.
TITLE     Direct Submission
JOURNAL   Submitted (05-NOV-2013) Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, N.E., Atlanta, GA 30333, USA
FEATURES  Location/Qualifiers
   source        1..4062
                     /organism="Middle East respiratory syndrome coronavirus"
                     /mol_type="genomic RNA"

The above comments from the characterization sheet for the full MERS spike sequence, Tunisia-Qatar_2013, from an earlier export of MERS from Qatar/Saudi Arabia to Tunisia with onward transmission.  The index case died ( 2 days after collection date) and was not PCR confirmed.  His two children were confirmed and he was classified as a probable case.
The determination of the full sequence of the spike and N gene (which includes ORF8b) using a serum source offers a significant advance.  Recent attention has been focused on serum testing because of detected onward MERS transmission in Illinois after casual contact with a confirmed export from Riyadh to Munster, Indiana,
Indiana/USA-1_Saudi Arabia_2014.

The ability to get a large sequence from serum samples can address the widespread false negatives on clinical samples due to transient presence of MERS-CoV , especially in upper respiratory samples, including samples from recent pilgrims who died in Indonesia and Egypt after performing Umrah, but were not PCR confirmed.

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