MERS-CoV infections present with a high case-fatality ratio, multiple transmission routes are suspected, cases are reported among healthcare workers, multiple disease foci are affecting SA, and cases have been exported. All these facts are criteria for considering declaring a public health event of international concern listed in annex II of the WHO international health regulations [18]. Two years and 345 cases after the start of this epidemic, we remain with many unanswered questions and lack serological studies and sequences from human cases.