Since 2012, at least 1,500 individuals have developed Middle East respiratory syndrome (MERS), resulting in more than 500 fatalities. Only now are results being reported of the first autopsy of a MERS patient, which was performed in 2014.

The autopsy showed that the lungs were the main target organs of MERS, with diffuse damage to the alveoli observed. Using immunohistochemistry, the researchers identified anti-MERS antibodies in specific cells in the lungs (pneumocytes and epithelial syncytial cells) and bronchial submucosal glands.

“Infection of bronchial submucosal glands is a likely source of viral shedding in respiratory secretions leading to human-to-human transmission,” explained lead investigator Sherif R. Zaki, MD, PhD, Chief of the Infectious Diseases Pathology Branch at the CDC in Atlanta.

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