1. MERS-CoV: example of family cluster Republic of Lebanon Ministry of Public Health Epidemiological Surveillance Program May 2014

2. Source Family Cluster of Middle East Respiratory Syndrome Coronavirus Infections Z. Memish, A. Zumla, R. F. Al-Hakeem, A. A. Al- Rabeeah, and G. M. Stephens n engl j med 368;26 nejm.org june 27, 2013

3. Summary Description of a family cluster of MERS-CoV infection: three young men who became ill with MERS-CoV infection after the hospitalization of an elderly male relative, who died of the disease. Twenty-four other family members living in the same household and 124 attending staff members at the hospitals did not become ill. MERS-CoV infection may cause a spectrum of clinical illness.

4. Patient 1

5. Patient 2 Source: Family Cluster of Middle East Respiratory Syndrome Coronavirus Infections. Ziad A. Memish, M.D., Alimuddin I. Zumla, M.D., Ph.D., Rafat F. Al-Hakeem, M.D., Abdullah A. Al-Rabeeah, M.D., and Gwen M. Stephens. n engl j med 368;26 nejm.org june 27, 2013

6. Patient 3

7. Patient 4

8. Family level of contact

9. Chain of transmission Patient 1 Patient 3 Patient 2Patient 4