Middle East respiratory syndrome

coronavirus (MERS-CoV) Surveillance

and testing in North England from 2012
to 2019 Hamzah Z. Farooqa
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 International Journal of Infectious Diseases 93 (2020) 237–244

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International Journal of Infectious Diseases

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Middle East respiratory syndrome coronavirus (MERS-CoV) —

Surveillance and testing in North England from 2012 to 2019
Hamzah Z. Farooqa,b,c,* , Emma Daviesa,c, Shazaad Ahmada,b,c , Nicholas Machina,c,d ,
Louise Hesketha,c,d, Malcolm Guivera,c,d , Andrew J. Turnera,c,d
a
Department of Virology, Manchester University NHS Foundation Trust, Manchester, United Kingdom
b
Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Manchester, United Kingdom
c
Public Health Laboratory Manchester, Manchester, United Kingdom
d
University of Manchester, Manchester, United Kingdom

A R T I C L E I N F O A B S T R A C T

Article history: Background: Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in Saudi Arabia in 2012
Received 17 October 2019 and caused an epidemic in the Middle East. Public Health England (PHE) Manchester is one of the two
Received in revised form 22 January 2020 PHE centres in the UK that perform testing for MERS-CoV. The results of the PHE Manchester MERS
Accepted 22 January 2020
surveillance from 2012 to 2019 are presented in this report.
Methods: Retrospective data were collected for returning travellers from the Middle East fitting the PHE
Keywords: MERS case definition. Respiratory samples were tested for respiratory viruses and MERS-CoV using an in-
Middle East respiratory syndrome
house RT-PCR assay.
coronavirus
MERS
Results: Four hundred and twenty-six (426) samples from 264 patients were tested for MERS Co-V and
MERS-CoV respiratory viruses. No MERS-CoV infections were identified by PCR. Fifty-six percent of samples were
High consequence infectious disease PCR positive for viral or bacterial pathogen with Influenza A as the predominant virus (44%). Sixty-two
HCID percent of all patients had a pathogen identified with the highest positivity from sputum samples.
Emerging infectious disease Patients with multiple samples demonstrated a 100% diagnostic yield.
EID Conclusions: Although no cases of MERS were identified, the majority of patients had Influenza infection
Public health epidemiological surveillance for which oseltamivir treatment was indicated and isolation warranted. Sputum samples were the most
useful in diagnosing respiratory viruses with a 100% diagnostic yield from patients with multiple
samples.
© 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).

Introduction was termed “Middle Eastern Respiratory Syndrome” (MERS) and

A novel coronavirus, Middle East respiratory syndrome
coronavirus (MERS-CoV) emerged in Saudi Arabia in 2012. The
first case was a Saudi national admitted in June 2012 with
pneumonia and renal failure which resulted in a fatal outcome.
The case was later identified in September 2012 as a novel
betacoronavirus belonging to lineage C (Zaki et al., 2012).
Retrospective testing of samples in the Middle East identified a
further nine cases in Jordan (Hijawi et al., 2013). The disease was
considered a clinical syndrome ranging from asymptomatic cases
to respiratory failure to multisystem organ failure. The syndrome
* Corresponding author at: Department of Virology, Manchester Royal Infirmary,
Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL,
United Kingdom.
E-mail address: H.farooq@nhs.net (H.Z. Farooq).
testing was performed accordingly in the Middle East and for
return travellers from Middle East countries based on epidemio-
logical risk factors.
The second global case of MERS was identified in a Qatari
national who had previously travelled to Saudi Arabia in 2012. He
was transferred from Qatar to a hospital in England where he
clinically deteriorated and was placed on extracorporeal mem-
brane oxygenation (ECMO) however, unfortunately had a fatal
outcome (Bermingham et al., 2012). A second case in the UK was
confirmed in February 2013, in a return traveler from Pakistan and
Saudi Arabia who was admitted with severe acute respiratory
symptoms. This patient required ECMO treatment, however also
unfortunately died. This case resulted in onward transmission to
two further cases, of which one subsequently died (The Health
Protection Agency UK Novel Coronavirus Investigation team C,
2013). In August 2018, a fifth case of MERS was diagnosed in a
return traveler from the Middle East. The patient was initially

