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Jamal Ahmadzadeh, Kazhal MobarakiSocial Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, IranCorrespondence: Kazhal MobarakiEpidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences, Resalat Street, Urmia, IranTel +98 918 173 2869Fax +98 443 224 0642Email Mobaraki.k@umsu.ac.irPurpose: This study represents the current epidemiological status of Middle East respiratory syndrome coronavirus (MERS-CoV) worldwide in the first three months of 2019.Patients and methods: Full details of the MERS-CoV cases available and published in the disease outbreak news on the WHO website were retrieved. Related details of laboratory-confirmed MERS-CoV were extracted and analyzed by standard statistical methods.Results: A total of 107 cases of MERS-CoV, including 18 deaths (overall case fatality rate (CFR), 16.8%; male-specific CFR was 17.5% [14/80] and female-specific CFR was 14.8% [4/27]) were reported to WHO from the National International Health Regulation Focal Points of Saudi Arabia and Oman. The overall mean age was 50±17 years and 80 patients (74.8%) were male. The average time from the onset of the symptoms to the first hospitalization was 3±3.3 days; from the first hospitalization to laboratory confirmation was 3.6±6.5 days; from the onset of symptom to death was 17.5±11.7 days; and the mean length of hospitalization forpatients with MERS-CoV was 3.5±3.9 days. Males in comparison to females had a 1.5-fold increased chance (adjusted OR =1.5 [95% CI: 1.3–1.8]) of death related to MERS-CoV infection; 1.05 [95% CI: 1.1–3.3], 1.05 [95% CI: 1.2–2.8] and 1.06 [95% CI: 1.2–2.0] for those who had exposure to camels, camel milk consumption, and close contact with MERS-CoV cases, respectively. Health care workers had 2.4 fold [95% CI: 1.2–3.1] greater odds of death compared to other people.Conclusion: The knowledge obtained from this study can contribute to the development of a prevention program and early system warning against MERS-CoV infection.Keywords: Middle East respiratory syndrome coronavirus, emerging infectious disease, disease outbreaks

Maryam Salamatbakhsh,1 Kazhal Mobaraki,2 Jamal Ahmadzadeh2 1Critical Care Nursing, Urmia University of Medical Sciences, Urmia, Iran; 2Epidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, IranCorrespondence: Jamal AhmadzadehEpidemiologist in Social Determinants of Health Research Center, Urmia University of Medical Sciences, Resalat Street, Urmia, IranTel +98-9143444924Fax +98-4432240642Email ahmadzadeh.j@umsu.ac.irAbstract: This commentary presents a novel outlook for public health authorities in the affected countries to detect and respond quickly to the emerging public health threats such as Middle East respiratory syndrome coronavirus (MERS-CoV). Implementing an innovative electronic surveillance system called syndromic surveillance system is essential for global health security.Keywords: syndromic surveillance system, traditional surveillance system, Middle East respiratory syndrome