MERS

What is Middle East respiratory syndrome?

Middle East respiratory syndrome (MERS) is an emerging infectious disease of the airways and lungs. It first appeared in April 2012 in Saudi Arabia. Most cases have occurred in Saudi Arabia and nearby countries, but the virus has also spread to some European and Asia-Pacific countries, as well as to the US.

About 25-40% of people identified with the virus have died. As of June 2015, 1180 cases have been identified; at least 480 of these have died from complications of the disease. ^{[1] [2] [3]}

An outbreak of MERS in the Republic of Korea was first identified in May 2015 and is ongoing at time of writing. The virus was passed on from an infected man returning from the Middle East to others at a hospital he was being treated at. As of June 5 2015, 30 cases have been identified in the Republic of Korea and two people have died. ^[1]

As this is a new disease, and information on it is still being collected and analyzed, many aspects of MERS are still not completely known; what we know of MERS at present may change significantly as the virus is studied and more clinical cases emerge.

Causes

The cause of MERS has been identified as a new type of virus belonging to the coronavirus family. The virus most likely originated in an animal, such as a camel or bat, and 'made the jump' from animal to human.

It is not yet clear exactly how the MERS virus spreads. The virus can be transmitted from animal to human. It is also capable of being transmitted from human to human, but not very efficiently. Thus, the risk of catching MERS from an infected person is currently thought to be not very high. It is known to be transmitted during close contact between people; for example, to health workers caring for people with the virus.

The most likely form of virus transmission is droplet transmission. When a person infected with MERS sneezes or coughs, millions of tiny droplets, each containing many viruses, are spread into the air. If a droplet enters your nose or mouth, you may then become infected with the virus. The droplets can also collect on surfaces and objects; you can then catch the virus by touching an infected surface and then touching your nose or mouth area.

Signs and symptoms

People who are infected with the MERS virus, especially if they were previously healthy, can sometimes exhibit no symptoms at all, or only mild symptoms.

The most common signs and symptoms of a MERS infection are:

• Fever, chills;
• Coughing, and;
• Shortness of breath.

Other less common symptoms that have been observed are:

• Diarrhea;
• Sore throat;
• Coughing up of blood;
• Vomiting;
• Abdominal pain, and;
• Headache.

Methods for diagnosis

A doctor will give a tentative diagnosis of MERS based on the person's clinical symptoms and their history (such as travel or any contact with infected people). A definite diagnosis relies on laboratory tests to analyze the virus.

Types of treatment

There is currently no specific treatment for MERS. Rather, the treatment is supportive and focuses on managing the symptoms that appear.

Potential complications

People with MERS can develop complications including severe pneumonia and kidney failure. These complications can lead to serious illness and death.

Prevention

Steps you can take to prevent infection with the MERS virus are similar to those of other viral diseases transmitted by sneezing and coughing. These can include:

• Cleaning and disinfecting surfaces and objects that might be infected;
• Avoiding close contact with infected people, and;
• Avoiding touching the mouth, eyes and nose areas of the face.

In addition, MERS appears to pass from infected animals to humans. As the virus has been identified in camels, avoiding contact with camels and camel products (raw milk, urine, uncooked camel meat) may help prevent infection.

There is currently no vaccine for MERS.

References

1. WHO | Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea. WHO. Accessed 5 June 2015, from link here
2. Middle East respiratory syndrome - The Lancet. Accessed 5 June 2015, from link here
3. Spread of MERS to South Korea and China - The Lancet Respiratory Medicine. Accessed 5 June 2015, from link here
4. CDC - Coronavirus - Middle East Respiratory Syndrome - MERS-CoV. Accessed 10 July 2014 from link here
5. CDCMERS-Photos. Accessed 10 July 2014 from link here
6. Choices N.H.S. (2014 September 7). Camels may be source of MERS virus transmission - Health News - NHS Choices. Accessed 10 July 2014 from link here
7. Health c=AU; st=Victoria; o=State G. of V. ou1=Department of. Update: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) - 13 January 2014: Chief Health Officer - Department of Health Victoria Australia. guidelines. Accessed 10 July 2014 from link here
8. Infographic: MERS Health Advisory | Travelers Health | CDC. Accessed 10 July 2014 from link here
9. MERS virus weakened by mutations researchers found - News - Nature Middle East. Accessed 10 July 2014 from link here
10. Michael T. Madigan John M. Martinko Kelly S. Bender Daniel H. Buckley David A. Stahl. Brock Biology of Microorganisms (14th ed.). Benjamin Cummins. Accessed from link here
11. MERS_CoV_Update_09_May_2014.docx - MERS_CoV_Update_09_May_2014.pdf. Accessed 10 July 2014 from link here
12. Middle East Respiratory Syndrome (MERS) Research NIAID NIH. Accessed 10 July 2014 from link here
13. Middle East respiratory syndrome coronavirus. Accessed 10 July 2014 from link here
14. Present danger. (2014). Nature 510: 311311.
15. WHO | Frequently Asked Questions on Middle East Respiratory Syndrome Coronavirus (MERS?CoV). WHO. Accessed 10 July 2014 from link here
16. WHO | Middle East respiratory syndrome coronavirus (MERS-CoV) update. WHO. Accessed 19 June 2014 from link here

10 Most frequently asked questions (FAQs)

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