Volume 22, Number 7—July 2016
Online Report
Development of Medical Countermeasures to Middle East Respiratory Syndrome Coronavirus
Table 5
Source | Vaccine | Status |
---|---|---|
Novavax, Gaithersburg, MD, USA |
Spike protein trimer in 40 nm particle; likely adjuvanted |
Mouse immunogenicity shown (58) |
NIAID/Vaccine Research Center, Bethesda, MD, USA |
Two candidate vaccine approaches: DNA spike prime-S1 protein boost and S1 prime-S1 boost |
Mouse and NHP immunogenicity shown; NHP2 (macaque-radiological efficacy shown) (59) |
GeneOne Life Science, Seoul, South Korea; Inovio Pharmaceuticals, Plymouth Meeting, PA, USA |
DNA expressing spike; electroporation device |
Mouse, NHP, and camel immunogenicity shown; NHP2 (viremia, lung pathology) (60); phase I study started (61) |
Greffex, Aurora, CO, USA |
Fully deleted adenovirus packaging vector |
Mouse immunogenicity (62) |
Erasmus University Rotterdam, the Netherlands; University of Marburg, Marburg, Germany; Ludwig-Maximilians University, Munich, Germany |
MVA vectored spike protein |
Mouse immunogenicity and protection shown; clinical trials in planning stage (63,64) |
New York Blood Center, New York, NY, USA; Shanghai Medical College, Shanghai, China | Spike receptor-binding domain subunit vaccine | Recombinant protein containing the 377–588 aa fragment of the S1 subunit (65) |
*MERS-CoV, Middle East respiratory syndrome coronavirus; spike, MERS-CoV spike protein; NHP, non -human primate; MVA, modified vaccinia Ankara; S1, portion of spike protein with the receptor binding domain.
References
- World Health Organization. Emergencies preparedness, response: Middle East respiratory syndrome coronavirus (MERS-CoV)—Saudi Arabia. 2016 Apr 27 [cited 2016 Apr 27]. http://www.who.int/csr/don/26-april-2016-mers-saudi-arabia/en/
- World Health Organization. Summary of current situation, literature update and risk assessment [updated 2015 July 7; cited 2015 Aug 12]. http://apps.who.int//iris/bitstream/10665/179184/2/WHO_MERS_RA_15.1_eng.pdf
- Assiri A, McGeer A, Perl TM, Price CS, Al Rabeeah AA, Cummings DAT, Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med. 2013;369:407–16. DOIPubMedGoogle Scholar
- Oboho IK, Tomczyk SM, Al-Asmari AM, Banjar AA, Al-Mugti H, Aloraini MS, 2014 MERS-CoV outbreak in Jeddah—a link to health care facilities. N Engl J Med. 2015;372:846–54. DOIPubMedGoogle Scholar
- Alraddadi BM, Watson JT, Almarashi A, Abedi GR, Turkistani A, Sadran M, Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans, Saudi Arabia, 2014. Emerg Infect Dis. 2016;22:49–55. Epub 2015 Dec 18. DOIPubMedGoogle Scholar
- Bin SY, Heo JY, Song MS, Lee J, Kim EH, Park SJ, Environmental contamination and viral shedding in MERS patients during MERS-CoV outbreak in South Korea. Clin Infect Dis. 2016;62:755–60. DOIPubMedGoogle Scholar
- Bialek SR, Allen D, Alvarado-Ramy F, Arthur R, Balajee A, Bell D, First confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the United States, updated information on the epidemiology of MERS-CoV infection, and guidance for the public, clinicians, and public health authorities—May 2014. MMWR Morb Mortal Wkly Rep. 2014;63:431–6 .PubMedGoogle Scholar
- Kapoor M, Pringle K, Kumar A, Dearth S, Liu L, Lovchik J, Clinical and laboratory findings of the first imported case of Middle East respiratory syndrome coronavirus to the United States. Clin Infect Dis. 2014;59:1511–8. DOIPubMedGoogle Scholar
- World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV)—Republic of Korea. 2015 Jul 21 [cited 2016 Jan 5]. http://www.who.int/csr/don/21-july-2015-mers-korea/en/
- World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV)—China. 2015 May 30 [cited 2015 Dec 21]. http://www.who.int/csr/don/30-may-2015-mers-china/en/
