Persistence of Antibodies Against MERS Coronavirus

In This Article

Abstract and Introduction

Abstract

To determine how long antibodies against Middle East respiratory syndrome coronavirus persist, we measured long-term antibody responses among persons serologically positive or indeterminate after a 2012 outbreak in Jordan. Antibodies, including neutralizing antibodies, were detectable in 6 (86%) of 7 persons for at least 34 months after the outbreak.

Introduction

Middle East respiratory syndrome coronavirus (MERS-CoV) causes acute respiratory illness, which can progress rapidly to respiratory failure and death in ≈40% of persons with laboratory-confirmed cases. The first known cases of MERS-CoV occurred during an outbreak of severe acute respiratory infections in Zarqa, Jordan, during March–April 2012.^[1] New cases and clusters of MERS-CoV infections continue to occur within the Arabian Peninsula, and the virus has been exported to other countries around the world.

For 2 persons affected by the April 2012 outbreak, the cause of death remained unknown until late 2012, when retained samples produced positive MERS-CoV results according to reverse transcription PCR. In May 2013, we obtained serologic and epidemiologic data from 124 persons: the 2012 outbreak survivors, their exposed contacts, and their household members. In that investigation, we found another 7 persons with positive MERS-CoV results according to ELISA and confirmatory results by immunofluorescence assay (IFA), microneutralization assay, or both.^[1] Results were indeterminate for another 8 exposed persons, whose results were positive by only 1 of these serologic methods; these 8 persons were deemed MERS test–negative overall.

For patients with severe acute respiratory syndrome coronavirus (SARS-CoV) infection, antibodies persist for at least 2 years after symptomatic infection.^[2] Recently, antibodies against MERS-CoV were found (by ELISA and IFA) in 9 healthcare workers in Saudi Arabia with symptomatic MERS-CoV infection at least 18 months after infection.^[3] Duration of antibody responses beyond 18 months has not been reported.^[4] Our objective was to evaluate long-term antibody responses among persons with laboratory-confirmed to MERS-CoV infection.

Table. Characteristics of Middle East respiratory syndrome patients and antibody titers at 13 and 34 months after 2012 outbreak, Jordan*
Patient no.	Age, y/sex	Underlying condition	Intensive care	Days hospitalized	Chest radiograph†	13-mo titer‡			34-mo titer‡
Patient no.	Age, y/sex	Underlying condition	Intensive care	Days hospitalized	Chest radiograph†	ELISA	IFA	MN	ELISA	IFA	MN
02	31/M	Atrial septal defect	Yes	16	Right lobar pneumonia	>6,400	Pos	160	1,600	Pos	80
03§	60/M	Hypertension	NA	NA	Bilateral consolidation; pneumonia	400	Pos	20	<400	Ind	20
04	35/M	Hypertension	Yes	8	Bilateral lobar pneumonia	>6,400	Pos	80	400	Pos	40
06	46/M	None reported	No	6	Right bronchial congestion with bronchovascular markings	1,600	Pos	20	1,600	Pos	20
09	45/M	None reported	No	10	Left consolidation; right infiltrate	400	Pos	40	<400	Neg	40
11¶	41/F	None reported	No	4	ND	1,600	Pos	<20	400	Neg	<20
HH303§	39/F	Pregnant	NA	NA	NA	1,600	Pos	80	400	Pos	80

*IFA, immunofluorescence assay; Ind, indeterminate; MN, microneutralization assay; NA, not applicable; ND, not documented; neg, negative; pos, positive.
†Taken within 3 days of presentation.
‡Antibodies against Middle East respiratory syndrome coronavirus.
§Symptomatic but refused hospitalization.
¶Classified overall as being serologically negative at 34 mo.

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Persistence of Antibodies Against Middle East Respiratory Syndrome Coronavirus

Abstract and Introduction

Abstract

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