https://doi.org/10.1016/j.ijid.2020.01.043
1201-9712/© 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
238 H.Z. Farooq et al. / International Journal of Infectious Diseases 93 (2020) 237–244
admitted to a hospital in Leeds and then transferred to a specialist
infectious disease unit in Liverpool. The patient had a positive
outcome and there was no onward transmission of MERS-CoV to
the close contacts (PHE, 2018)
As of the end of November 2019, MERS Co-V has infected 2,494
people with a case fatality rate (CFR) of 37.1% (World Health
Organization W, 2019; (WHO) WHO, 2019) and a notably higher
CFR in ITU settings (Arabi et al., 2014). Nosocomial outbreaks have
occurred in Saudi Arabia and South Korea demonstrating the need
for stringent infection control polices (Park et al., 2015). In view of
the high risk of imported cases, Public Health England (PHE)
commissioned regional centers to perform MERS-CoV testing for
possible MERS cases arriving in England. PHE Manchester
laboratory is one of two centers that currently perform testing
for MERS-CoV. It receives samples from the Greater Manchester
region and surrounding counties of Lancashire, Merseyside,
Cumbria and Cheshire. Additionally it receives samples from other
areas of the North-West region of the United Kingdom which
entails the counties of Yorkshire, Humber and also the counties of
the North-East region.
The Greater Manchester (GM) region has a population of
around 2.5 million people with a black and minority ethnic
population of 33.4% (Manchester City Council M, 2011); some of
whom are more likely to travel to the Middle East for visiting
friends or family, business, religious pilgrimage or tourism. The
GM region also has a Muslim population of 15.8% (Office for
National Statistics O, 2019; Review WP, 2018) which is greater
Figure 1. Greater Manchester MERS pathway.
than the national average in the United Kingdom of 5% (Office for
National Statistics O, 2019). The Muslim population will visit the
Kingdom of Saudi Arabia (KSA) at least once in their lifetime to
the holy cities of Mecca and Medina for the compulsory
pilgrimage of Hajj. Over 2 million pilgrims from 188 countries
attend the Hajj annually, which may result in dissemination of
MERS-CoV or other pathogens to multiple countries, including to
the United Kingdom. Muslims also travel to KSA for Umrah (mini-
pilgrimage) and Ramadan which may increase the possibility of
the spread of MERS.
Manchester has the UK’s third busiest airport (UK Civil Aviation
Authority C, 2017) with around 27.8 million passengers being
processed in 2017. It was specially adapted to accommodate the
Airbus A380 which has a capacity of 853 passengers per flight. As a
result of this, a significant proportion of passengers return from the
Middle East to the Greater Manchester region.
Manchester also hosts the North-West region’s tertiary Infec-
tious Disease unit. The Regional Infectious Diseases Unit (RIDU) at
North Manchester General Hospital accepts direct admissions of
returning travelers with fever and consequently assesses a
multitude of patients for possible MERS-CoV infection. The PHE
Manchester laboratory works closely with RIDU and both provide a
7-day service.
We present a detailed analysis of the results of the surveillance
for MERS-CoV testing at the PHE Manchester laboratory initially
between 2012 to 2013 and then from 1st September 2015 to 1st
February 2019.
 H.Z. Farooq et al. / International Journal of Infectious Diseases 93 (2020) 237–244
Methods
Data collection of patients
Initial testing was carried out in 2012–2013 when the first
MERS-CoV case was identified in the UK. There was pause in testing
from June 2013 to September 2015 when testing was carried out at
PHE Birmingham.
From 1st September 2015 to 1st February 2019, returning
travellers presenting to any hospital in the North West region with
respiratory symptoms from the Middle East were risk assessed for
potential MERS-CoV infection. This risk assessment was performed
utilizing the PHE MERS criteria with a possible case defined as:
1. A person with severe acute respiratory infection requiring
admission to hospital with symptoms of fever (38  C) or history
of fever and evidence of pulmonary parenchymal disease; and at
least one of the following:
 History of travel to, or residence in an area where infection with
MERS-CoV could have been acquired in the 14-days before
symptom onset
 Close contact during the 14-days before onset of illness with a
symptomatic confirmed case of MERS-CoV infection
 Person is a healthcare worker based in ICU caring for patients
with severe acute respiratory infection, regardless of travel or
PPE use
 Part of a cluster of two or more epidemiologically linked cases
within a two-week period requiring ICU admission, regardless of
history of travel
2. Acute influenza-like-illness symptoms (ILI), and contact with
camels, camel environments or consumption of camel products in
the 14-days prior to onset.
3. Acute respiratory illness (ARI) and contact with a confirmed
case of MERS-CoV in the 14 days prior to onset.
Those meeting the PHE case definition were discussed with the
Regional Infectious Diseases team and/or the Consultant Virologist
and then tested for infection ((PHE) PHE, 2018a) (Figure 1).
Figure 2. Number of samples received at PHE Manchester during the study period.
239
The majority of cases were initially discussed with the RIDU
team and then transferred to North Manchester General
Hospital for further assessment in the negative pressure rooms
with appropriate personal protective equipment (PPE) use.
Some local hospital cases were discussed directly with the PHE
Manchester Consultant virologist. In these scenarios, the risk
assessment was directly carried out by the PHE Virologist and
advice on infection control, use of PPE and FFP 3 masks was
given to reduce the chance of nosocomial transmission in case
the test was found to be positive (Figure 1). Local Health
Protection Teams were involved throughout the process from
the time of presentation to the referring hospital until the result
of the testing.
Data were extracted from the laboratory information manage-
ment system (LIMS) into MS Excel. After initial screening, data
were extracted and analysed in SPSS. Utilising SPSS and Tableau
Desktop, the results and figures were produced.
Samples
