MERS (Middle East Respiratory Syndrome)

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