- National Institutes of Health. Middle East respiratory syndrome coronavirus (MERS-CoV) research: current status and future priorities. 2013 Jun 24 [cited 2015 Dec 1]. http://www.niaid.nih.gov/about/organization/dmid/documents/mers-covmeeting.pdf
- National Academies of Sciences, Engineering, and Medicine. 2016. Rapid medical countermeasure response to infectious diseases: enabling sustainable capabilities through ongoing public and private-sector partnerships. Workshop summary [cited 2016 Mar 17]. http://www.nap.edu/read/21809/chapter/1
- Zhao J, Li K, Wohlford-Lenane C, Agnihothram SS, Fett C, Zhao J, Rapid generation of a mouse model for Middle East respiratory syndrome. Proc Natl Acad Sci U S A. 2014;111:4970–5. DOIPubMedGoogle Scholar
- Agrawal AS, Garron T, Tao X, Peng B-H, Wakamiya M, Chan T-S, Generation of transgenic mouse model of Middle East respiratory syndrome-coronavirus infection and disease. J Virol. 2015 Jan 14;JVI.03427–14. PubMedGoogle Scholar
- Pascal KE, Coleman CM, Mujica AO, Kamat V, Badithe A, Fairhurst J, Pre- and postexposure efficacy of fully human antibodies against spike protein in a novel humanized mouse model of MERS-CoV infection. Proc Natl Acad Sci U S A. 2015;213:8738–43 http://dx.doi.org10.1073/pnas.1510830112. DOIPubMedGoogle Scholar
- Houser KV, Gretebeck L, Ying T, Wang Y, Vogel L, Lamirande EW, Prophylaxis with a Middle East respiratory syndrome coronavirus (MERS-CoV)–specific human monoclonal antibody protects rabbits from MERS-CoV infection. J Infect Dis. Epub 2016 Mar 3.
- de Wit E, Rasmussen AL, Falzarano D, Bushmaker T, Feldmann F, Brining DL, Middle East respiratory syndrome coronavirus (MERS-CoV) causes transient lower respiratory tract infection in rhesus macaques. Proc Natl Acad Sci U S A. 2013;110:16598–603 . DOIPubMedGoogle Scholar
- Falzarano D, de Wit E, Feldmann F, Rasmussen AL, Okumura A, Peng X, Infection with MERS-CoV causes lethal pneumonia in the common marmoset. PLoS Pathog. 2014;10:e1004250. DOIPubMedGoogle Scholar
- Adney DR, van Doremalen N, Brown VR, Bushmaker T, Scott D, de Wit E, Replication and shedding of MERS-CoV in upper respiratory tract of inoculated dromedary camels. Emerg Infect Dis. 2014;20:1999–2005 . DOIPubMedGoogle Scholar
- Gretebeck LM, Subbarao K. Animal models for SARS and MERS coronaviruses. Curr Opin Virol. 2015;13:123–9.
- Baseler L, de Wit E, Feldmann H. A comparative review of animal models of Middle East respiratory syndrome coronavirus infection. Vet Pathol. Epub 2016 Feb 11. PubMedGoogle Scholar
- Pascal KE, Coleman CM, Mujica AO, Kamat V, Badithe A, Fairhurst J, Pre- and postexposure efficacy of fully human antibodies against spike protein in a novel humanized mouse model of MERS-CoV infection. Proc Natl Acad Sci U S A. 2015;112:8738–43. DOIPubMedGoogle Scholar
- van Doremalen N, Munster VJ. Animal models of Middle East respiratory syndrome coronavirus infection. Antiviral Res. 2015;22:28–38. Epub 2015 Jul 16. DOIPubMedGoogle Scholar
- Chan JFW, Yao Y, Yeung ML, Deng W, Bao L, Jia L, Treatment with lopinavir/ritonavir or interferon-β1b improves outcome of MERS-CoV infection in a non-human primate model of common marmoset. J Infect Dis. 2015;212:1904–13. DOIPubMedGoogle Scholar
- Johnson RF, Via LE, Kumar MR, Cornish JP, Yellayi S, Huzella L, Intratracheal exposure of common marmosets to MERS-CoV Jordan-n3/2012 or MERS-CoV EMC/2012 isolates does not result in lethal disease. Virology. 2015;485:422–30. DOIPubMedGoogle Scholar
- Adney D, Bielefeldt-Ohmann H, Hartwig A, Bowen RA. Infection, replication, and transmission of Middle East respiratory syndrome coronavirus in alpacas. Emerg Infect Dis. 2016 Jun. Epub 2016 Mar 4.