Respiratory samples were taken by the referring physician from
the patient whilst in PPE. Both Upper Respiratory Tract (URT)
samples (nose and throat swabs or nasopharyngeal aspirates) and
Lower Respiratory Tract (LRT) sample (sputum or Bronchoalveolar
lavage) were submitted. In addition, clotted blood was also
requested and stored for possible serological testing in the future.
Other samples (urine for legionella and pneumococcal antigen,
URT and LRT samples for bacterial culture) were submitted for
investigation of other pathogens. All samples were processed at
the appropriate containment level in accordance with national
guidance. Samples were transported and packed in accordance
with UN3373 (category B, biological substance) regulations (Public
Health England P, 2016).
MERS-CoV and respiratory virus testing
URT and LRT samples were initially tested for MERS Co-V by a
quantitative real time reverse transcription polymerase chain
240 H.Z. Farooq et al. / International Journal of Infectious Diseases 93 (2020) 237–244
reaction (rRT-PCR) from 1st January 2012 to 31st December 2016 in
all PHE centers.
An assay verification of CE marked commercially available testing
kits for MERS-CoV across five PHE laboratories led to selection of the
Altona RealStar MERS RT-PCR Kit for patient testing from January
2017 (Diagnostics A, 2019). All samples were also tested for Influenza
A (Flu A -H1 and H3), Influenza B (Flu B), Respiratory syncytial virus
(RSV), Rhinoviruses, Adenovirus (Adeno), Human Metapneumovirus
(MPV) and Parainfluenza Virus (PF Types 1-3). Testing is performed
using a mixture of triplex (FluA/FluB/RSV, PF1-3), duplex (Adeno/
Rhino) and singleplex (MPV) PCR assays.
Results
Samples
Four hundred and twenty-six samples (426) were received for
two hundred and sixty-four (264) patients who fulfilled the criteria
of MERS Co-V testing under the PHE case definition algorithm
((PHE) PHE, 2018a) (Figure 2). Samples were sent from locations
throughout the North-West of England with the majority sent from
the regional infectious disease unit and from university teaching
hospitals (Supplementary Figures S1 and S2).
Patient demographics
Patient age ranged from 18 weeks to 89 years old. Patient
demographic characteristics are shown in Table 1. Fifty-five
percent of patients were of Asian background with 23% and 19%
of Arab and Caucasian backgrounds, respectively (Supplementary
Figure S3).
Travel history
The travel history as noted on the LIMS system and request
forms showed the majority of patients returned from KSA (102)
and the UAE (Refaey et al., 2017) as demonstrated by Figure 3 and
Supplementary Figure S4.
Results of testing
Of 426 samples, 55% (234) were positive for a viral pathogen.
44% were negative via viral PCR testing and considered of bacterial
origin (Supplementary Figure S5). Of note, 18 samples were
positive for dual viral infections with 1 sample positive for a triple
viral infection (Supplementary Figures S6 and S7).
Sample types and number of samples per patient
The majority of samples sent were nose and throat swabs (179),
sputum samples (120) and throat swabs (60), as demonstrated by
Figure 4.
Sputum samples had the highest positivity rate for viral
pathogens (69.17%) followed by BAL samples (57.14%) as shown by
Supplementary Figure S8.
Patient end-diagnosis positivity for a viral pathogen is 100% when
more than 4 samples are sent. This is in contrast to an end-diagnosis
Table 1
Patient demographics of referred samples to PHE Manchester (2012–2019).
Age 0–16 17–30 31–45
Male 11 22 27
Female 5 12 17
Total 16 (6%) 34 (13%) 44 (17%)
positivity of 51.1% when 1 sample is sent for a patient (Supplemen-
tary Figures S9 and S10).
Total results by patient
Four hundred and twenty-six (426) samples were sent for 264
patients. Hence, if the results were viewed according to patient
numbers, the percentage of total patients with positive microbio-
logical end-diagnoses increases to 62% (Figure 5)
Viral results
Supplementary Figures S11 and S12 demonstrates the number
of positive viral results of patients and the subsequent positive
dual and triple viral infections.
Bacterial results
Of the 10% bacterial aetiology patients, 29% of patients were
positive for Legionella initially via urinary antigen testing and then
confirmed via reference laboratory testing. 15% of total patients
were positive for co-infection with Methicillin Sensitive Staphylo-
coccus aureus (MSSA) and Group G Streptococcus. The rest were
equally divided for Escherichia coli (E.coli), Haemophilus influenza,
PCP and Mycoplasma (Supplementary Figure S13).
Peak testing for MERS-CoV
The dates for Hajj, Umrah and Ramadan fluctuates every year as
the Islamic calendar is lunar based; the dates usually change by 10
days annually (Table 2). Supplementary Figures S10 to 183
demonstrate the testing for MERS-CoV and subsequent results
at PHE Manchester during the period of 2012 to 2013 and then from
2015-2018 demonstrating seasonal variation.
Discussion
During the surveillance period, there were no MERS-CoV
detected at PHE Manchester from travellers returning from the
Middle East. This correlates with PHE Birmingham’s data during a
similar period (Atabani et al., 2016) and the wider global findings
via the WHO and Pro-Med monitoring reports. However, as
discussed previously, in August 2018, a MERS-CoV case was
diagnosed positive by PHE Birmingham highlighting the need for
continued vigilance ((PHE) PHE, 2018b). Of the patients whose
travel history was known (145), the majority travelled to the
Kingdom of Saudi Arabia and the United Arab Emirates.
Unfortunately, 123 patients had no travel history documented
on the databases, demonstrating the need for improving travel
history documentation on clinical laboratory request forms.
Other patients had travelled to various countries in the Middle
East (Supplementary Figure S4).
When analysing the sample type, of note is that the highest
positivity is of sputum samples, followed by BAL. Although the
lowest positivity of samples is of nasopharyngeal aspirates (NPA),
the number of samples was too low for this to be considered
significant as only one NPA sample was received.
46–60 60–75 >75 Total
46 36 19 161 (61%)
31 25 13 103 (39%)
77 (29%) 61 (23%) 32 (12%) 264 (100%)
 H.Z. Farooq et al. / International Journal of Infectious Diseases 93 (2020) 237–244 241

