Middle East respiratory syndrome, better known by its acronym MERS, is a viral disease caused by the coronavirus (CoV).
MERS is a communicable disease that affects the respiratory system, specifically the lungs and upper air passages (i.e., bronchi, trachea, larynx/pharynx). It can develop into a pneumonia * , causing fluid to build up in the air sacs of the lungs and can quickly progress to respiratory failure *
Since identifying MERS in Saudi Arabia in 2012, the disease has spread throughout the Middle East, to Europe, Southeast Asia, Africa, and the United States. As of 2014, only three cases of MERS have tested positive for MERS-CoV infection in the United States. The three individuals from the United States who contracted MERS had been travelers to the Middle East.
MERS is a viral disease caused by the coronavirus. The virus has been found in dromedary camels. How the disease was transmitted from camels to humans is unknown, but it is believed that humans in direct or indirect contact with infected camels are at risk for the disease.
People who have had direct or indirect contact with infected camels or with a person who has the disease are at risk for getting MERS. People who have traveled recently to countries in the Arabian Peninsula are also at increased risk. Travelers who develop MERS symptoms within two weeks of travel to the Middle East should contact their healthcare provider immediately for evaluation of their symptoms. People who have weakened immune systems * , such as the elderly, and those with chronic diseases such as diabetes * , cancer * , renal (kidney) disease, and chronic pulmonary disease, are at increased risk for severe forms of the disease and death. Usually, direct contact with an infected individual is required to spread MERS. Healthcare workers and home caregivers who recently cared for individuals diagnosed with MERS are at high risk for contracting the disease. The disease has been transmitted from MERS infected individuals to some of the healthcare workers who were directly involved in their treatment.
Signs of MERS include flu-like symptoms such as shortness of breath, fever, chills, sore throat, headache, body aches, runny nose, and cough. These respiratory symptoms may progress quickly to shortness of breath and trouble breathing. In severe cases, the illness may result in respiratory failure and the patient may require supportive treatment with mechanical ventilation * * period for MERS is from 2 to 14 days. Infected people may not have signs of the disease during the incubation period.
The diagnosis of MERS is based on a history of MERS-related signs and symptoms and of recent travel to one or more countries where MERS is endemic * . There are two tests to determine whether a person has MERS: one examines respiratory secretions for the MERSCoV virus, and the other examines a blood sample to detect the virus or the development of antibodies to the virus.
There is no specific disease-related treatment. Treatment is focused on relief of symptoms. For example, acetominphen or a nonsteroidal anti-inflammatory drug (NSAID) (e.g., ibuprofen, naproxen) may be given to relieve fever and muscle aches. For severe cases, the support and maintenance of vital functions (e.g., breathing, kidney function) are essential. A person diagnosed and being treated with MERS will be isolated from others (placed in a single room), and isolation precautions will be used to prevent spread of the disease. With isolation precautions, anyone entering the infected person's room must wear a disposable mask, gown, cap, and gloves. After leaving the room, all equipment, including mask, gown, cap, and gloves, must be disposed of in an appropriate manner.
As of August 2015, there was no vaccine * available to prevent MERSCoV. The most effective strategies for prevention of MERS are to avoid travel to countries of the Middle East, where the disease is endemic. If travel is required to countries where the disease is endemic, avoid direct or indirect contact with people who have the disease and avoid visiting farms, markets, barns, or other places where animals are found.
See also Fever • Global Health Issues: Overview • Immune System and Other Body Defenses: Overview • Pneumonia • Viral Infections
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Gorney, Cynthia. “The Camels and the Contagion.” National Geographic. May 13, 2014. http://news.nationalgeographic.com/news/2014/05/140513-mers-saudi-camels-health-contagionspillover-bats-disease/ (accessed March 30, 2016).
Reuters. “Lack of MERS Vaccine Foresight Frustrates Scientists.” CNBC. June 15, 2015. http://www.cnbc.com/2015/06/15/lack-of-mersvaccine-foresight-frustrates-scientists.html (accessed March 30, 2016).
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World Health Organization. “Middle East Respiratory Syndrome Coronavirus (MERS-Co-V).” http://www.who.int/emergencies/mers-cov/en/ (accessed March 30, 2016).
Centers for Disease Control and Prevention. 1600 Clifton Rd., Atlanta, GA 30329. Toll-free: 800-232-4636. Website: http://www.cdc.gov (accessed March 30, 2016).
World Health Organization. Avenue Appia 20, 1211 Geneva 27, Switzerland. Telephone: 41-22-791-2111. Website: http://www.who.int (accessed March 30, 2016).
* pneumonia (nu-MO-nyah) is inflammation of the lungs.
* respiratory failure is the sudden inability of the lungs to provide normal oxygen delivery or normal carbon dioxide removal.
* immune system (im-YOON SIStem) is the system of the body composed of specialized cells and the substances they produce that helps protect the body against disease-causing germs.
* diabetes (dye-uh-BEE-teez) is a condition in which the body's pancreas does not produce enough insulin or the body cannot use the insulin it makes effectively, resulting in increased levels of sugar in the blood. This can lead to increased urination, dehydration, weight loss, weakness, and a number of other symptoms and complications related to chemical imbalances within the body.
* cancer is a condition characterized by abnormal overgrowth of certain cells, which may be fatal.
* mechanical ventilation is the process by which a machine, called a ventilator, is connected to a patient who is unable to breathe naturally, in order to support normal functioning of the respiratory system.
* incubation (ing-kyoo-BAY-shun) is the period of time between infection by a germ and when symptoms first appear. Depending on the germ, this period can be from hours to months.
* endemic (en-DEH-mik) is a disease or condition that is present in a population or geographic area at all times.
* vaccine (vak-SEEN) is a preparation of killed or weakened germs, or a part of a germ or product it produces, given to prevent or lessen the severity of the disease that can result if a person is exposed to the germ itself. Use of vaccines for this purpose is called immunization.