In September 2012 a patient in Saudi Arabia died of acute respiratory illness and kidney failure due to an unknown infectious agent. A novel species of coronavirus was later identified and shown to be the cause of this and eleven subsequent cases, which were spread across the Middle East and the UK. A timely review, published today in Virology Journal, summarises the outbreak and timeline of events so far.

The most common initial symptoms were reported to be fever, cough and shortness of breath, which developed to severe pneumonia and in some cases renal failure. Interestingly, all other known human coronaviruses cause mild respiratory disease and contribute to the common cold, with the exception of the SARS coronavirus, which can also cause fatal respiratory disease. It is possible, indeed likely, that in some cases this coronavirus is associated with a mild respiratory tract infection that goes unnoticed, as only patients with severe disease seek medical attention. So far, there is limited evidence of human-to-human transmission.

This novel coronavirus is the sixth known human coronavirus and the third to be isolated in the last ten years, showing how much more we have to learn about this family. It is striking that the coronaviruses that cause SARS and this new outbreak are both closely related to those found in bats. The bat genome has only just been sequenced, which will greatly help research into this source of human infections. Until then, we must remain ever vigilant for the next potential pandemic.

NOTE:
This is a rapidly evolving situation, with one patient still in intensive care in the UK. We therefore encourage all those with an interest in this outbreak to provide notes on new cases using the Comment facility, thereby providing a useful resource for the community.