Figure 3. Travel history of patients to PHE Manchester during the study period.

Figure 4. Type of samples sent patients to PHE Manchester during the study period.

Four hundred and twenty-six samples were sent for a total of
264 patients, as some of the referring hospitals sent multiple
samples per patient as advised to ensure a PCR confirmed end-
diagnosis for the patient. Patients with four or more samples sent
had a confirmed end-diagnosis, contrasting with an end-diagnosis
in only half of patients with one sample sent. However, a limitation
in this study is a low number of patients who have had greater than
four samples sent.
Although 56% of all samples were PCR positive for a pathogen, if
the results were viewed according to patient numbers, 62.1% of all
patients had a positive microbiological result. This was due to the
bacterial investigations eliciting a positive diagnosis and higher
pathogen positivity in patients who have had more than two
samples sent. For patient numbers, the most common viral
pathogen for the tested patients was Influenza A followed by
Rhinovirus. Of total patients, 10% were positive for a bacterial
pathogen via PCR testing or culture/antigen results.
During 2015, PHE Manchester received the greatest number for
MERS Co-V testing in October. This correlates with the post Hajj
period (21st to the 26th of September 2015 - Supplementary Figure
S16). During 2016, the greatest number of samples received was
during July (Supplementary Figure S17). This did not correlate with
Hajj (10th–15th September 2016), however, it did correlate with
the post Ramadan period (6th June–5th July 2016) and post
242 H.Z. Farooq et al. / International Journal of Infectious Diseases 93 (2020) 237–244

Figure 5. Patient end-diagnoses of referred samples to PHE Manchester during the study period.

