Global Genomic Surveillance of Middle East Respiratory Syndrome Coronavirus.

Middle East respiratory syndrome coronavirus (MERS-CoV) is a persistent zoonotic and epidemic threat. We analyzed 807 publicly available human- and camel-derived MERS-CoV genomes collected during 2012-2024 to assess global genomic surveillance. Most sequences originated from Saudi Arabia and the United Arab Emirates. Major gaps in surveillance persist across Africa and South and Central Asia despite large camel populations, active trade, and evidence of viral circulation. Phylogenetic analysis confirmed predominance of clade B in the Arabian Peninsula and clade C in East Africa, consistent with regional patterns. We identified uneven sampling, incomplete metadata, and long delays between sample collection and public sequence submission, often spanning years. Those limitations reduce the value of genomic data for timely situational awareness. Integrating genomic with population and trade data supports timelier, more representative, and coordinated One Health surveillance for MERS-CoV but reveals major blind spots.