MERS-CoV Italian case linked to Jordan

The Italian Ministry of Health has reported a case of an Italian national who had visited Jordan being confirmed with MERS-CoV on his return to Italy. This is striking because since the earliest known cases of MERS-CoV in Jordan in April 2012, no other cases have been reported there. I think this probably makes this an interesting test of whether the virus has moved to sustained transmission in humans in the Arabian Peninsula or represents repeated self-limiting chains of transmission after jumps from a reservoir host. The most recent sequences from 2013 - England2 (likely infected in KSA) and Munich/AbuDhabi group together with the September sequence England1/Qatar (see http://epidemic.bio.ed.ac.uk/coronavirus_analysis for details). If the new Italy/Jordan case was sequenced and grouped with the Jordan-N3 sequence from April last year or was even more divergent, then this would make a stronger case for a geographically structured reservoir population. If it groups in the clade with the 2013 sequences then this would be some evidence that the virus has made a jump towards sustained human-to-human transmission.

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