- Crameri G, Durr PA, Klein R, Foord A, Yu M, Riddell S. Experimental infection and response to rechallenge of alpacas with Middle East respiratory syndrome coronavirus. Emerg Infect Dis. 2016 Jun. Epub 2016 Mar 7.
- Reusken CBEM, Schilp C, Raj VS, De Bruin E, Kohl RHG, Farag EABA, MERS-CoV infection of alpaca in a region where MERS-CoV is endemic [letter]. Emerg Infect Dis. 2016 Jun. Epub 2016 Feb 16.
- Song JY, Cheong HJ, Choi MJ, Jeon JH, Kang SH, Jeong EJ, Viral shedding and environmental cleaning in Middle East respiratory syndrome coronavirus infection. Infect Chemother. 2015;47:252–5.
- Memish ZA, Assiri AM, Al-Tawfiq JA. Middle East respiratory syndrome coronavirus (MERS-CoV) viral shedding in the respiratory tract: an observational analysis with infection control implications. Int J Infect Dis. 2014;29:307–8. DOIPubMedGoogle Scholar
- Office of the Commissioner. MCM Legal, Regulatory and Policy Framework—Emergency Use Authorization; Middle East respiratory syndrome coronavirus (MERS-VoV) EUS information [cited 2015 Oct 1]. http://www.fda.gov/EmergencyPreparedness/Counterterrorism/MedicalCountermeasures/MCMLegalRegulatoryandPolicyFramework/ucm182568.htm#MERS
- Corman VM, Müller MA, Costabel U, Timm J, Binger T, Meyer B, Assays for laboratory confirmation of novel human coronavirus (hCoV-EMC) infections. Euro Surveill. 2012;17:20334.PubMedGoogle Scholar
- Pas SD, Patel P, Reusken C, Domingo C, Corman VM, Drosten C, First international external quality assessment of molecular diagnostics for Mers-CoV. J Clin Virol. 2015;69:81–5 and. DOIPubMedGoogle Scholar
- de Wilde AH, Jochmans D, Posthuma CC, Zevenhoven-Dobbe JC, van Nieuwkoop S, Bestebroer TM, Screening of an FDA-approved compound library identifies four small-molecule inhibitors of Middle East respiratory syndrome coronavirus replication in cell culture. Antimicrob Agents Chemother. 2014;58:4875–84. Epub 2014 May 19. DOIPubMedGoogle Scholar
- Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J, Repurposing of clinically developed drugs for treatment of Middle East respiratory syndrome coronavirus infection. Antimicrob Agents Chemother. 2014;58:4885–93. DOIPubMedGoogle Scholar
- Falzarano D, de Wit E, Rasmussen AL, Feldmann F, Okumura A, Scott DP, Treatment with interferon-α2b and ribavirin improves outcome in MERS-CoV–infected rhesus macaques. Nat Med. 2013;19:1313–7 . DOIPubMedGoogle Scholar
- Al-Tawfiq JA, Momattin H, Dib J, Memish ZA. Ribavirin and interferon therapy in patients infected with the Middle East respiratory syndrome coronavirus: an observational study. Int J Infect Dis. 2014;20:42–6. DOIPubMedGoogle Scholar
- Omrani AS, Saad MM, Baig K, Bahloul A, Abdul-Matin M, Alaidaroos AY, Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study. Lancet Infect Dis. 2014;14:1090–5. DOIPubMedGoogle Scholar
- European Medicines Agency. Public summary of opinion on orphan designation. Interferon alfa-n3 for the treatment of Middle East respiratory syndrome. 5 Jan 2016 [cited 2016 Mar 17]. http://www.ema.europa.eu/docs/en_GB/document_library/Orphan_designation/2016/01/WC500199406.pdf
