#19,415
Although reports of human infection with MERS-CoV have dwindled in recent years, this family of coronaviruses still circulates (and evolves) in dromedary camels both in the Middle East and Africa, and still poses a zoonotic threat.
A month ago - in WHO DON: Middle East respiratory syndrome coronavirus - Kingdom of Saudi Arabia - we looked at the WHO's first Saudi MERS update of 2026, which chronicled 8 cases reported by KSA since last December.
Last August, in WHO: Risk assessment of the introduction, spread, and zoonotic spillover of MERS-CoV Clade B in camel populations of the Nile Basin and Across Africa, we looked at concerns over the cryptic spread of MERS in Africa.
While some of this decline is likely due to difficulties in identifying cases, at the same time some Middle Eastern countries have shown past reluctance to report cases.But whether in Africa or the Arabian peninsula, MERS-CoV spillover to humans is viewed as likely underreported (see (Referral) Nature: Human MERS-CoV cases are falling but pose an ongoing pandemic threat).
Yesterday the WHO published a DON (Disease Outbreak News) on two (apparently unrelated) MERS cases from Qatar which occurred in August, but were only recently (Oct 29th) reported to the WHO.
Of particularly note, the first case fell ill on July 22nd - was hospitalized on July 25th, but not diagnosed with MERS-CoV until the 5th of August - a delay which may help explain the large number of contacts (73), including 62 healthcare workers.
The second case was identified relatively quickly, but 22 HCWs were identified as close contacts. In both instances, no secondary infections were reported.
Due to its length, I've only posted excerpts from the WHO DON report. Follow the link to read it in its entirety. I'll have a brief postscript after the break.
Middle East respiratory syndrome (MERS) – Qatar
13 November 2026
Situation at a glance
On 29 October 2026, the National International Health Regulations (IHR) Focal Point of the State of Qatar notified the World Health Organization (WHO) of two laboratory-confirmed cases of Middle East respiratory syndrome (MERS). The cases were confirmed on 5 and 25 August 2026 and are the first MERS cases reported from Qatar since 2022. MERS is a viral zoonotic infection, principally transmitted to humans through direct or indirect contact with infected dromedary camels. Both patients were men aged over 50 years with underlying medical conditions and occupational exposure to dromedary camels. Both were hospitalized and subsequently discharged in a stable condition. A total of 99 contacts from both cases were identified, tested, and monitored for 14 days following their last exposure. All contacts tested negative for MERS-CoV, and no secondary cases were identified. The two cases reported exposure to dromedary camels at geographically separate farms, with no epidemiological link identified between them. The cases appear to represent sporadic infections associated with zoonotic transmission from dromedary camels rather than human-to-human transmission.
Description of the situation
On 29 October 2026, the National IHR Focal Point of Qatar notified WHO of two laboratory-confirmed cases of Middle East respiratory syndrome (MERS). The cases were confirmed on 5 and 25 August 2026. These are the first MERS-CoV cases reported by the State of Qatar since 2022.
The first case was a man aged over 50 years who worked with dromedary camels and had chronic medical conditions. He developed symptoms on 22 July 2026 and was admitted to hospital on 25 July. Real-time reverse transcription-polymerase chain reaction (RT-PCR) on an upper-respiratory tract specimen initially tested negative for MERS-CoV. A subsequent lower-respiratory tract specimen tested positive by RT-PCR, and infection was laboratory-confirmed on 5 August. He reported longstanding occupational exposure to dromedary camels, including during the 14 days before symptom onset. He did not report consuming raw camel milk or any recent travel. He recovered and was discharged in a stable condition after two consecutive negative PCR test results.
A total of 73 contacts were identified for this case, comprising 11 close contacts and 62 health and care workers. All contacts were tested and monitored for 14 days following their last exposure. All tested negative for MERS-CoV, and no secondary cases were identified.
The second case was a man aged over 50 years who was involved in camel breeding and rearing and had underlying chronic medical conditions. He developed symptoms on 23 August 2026. Two nasopharyngeal specimens tested positive for MERS-CoV by RT-PCR on 25 August. He reported sustained occupational exposure to dromedary camels, including directly caring for recently ill young camels during the 14 days preceding symptom onset. He also reported consuming raw camel milk during this period but had no recent travel history.
He developed severe MERS-CoV pneumonia complicated by acute hypoxemic respiratory failure and required high-flow nasal oxygen and non-invasive ventilatory support. He subsequently recovered and was discharged in a stable condition after two consecutive negative PCR test results.
A total of 26 contacts were identified for this case, comprising four close contacts and 22 health and care workers. All contacts were tested and monitored for 14 days following their last exposure and tested negative for MERS-CoV. One high-risk contact who was a health and care worker developed respiratory symptoms but tested negative for MERS-CoV on two specimens. No secondary cases were identified.
The two cases reported occupational exposure at geographically separate camel farms, with no epidemiological link identified between the farms or the cases. The precise sources of infection remain undetermined. However, their sustained occupational exposure to dromedary camels, including direct contact with recently ill camels in one case and the consumption of raw camel milk by the same case, suggest probable zoonotic acquisition.
(SNIP)
Prior to COVID's emergence in late 2019, MERS-CoV was the top contender for sparking a coronavirus pandemic, sporting a high mortality rate (>30%), and spreading easily through hospitals in the Middle East (and South Korea) (see Ziad Memish: Two MERS-CoV Hospital Super Spreading Studies).
In the summer of 2025 we looked at an editorial in Journal of Epidemiology & Global Health on the importance of continued healthcare preparedness and surveillance (see Al-Tawfiq & Memish On Recurrent MERS-CoV Transmission in Saudi Arabia), with an emphasis on identifying asymptomatic carriers.
These are the first MERS cases reported from Qatar since 2022. Both cases had occupational exposure to dromedary camels, and one reported tending to sick camels and consuming raw camel milk during the 14 days before symptom onset. The cases were exposed at geographically separate farms, with no epidemiological link identified between them. All 99 identified contacts tested negative for MERS-CoV, and no secondary cases were identified. The available information therefore suggests that these were sporadic infections associated with zoonotic transmission rather than human-to-human transmission.(Continue . . . )
The occurrence of two apparently unlinked cases highlights the continued risk of zoonotic spillover among people with frequent or occupational exposure to dromedary camels, particularly those with underlying medical conditions.
As per WHO’s rapid risk assessment of 29 January 2026, the overall risk associated with MERS-CoV remains moderate at both the regional and global levels. This assessment reflects continued sporadic zoonotic spillover into the human population and the potential for subsequent health care-associated transmission and international importation into countries where the disease is not endemic.
Based on the information reported by the State of Qatar, there is no evidence of sustained human-to-human transmission associated with these cases. Continued surveillance and animal health investigations remain important to detect and assess any potential further transmission.
Prior to COVID's emergence in late 2019, MERS-CoV was the top contender for sparking a coronavirus pandemic, sporting a high mortality rate (>30%), and spreading easily through hospitals in the Middle East (and South Korea) (see Ziad Memish: Two MERS-CoV Hospital Super Spreading Studies).
In the summer of 2025 we looked at an editorial in Journal of Epidemiology & Global Health on the importance of continued healthcare preparedness and surveillance (see Al-Tawfiq & Memish On Recurrent MERS-CoV Transmission in Saudi Arabia), with an emphasis on identifying asymptomatic carriers.
Whether MERS-CoV will re-emerge as a global health threat remains unknown, but it continues to circulate and evolve - largely out of our view - on both the Arabian Peninsula and in Africa.
Which makes it very much worth our attention.