Table 2
do not attend hospital. However, the risk of transmission
Dates of Hajj and Ramadan during PHE Manchester testing periods (2012–2018).
from asymptomatic cases is considered lower than symptomatic
Year Hajj dates Ramadan dates cases, thus there is less of a need to focus on these patients
2012 25th October 2012 20/7/12–19/8/12 from a public health perspective (Moon and Son, 2017).
2013 14th October 2013 9/7/13–8/8/13 Furthermore, attempting to screen every traveller returning
2015 23th September 2015 18/6/15–18/7/15
from a MERS-CoV endemic country would be very difficult from
2016 11th September 2016 7/6/16–6/7/16
2017 31st August 2017 27/5/17–26/6/17
both logistical and financial perspectives. In this scenario, it
2018 20th August 2018 16/5/18–15/6/17 would be prudent to test for seroprevalence of MERS-CoV in
travellers returning from the Middle East to establish if there
are any MERS-CoV cases which do not fit the PHE MERS-CoV
criteria.
The primary finding of this study is that 56% of the samples had
vacation period with tourism travel to Dubai and the UAE. A a viral aetiology with 62.1% of total patients being positive.
secondary peak was in April which could correlate to the period Influenza A was the most common viral cause followed by
after the Easter school holidays (25th March–10th April 2016) Rhinovirus. Although no patient was positive for MERS-CoV, this
when travellers may be returning to the UK after travel to the positivity for Influenza A amongst travellers returning from the
Middle East for tourism purposes. The peak testing for 2017 was Middle East demonstrates the need to carry out infection control
during the months of September and November. This occurred measures with isolation in side-rooms to reduce nosocomial
post-Ramadan (26th May–24th June 2017) and Hajj (30th August– spread of Influenza A and other respiratory viruses. It also
4th September 2017). This is longer than the 14-day incubation demonstrates the need for empirical use of Neuraminidase
period for MERS which may be explained by pilgrims extending inhibitors pending the viral result for the assessed patients.
their stay for the holy festival of Eid, thus, resulting in possible Previous studies (Refaey et al., 2017; Annan et al., 2015; Benkouiten
increased exposure to other MERS-infected people and/or camel et al., 2014; Assiri et al., 2014; Zumla et al., 2016) in the Middle East
exposure. have also demonstrated the high positivity for Influenza A virus in
It is likely there will be more testing after these periods, returning Hajj pilgrims. This gives more evidence that influenza
especially as travellers might also be returning via the Middle East vaccination should be advised before travel for people considering
after the summer vacation months. Similarly the peak testing was Hajj.
September and June in 2018 correlating post Hajj (19th–24th A secondary finding was the high positivity of sputum samples
August 2018) and Ramadan (16th May–14th June 2018). compared to BAL samples. Previous studies have demonstrated the
Combined with the UK school vacation periods this resulted in higher yield of BAL testing to sputum testing (Sing et al., 2000) for
more returning travellers, causing a higher testing rate after these PCP testing and of the higher yield of sputum compared to
periods. nasopharyngeal swabs (Falsey et al., 2012). This study demon-
As the clinical spectrum of MERS is broad, there is the strates the higher yield of sputum but not of BAL testing. However,
possibility that some cases may be missed in asymptomatic the limitation here is of the higher number of sputum samples (n =
patients who do not fit the PHE criteria and those patients who 120) submitted compared to BAL samples (n = 7). Additionally, it is
 H.Z. Farooq et al. / International Journal of Infectious Diseases 93 (2020) 237–244
noted that sputum PCR positivity is higher than the combined pool
positivity of all nose, throat and combined nose-throat swabs.
However the total number of sputum samples received is 120
compared to 270 samples received for nose, throat or combination
NT swabs. This finding demonstrates the need for further studies
on sample type and PCR positivity of respiratory viruses.
Also of note is the higher positivity rate when a higher number
of samples is sent by the referring hospital. For diagnosis of MERS-
CoV, PHE Manchester requests samples for sputum, nose  throat