- Stockman LJ, Bellamy R, Garner P. SARS: Systematic review of treatment effects. PLoS Med. 2006;3:e343. DOIPubMedGoogle Scholar
- Warren TK, Wells J, Panchal RG, Stuthman KS, Garza NL, Van Tongeren SA, Protection against filovirus diseases by a novel broad-spectrum nucleoside analogue BCX4430. Nature. 2014;508:402–5. DOIPubMedGoogle Scholar
- Adedeji AO, Singh K, Kassim A, Coleman CM, Elliott R, Weiss SR, Evaluation of SSYA10–001 as a replication inhibitor of SARS, MHV and MERS coronaviruses. Antimicrob Agents Chemother. Epub 2014 May 19 [cited 2014 May 22]. http://aac.asm.org/cgi/doi/10.1128/AAC.02994-14
- Wycoff K, Maclean J, Belle A, Yu L, Tran Y, Roy C, Anti-infective immunoadhesins from plants. Plant Biotechnol J. 2015;13:1078–93. DOIPubMedGoogle Scholar
- Channappanavar R, Lu L, Xia S, Du L, Meyerholz DK, Perlman S, Protective effect of intranasal regimens containing peptidic Middle East respiratory syndrome coronavirus fusion inhibitor against MERS-CoV infection. J Infect Dis. 2015;212:1894–903. DOIGoogle Scholar
- Kilianski A, Mielech AM, Deng X, Baker SC. Assessing activity and inhibition of Middle East respiratory syndrome coronavirus papain-like and 3C-like proteases using luciferase-based biosensors. J Virol. 2013;87:11955–62. DOIPubMedGoogle Scholar
- ClinicalTrials.gov. Anti–MERS-COV convalescent plasma therapy [cited 2015 Aug 11]. https://clinicaltrials.gov/ct2/show/NCT02190799
- Shultz D. Cows with human chromosomes enlisted to fight hantavirus. Science. Epub 2014 Nov 25 [cited 2015 Aug 11. http://news.sciencemag.org/biology/2014/11/cows-human-chromosomes-enlisted-fight-hantavirus
- Ying T, Du L, Ju TW, Prabakaran P, Lau CCY, Lu L, Exceptionally potent neutralization of Middle East respiratory syndrome coronavirus by human monoclonal antibodies. J Virol. 2014;88:7798–806. DOIPubMedGoogle Scholar
- Jiang L, Wang N, Zuo T, Shi X, Poon KMV, Wu Y, Potent neutralization of MERS-CoV by human neutralizing monoclonal antibodies to the viral spike glycoprotein. Sci Transl Med. 2014;6:234ra59. PubMedGoogle Scholar
- Tang XC, Agnihothram SS, Jiao Y, Stanhope J, Graham RL, Peterson EC, Identification of human neutralizing antibodies against MERS-CoV and their role in virus adaptive evolution. Proc Natl Acad Sci U S A. 2014;111:E2018–26. DOIPubMedGoogle Scholar
- Du L, Zhao G, Yang Y, Qiu H, Wang L, Kou Z, A conformation-dependent neutralizing monoclonal antibody specifically targeting receptor-binding domain in MERS-CoV spike protein. J Virol. 2014;88:7045–53. DOIPubMedGoogle Scholar
- Ohnuma K, Haagmans BL, Hatano R, Raj VS, Mou H, Iwata S, Inhibition of Middle East respiratory syndrome coronavirus infection by anti-CD26 monoclonal antibody. J Virol. 2013;87:13892–9. DOIPubMedGoogle Scholar
- Corti D, Zhao J, Pedotti M, Simonelli L, Agnihothram S, Fett C, Prophylactic and postexposure efficacy of a potent human monoclonal antibody against MERS coronavirus. Proc Natl Acad Sci U S A. 2015;112:10473–8. DOIPubMedGoogle Scholar
- Zumla A, Chan JFW, Azhar EI, Hui DSC, Yuen KY. Coronaviruses—drug discovery and therapeutic options. Nat Rev Drug Discov. Epub 2016 Feb 12.
