SUMMARY / RELATED TOPICS

Christian Hochstätter

Christian Hochstätter is a retired German football player. He is a nephew of Helmut Haller, he appeared in more than 330 German top-flight matches. Hochstätter played in two friendlies for West Germany in December 1987 – against Brazil and Argentina. After his playing career he was director of football for Borussia Mönchengladbach from 1999 to 2005 and for Hannover 96 from 2006 to 2009. In June 2013, Hochstätter was hired as sports director at VfL Bochum. DFB-Pokal winner: 1994–95 DFB-Pokal finalist: 1983–84, 1991–92 Christian Hochstätter at WorldFootball.net Christian Hochstätter at fussballdaten.de Christian Hochstätter at National-Football-Teams.com

Middle East respiratory syndrome-related coronavirus

Middle East respiratory syndrome-related coronavirus, or EMC/2012, is a species of coronavirus which infects humans and camels. The infecting virus is an enveloped, positive-sense, single-stranded RNA virus which enters its host cell by binding to the DPP4 receptor; the species is a member of the genus Betacoronavirus and subgenus Merbecovirus. Called 2012 novel coronavirus or novel coronavirus, it was first reported in 2012 after genome sequencing of a virus isolated from sputum samples from a person who fell ill in a 2012 outbreak of a new flu; as of July 2015, MERS-CoV cases have been reported in over 21 countries, including Saudi Arabia, Qatar, the United Arab Emirates, Turkey, Algeria, Indonesia, the United Kingdom, South Korea, the United States, Mainland China and the Philippines. MERS-CoV is one of several viruses identified by WHO as a cause of a future epidemic, they list it for urgent development. The virus MERS-CoV is a new member of the beta group of coronavirus, lineage C. MERS-CoV genomes are phylogenetically classified into two clades, clade A and B.

The earliest cases of MERS were of clade A clusters, new cases are genetically distinct. MERS-CoV is distinct from SARS coronavirus and distinct from the common-cold coronavirus and known endemic human betacoronaviruses HCoV-OC43 and HCoV-HKU1; until 23 May 2013, MERS-CoV had been referred to as a SARS-like virus, or the novel coronavirus, earlier it was referred to colloquially on messageboards as the "Saudi SARS". Over 2,000 cases of MERS have been reported by 2017 with about 600 deaths, so the case fatality rate is >30%. 182 genomes have been sequenced by 2015. All sequences are >99% similar. The genomes can be divided into two clades - A and B - with the majority of cases being caused by clade B. Human and camel strains are intermixed suggesting multiple transmission events; the first confirmed case was reported in Saudi Arabia in 2012. Egyptian virologist Dr. Ali Mohamed Zaki isolated and identified a unknown coronavirus from the man's lungs. Dr. Zaki posted his findings on 24 September 2012 on ProMED-mail.

The isolated cells showed cytopathic effects, in the form of syncytia formation. A second case was found in September 2012, a 49-year-old male living in Qatar presented with similar flu symptoms, a sequence of the virus was nearly identical to that of the first case. In November 2012, similar cases appeared in Saudi Arabia. Additional cases were noted, with deaths associated, rapid research and monitoring of this novel coronavirus began, it is not certain whether the infections are the result of a single zoonotic event with subsequent human-to-human transmission, or if the multiple geographic sites of infection represent multiple zoonotic events from an unknown common source. A study by Ziad Memish of Riyadh University and colleagues suggests that the virus arose sometime between July 2007 and June 2012, with as many as 7 separate zoonotic transmissions. Among animal reservoirs, CoV has a large genetic diversity yet the samples from patients suggest a similar genome, therefore common source, though the data are limited.

It has been determined through molecular clock analysis, that viruses from the EMC/2012 and England/Qatar/2012 date to early 2011 suggesting that these cases are descended from a single zoonotic event. It would appear the MERS-CoV has been circulating in the human population for greater than one year without detection and suggests independent transmission from an unknown source. In humans, the virus has a strong tropism for nonciliated bronchial epithelial cells, it has been shown to evade the innate immune responses and antagonize interferon production in these cells; this tropism is unique in. Due to the clinical similarity between MERS-CoV and SARS-CoV, it was proposed that they may use the same cellular receptor. However, it was discovered that neutralization of ACE2 by recombinant antibodies does not prevent MERS-CoV infection. Further research identified dipeptidyl peptidase 4 as a functional cellular receptor for MERS-CoV. Unlike other known coronavirus receptors, the enzymatic activity of DPP4 is not required for infection.

As would be expected, the amino acid sequence of DPP4 is conserved across species and is expressed in the human bronchial epithelium and kidneys. Bat DPP4 genes appear to have been subject to a high degree of adaptive evolution as a response to coronavirus infections, so the lineage leading to MERS-CoV may have circulated in bat populations for a long period of time before being transmitted to people. On 13 February 2013, the World Health Organization stated "the risk of sustained person-to-person transmission appears to be low." The cells MERS-CoV infects in the lungs only account for 20% of respiratory epithelial cells, so a large number of virions are needed to be inhaled to cause infection. Dr. Anthony S. Fauci of the National Institutes of Health in Bethesda, stated that as of now MERS-CoV "does not spread in a sustained person to person way at all." Dr. Fauci stated that there is potential danger in that it is possible for the virus to mutate into a strain that does transmit from person to person.

However, the infection of healthcare workers has led to concerns of human to human transmission. The Centers for Disease Control and Prevention list MERS as transmissible from human-to-human. From their FAQ, in answe