swabs, BAL (if available) and clotted blood. Due to the high clinical
workload of the referring hospitals, we received a variable number
of samples per patient. In this study we have seen that patients
who have greater than four samples sent demonstrated a 100%
diagnostic yield compared to 51.1% when one sample per patient
was sent. In one specific patient case, six samples were sent, of
which only 1/6 was positive for Influenza A. We conclude from our
observation that four samples or more from a patient should be
taken to ensure a viral diagnosis.
Conclusion
Although no cases of MERS Coronavirus were identified at PHE
Manchester, the majority of patients identified under the PHE
MERS criteria had a viral respiratory pathogen for which
Neuraminidase inhibitors treatment was indicated and for whom
nosocomial isolation was warranted. Respiratory tract viral
infections post travel to the Middle East are common and
vaccination for influenza is strongly recommended for people
travelling to the Middle East for religious purposes.
With the positive MERS-CoV case in August 2018 in the UK
and previous devastating nosocomial outbreaks of MERS in
the world, it is essential to raise awareness of this fatal pathogen.
We need to continue proactive investigation and rapidly
identify and isolate possible MERS-CoV patients after return
from the Middle East. We need to continue surveillance of
returning travellers at risk for MERS-CoV infection not only to
further the knowledge of this important syndrome but also to
facilitate the public health response and management of cases.
MERS-CoV is a high consequence infectious disease which
requires the highest vigilance to ensure preventing its spread
and lethal outcomes.
Funding
This research did not receive any specific grant from funding
agencies in the public, commercial, or not-for-profit sectors.
Conflicts of interests
All authors declare they have no conflicts of interests or
anything to declare.
Ethical approval
Ethical approval was not obtained as this study is an analysis of
laboratory surveillance data. However, patient identifiable infor-
mation was anonymized to ensure patient confidentiality during
the data analysis.
Acknowledgments
We wish to acknowledge the contributions of the staff of the
Department of Virology in Manchester Royal Infirmary and the
Department of Infectious Diseases and Tropical Medicine in North
Manchester General Hospital.
243
Appendix A. - Supplementary data
Supplementary material related to this article can be found, in the
online version, at doi:https://doi.org/10.1016/j.ijid.2020.01.043.
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Another random document with
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some difficulty in identifying the descendants of Lieutenant Thomas
Allen, or Red Eagle, who mistook himself for a never-existing son of
the once ‘young Chevalier.’ Perhaps the countship of Albany is not
the exclusive possession of Lieutenant Allen’s descendants. It is at
least certain that, a couple of years ago, there was some talk in
London of a Count and Countess ‘d’Albanie,’ in Hungary, but what
their pretensions were has gone out of memory; but they must,
rightly or wrongly, have had some, if the tale be true that they quitted
a small estate there, somewhat offended, because the bishop of the
diocese had refused to allow them to sit in the sanctuary of some
church, on purple velvet chairs!
In all this affair Lieutenant Thomas Allen may FULLER
deserve rather to be pitied than blamed. That he was PARTICULARS.
under a delusion seems undeniable. The immediate
victims of it, his sons, do not forfeit respect for crediting a father’s
assertions. They or their descendants must not expect the world to
have the same confidence in them.
A clear and comprehensive view of this family matter may be
acquired by perusing the following statement, which appeared in
‘Notes and Queries,’ July 28th, 1877, and which is from one who
speaks with knowledge and authority.
‘When James Stuart, Count d’Albanie, died, he left two sons and
one daughter.’
To understand this starting point aright, the reader should
remember that the above-named James Stuart was originally known
as Lieutenant Thomas Allen, second son of Admiral Allen. The two
sons and one daughter are thus enumerated:—

‘1st. John Sobieski Stuart, Count d’Albanie,

2nd. Count Charles Edward d’Albanie.
3rd. Countess Catherine Matilda d’Albanie.’

