MERS (Middle East Respiratory Syndrome)

Middle East respiratory syndrome, better known by its acronym MERS, is a viral disease caused by the coronavirus (CoV).

What Is MERS?

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 *




A veterinarian extracts blood samples from a camel's neck to test for MERS (Middle East Respiratory Syndrome) during an investigation into the first reported MERS coronavirus in Haramout,





A veterinarian extracts blood samples from a camel's neck to test for MERS (Middle East Respiratory Syndrome) during an investigation into the first reported MERS coronavirus in Haramout, Yemen. MERS is a viral respiratory illness that is new to humans. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries, including the United States.
CDC/Awadh Mohammed Ba Saleh, Yemen.

How Common Is MERS?

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.

What Are the Causes of MERS?

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.

Who Is At Risk for MERS?

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.

What Are the Signs of MERS?

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.

How is MERS Diagnosed and Treated?

Diagnosis

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.

Treatment

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.

Can MERS Be Prevented?

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.

Some general strategies to prevent respiratory illness include the following:

  • Wash hands frequently and thoroughly with soap and water.
  • Cover nose and mouth with a tissue when coughing or sneezing. Discard tissue in an appropriate container.
  • Avoid touching eyes, nose, and mouth with hands/fingers.
  • Avoid direct contact with people who are infected with a communicable disease.
  • Clean and disinfect surfaces that are frequently touched (e.g., telephones, doorknobs, countertops, and utensils).

See also Fever • Global Health Issues: Overview • Immune System and Other Body Defenses: Overview • Pneumonia • Viral Infections

Resources

Books and Articles

Butler, Declan. “MERS Virus's Ability to Jump from Animals to Humans Puzzles Scientists.” Scientific American. June 10, 2015. http://www.scientificamerican.com/article/mers-virus-s-ability-to-jump-fromanimals-to-humans-puzzles-scientists/ (accessed March 30, 2016).

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).

Websites

Centers for Disease Control and Prevention. “Middle East Respiratory Syndrome (MERS).” http://www.cdc.gov/coronavirus/mers/ (accessed March 20, 2016).

MedlinePlus. “Coronavirus Infections.” U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/coronavirusinfections.html (accessed March 30, 2016).

World Health Organization. “Middle East Respiratory Syndrome Coronavirus (MERS-Co-V).” http://www.who.int/emergencies/mers-cov/en/ (accessed March 30, 2016).

Organizations

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.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)