- Johnson RF, Bagci U, Keith L, Tang X, Mollura DJ, Zeitlin L, 3B11-N, a monoclonal antibody against MERS-CoV, reduces lung pathology in rhesus monkeys following intratracheal inoculation of MERS-CoV Jordan-n3/2012. Virology. 2016;490:49–58.PubMedGoogle Scholar
- Ying T, Li H, Lu L, Dimitrov DS, Jiang S. Development of human neutralizing monoclonal antibodies for prevention and therapy of MERS-CoV infections. Microbes Infect. 2015;17:142–8. DOIPubMedGoogle Scholar
- Luke T, Wu H, Zhao J, Channappanavar R, Coleman CM, Jiao JA, Human polyclonal immunoglobulin G from transchromosomic bovines inhibits MERS-CoV in vivo. Sci Transl Med. 2016;8:326. DOIPubMedGoogle Scholar
- Arabi YM, Arifi AA, Balkhy HH, Najm H, Aldawood AS, Ghabashi A, Clinical course and outcomes of critically ill patients with Middle East respiratory syndrome coronavirus infection. Ann Intern Med. 2014;160:389–97 . DOIPubMedGoogle Scholar
- Wang L, Shi W, Joyce MG, Modjarrad K, Zhang Y, Leung K, Evaluation of candidate vaccine approaches for MERS-CoV. Nat Commun. 2015;6:7712.
- Muthumani K, Falzarano D, Reuschel EL, Tingey C, Flingai S, Villarreal DO, A synthetic consensus anti-spike protein DNA vaccine induces protective immunity against Middle East respiratory syndrome coronavirus in nonhuman primates. Sci Transl Med. 2015;7:301ra132. PubMedGoogle Scholar
- Clinical Trials.gov. Phase I, open label dose ranging safety study of GLS-5300 in healthy volunteers [cited 2016 Mar 17]. https://clinicaltrials.gov/ct2/show/NCT02670187?term=mers-cov&rank=7
- Greffex, Inc. MERS [cited 2015 Oct 1]. http://www.greffex.com/vaccines/mers/
- Song F, Fux R, Provacia LB, Volz A, Eickmann M, Becker S, Middle East respiratory syndrome coronavirus spike protein delivered by modified vaccinia virus Ankara efficiently induces virus-neutralizing antibodies. J Virol. 2013;87:11950–4. DOIPubMedGoogle Scholar
- Volz A, Kupke A, Song F, Jany S, Fux R, Shams-Eldin H, Protective efficacy of recombinant modified vaccinia virus Ankara delivering Middle East respiratory syndrome coronavirus spike glycoprotein. J Virol. 2015;89:8651–6. DOIPubMedGoogle Scholar
- Wang L, Shi W, Joyce MG, Modjarrad K, Zhang Y, Leung K, Evaluation of candidate vaccine approaches for MERS-CoV. Nat Commun. 2015;6:7712.
- Almazan F, DeDiego ML, Sola I, Zuniga S, Nieto-Torres JL, Marquez-Jurado S, Engineering a replication-competent, propagation-defective Middle East respiratory syndrome coronavirus as a vaccine candidate. mBiol 2013;4:e00650-13. PubMedGoogle Scholar
- Zhang N, Channappanavar R, Ma C, Wang L, Tang J, Garron T, Identification of an ideal adjuvant for receptor-binding domain-based subunit vaccines against Middle East respiratory syndrome coronavirus. Cell Mol Immunol. 2016;13:180–90. DOIPubMedGoogle Scholar
- Agnihothram S, Gopal R, Yount BL, Donaldson EF, Menachery VD, Graham RL, Evaluation of serologic and antigenic relationships between Middle Eastern respiratory syndrome coronavirus and other coronaviruses to develop vaccine platforms for the rapid response to emerging coronaviruses. J Infect Dis. 2014;209:995–1006. DOIPubMedGoogle Scholar
- Tseng CT, Sbrana E, Iwata-Yoshikawa N, Newman PC, Garron T, Atmar RL, Immunization with SARS coronavirus vaccines leads to pulmonary immunopathology on challenge with the SARS virus. PLoS ONE. 2012;7:e35421. DOIPubMedGoogle Scholar