The first of the three was the author of poems published in 1822,
as written by John Hay Allen. Both those gentlemen subsequently
became authors of works, under the name of Stuart.
 ‘The elder son, John Sobieski, Count d’Albanie,
THE STUART-
married the eldest surviving daughter of Edward D’ALBANIES.
Kendall, of Osterey (vide Burke’s ‘Landed Gentry,’
under Kendall of Osterey), and died, leaving no children.
‘The second son, Charles Edward Stuart, now Count d’Albanie,
married Anna Beresford, daughter of the Hon. and Right Hon. John
Beresford, second son of Marcus Beresford, Earl of Tyrone, and
brother of the first Marquis of Waterford, and by her had four
children.
‘1st. Count Charles Edward d’Albanie, major in the Austrian
Cavalry, in which he served from 1840 to 1870, when he left the
service and came to England, and in 1874 married Lady Alice Mary
Hay, sister of the present and eighteenth Earl of Errol.
‘2nd. Countess Marie, who died at Beaumanoir on the Loire, on
the 22nd of August, 1873, and was buried in the cemetery of St. Cyr
sur Loire.
‘3rd. Countess Sobieska Stolberg, married Edouard Platt de Platt,
in the Austrian Imperial Body Guard, and has one son, Alfred
Edouard Charles.
‘4th. The Countess Clementina, a nun.
‘The Countess Catherine Matilda, daughter of JACOBITE
James Count d’Albanie’ (that is, of the gentleman first LORD
known as Admiral Allen’s son), ‘married Count CAMPBELL.
Ferdinand de Lancastro, by whom she had one son,
Count Charles Ferdinand Montesino de Lancastro et d’Albanie, from
his mother. He also served in the Austrian army, in the Kaiser
Kürassier Regiment, or Imperial Cuirassiers, of which the emperor is
colonel. He volunteered, by permission of the emperor, Franz
Joseph, into the Lancers of the Austrian Army Corps which
accompanied the Arch-Duke Maximilian to Mexico, and during the
three years’ campaign he received four decorations for valour in the
many actions at which he was present, two of which were given to
him by the Emperor Maximilian, one being the Gold Cross and Eagle
of the Order of Ste. Marie de Guadalupe, and two by the Emperor
Napoleon III., and also four clasps. After the campaign terminated,
he returned to Austria with his regiment, and got leave to visit his
uncle, the present Count d’Albanie, then in London, where he died
on the 28th September, 1873, from inflammation of the lungs, at the
age of twenty-nine years and five days.’ (Signed ‘R. I. P.’)
Some adherents to the cause of the Stuarts have LORD
survived to the present reign, and one at least may be CAMPBELL,
found who was keeper of the sovereign’s conscience, ON OLD
and sat on the woolsack. It is certainly somewhat JUDGMENTS.
remarkable to find that one of Her Majesty’s chancellors was not only
a Jacobite at heart, like Johnson in part of the Georgian Era, but
openly expressed, that is, printed and published, his opinions. In
Lord Campbell’s life of Lord Cowper, the lord chancellor who
presided at the trial of the rebel lords in 1716, the biographer alludes
to the new Riot Act brought in by Cowper, in which it was stated that
if as many, or as few, as a dozen persons assembled together in the
streets, and did not disperse within an hour after a magistrate’s order
to that effect, the whole dozen would incur the penalty of death, and
might be lawfully strangled at Tyburn. ‘This,’ says Lord Campbell,
‘was perhaps a harsher law than ever was proposed in the time of
the Stuarts,’ but he adds that it was not abused in practice, yet,
nevertheless, ‘it brought great obloquy upon the new dynasty.’ Lord
Cowper in charging and in sentencing the rebel lords in 1716, and
Lord Hardwicke, in addressing and passing judgment upon the rebel
lords in 1746, could scarcely find terms harsh enough to express the
wickedness, barbarity, and hellish character of the rebellion and of
the lords who were the leaders in it. As to their own disgust at such
unmatched infamy, like Fielding’s Noodle, they could scarcely find
words to grace their tale with sufficiently decent horror. Lord
Chancellor Campbell, in the reign of Victoria, flames up into quite
old-fashioned hearty Jacobitism, and ‘bites his thumb’ at his two
predecessors of the reigns of the first two Georges. In especial
reference to the ultra severe strictures of the Chancellor Hardwicke
in 1746, the Jacobite chancellor in the reign of Victoria says, in
Hardwicke’s ‘Life,’ ‘He forgot that although their attempt, not having
prospered, was called treason, and the law required that they should
be sentenced to death, they were not guilty of any moral offence,
and that if they had succeeded in placing Charles Edward on the
throne of his grandfather, they would have been celebrated for their
loyalty in all succeeding ages.’
And now, in the year 1877, we are gravely told that TIME’S
the claims of the brother, who supposes himself to be CHANGES.
a legitimate heir of the Stuarts (a supposition as idle
as the claim of the convict Orton to be a baronet is infamous), have
been fully investigated by a ‘delegation of Roman Catholic clergy,
nobility, and nobles of Scotland,’ who, it is added, with amusing
significance, pronounced those claims to be valid.’ We hear nothing,
however, of the names of the investigators, nor of the evidence on
which their judgment was founded. Awaiting the publication of both,
the investigation (if it ever took place) may be called a trait of the
very latest Jacobitism on record.[3]
After being a serious fact, Jacobitism became (with AT CHELSEA
the above exception) a sentiment which gradually AND
died out, or which was applied in quite an opposite BALMORAL.
sense to that in which it originated. When the French
revolution showed a taste for pulling down everything that was right
on end, the old London Jacobite toast, ‘May times mend, and down
with the bloody Brunswickers!’ ceased to be heard. Later, too, the
wearing of gilded oak-apples, on the 29th of May, ceased to be a
Jacobite emblem of love for the Stuart race of kings. It was taken as
a sign that the wearer was glad that a king at all was left to reign in
England. It is only as yesterday that in Preston unruly lads were
called ‘a parcel of young Jacobites,’—so strong and enduring was
the memory of the Jacobite presence there. Now, yearly at Chelsea,
the veteran soldiers are drawn up in presence of the statue of
Charles II., on the anniversary of his restoration. They perform an act
of homage by uncovering in that bronze presence (with its
permanent sardonic grin), and they add to it the incense of three
cheers in honour of that civil and religious king, and his ever-
welcome restoration. How different from the time of the first George,
when soldiers in the Guards were lashed to death, or near to it, in
the Park, for mounting an oak leaf on the 29th of May, or giving a
cheer over their cups for a prince of the line of Stuart. The
significance of words and things has undergone a happy change.
Donald Cameron, of Lochiel, is groom-in-waiting to the Queen; and,
on Her Majesty’s last birthday, at Balmoral, the singers saluted her
awaking with welcome Jacobite songs, and ended their vocalisation
with ‘Wha’ll be King but Charlie?’

[3] As this page is going through the press, we have the Comte
d’Albanie’s authority for stating that the above story (alluded to in
‘Notes and Queries,’ Oct. 6, p. 274) is ‘a pure invention,’ or ‘a
mystification.’

THE END.

Spottiswoode & Co., Printers, New-street Square and Parliament Street.

 Transcriber’s Note:
This book was written in a period when many words had not
become standardized in their spelling. Words may have multiple
spelling variations or inconsistent hyphenation in the text. Jargon
and obsolete spellings have been left unchanged unless indicated
below.
Footnotes were renumbered sequentially and were moved to the
end of the chapter in which the corresponding anchor occurs. Page
headers were converted to sidenotes. Final stops missing at the end
of sentences and abbreviations were added. Duplicate words at line
endings were removed. Archibald Cameron’s brother, Donald, is
misidentified in the text as Duncan.
The following items were changed:

punnished to punished
Scotand to Scotland
Jabobite to Jacobite
orignal to original
Lous to Louis
It to In
*** END OF THE PROJECT GUTENBERG EBOOK LONDON IN
THE JACOBITE TIMES, VOLUME II ***

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