- Dodge J. Camels emit dangerous MERS virus, CSU confirms. November 2014 [cited 2015 Oct 2]. http://source.colostate.edu/camels-emit-mers/
- Kupferschmidt K. MERS surges again, but pandemic jitters ease. Science. 2015;347:1296–7. DOIPubMedGoogle Scholar
- Kim E, Okada K, Kenniston T, Raj VS, AlHajri MM, Farag EA, Immunogenicity of an adenoviral-based Middle East respiratory syndrome coronavirus vaccine in BALB/c mice. Vaccine. 2014;32:5975–82. DOIPubMedGoogle Scholar
- Khalafalla AI, Lu X, Al-Mubarak AIA, Dalab AHS, Al-Busadah KAS, Erdman DD. MERS-CoV in upper respiratory tract and lungs of dromedary camels, Saudi Arabia, 2013–2014. Emerg Infect Dis. 2015;21:1153–8. DOIPubMedGoogle Scholar
- Hemida MG, Chu DKW, Poon LLM, Perera RAPM, Alhammadi MA, Ng H, MERS coronavirus in dromedary camel herd, Saudi Arabia. Emerg Infect Dis. 2014;20:1231–4. DOIPubMedGoogle Scholar
- Farag EA, Reusken CB, Haagmans BL, Mohran KA, Raj V, Pas SD, High proportion of MERS-CoV shedding dromedaries at slaughterhouse with a potential epidemiological link to human cases, Qatar 2014. Infect Ecol Epidemiol. 2015;5:28305. PubMedGoogle Scholar
- Haagmans BL, van den Brand JMA, Raj VS, Volz A, Wohlsein P, Smits SL, An orthopoxvirus-based vaccine reduces virus excretion after MERS-CoV infection in dromedary camels. Science. 2016;351:77–81. DOIPubMedGoogle Scholar
- Food and Drug Administration. Guidances (Drugs) [cited 2015 Aug 11]. http://www.fda.gov/Drugs/GuidancecomplianceRegulatoryInformation/Guidances/default.htm
- Saad M, Omrani AS, Baig K, Bahloul A, Elzein F, Matin MA, Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis. 2014;29:301–6. DOIPubMedGoogle Scholar
- Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013;13:752–61. DOIPubMedGoogle Scholar
- Ng DL, Al Hosani F, Keating MK, Gerber SI, Jones TL, Metcalfe MG, Clinicopathologic, immunohistochemical, and ultrastructural findings of a fatal case of Middle East respiratory syndrome coronavirus infection in United Arab Emirates, April 2014. Am J Pathol. 2016;186:652–8. Epub 2016 Feb 5. DOIPubMedGoogle Scholar
- Chu H, Zhou J, Wong BHY, Li C, Chan JFW, Cheng ZS, Middle East respiratory syndrome coronavirus efficiently infects human primary T lymphocytes and activates the extrinsic and intrinsic apoptosis pathways. J Infect Dis. 2016;904–14. http:DOIGoogle Scholar
- International Severe Acute Respiratory and Emerging Infection Consortium. Severe acute respiratory infection data tools [cited 2015 Aug 11]. https://isaric.tghn.org/protocols/severe-acute-respiratory-infection-data-tools/
- Dunning JW, Merson L, Rohde GGU, Gao Z, Semple MG, Tran D, Open source clinical science for emerging infections. Lancet Infect Dis. 2014;14:8–9 and.PubMedGoogle Scholar
- World Health Organization. Clinical management of severe acute respiratory infection when Middle East respiratory syndrome coronavirus (MERS-CoV) infection is suspected. Interim guidance. Updated 2 July 2015 [cited 2015 Aug 11]. http://apps.who.int/iris/bitstream/10665/178529/1/WHO_MERS_Clinical_15.1_eng.pdf
- Meyer B, Juhasz J, Barua R, Das Gupta A, Hakimuddin F, Corman VM, Time course of MERS-CoV infection and immunity in dromedary camels. Emerg Infect Dis. 2016 Dec [cited 2016 June 3]. http://dx.doi.org/10.3201/eid2212.160382
1These authors contributed equally to this article.
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