What is Middle East respiratory syndrome (MERS)?
A new aggressive pathogen has recently been identified; it's a coronavirus that causes symptoms of fever, cough, and shortness of breath that may become severe or deadly. The disease is termed MERS (Middle East Respiratory Syndrome or MERS-CoV). The disease was first noted in Saudi Arabia in 2012. Researchers suggest the MERS virus originated in animals (camels) and, like other viruses, mutated to be able to infect humans. MERS has currently spread beyond the Middle East to about 18 countries throughout the world including Egypt, Turkey, France, Greece, Tunisia, Italy, UK, and the U.S. Unfortunately, in March 2014, the number of people infected started increasing globally. There is worldwide concern about this infection; of the approximately 500 individuals diagnosed with MERS so far, about 36% have died, resulting in a 64% survival rate.
What are the symptoms of MERS?
Although some people with MERS virus infection have mild or even no symptoms, many others suffer flu-like symptoms (fever, cough, malaise; some develop diarrhea, nausea, vomiting, and kidney failure) that progress to a severe respiratory syndrome that has caused death, as mentioned above, in about 36% of people infected. Although the majority of patients have had close association with an infected person (family members and health-care workers), a recent case report documents only a casual contact with an infected individual (business meeting), suggesting that prolonged contact may not be required to infect other individuals. Spread or transmission of the virus is thought to be by direct contact, but research is ongoing to determine the precise way the virus is spread.
The U.S. Centers for Disease Control and Prevention (CDC) has issued travel alerts to use standard precautions when visiting countries in or near the Arabian Peninsula and has issued MERS warnings in 22 airports in the U.S. to alert travelers about the disease and its symptoms.
Are there vaccines or treatments for MERS?
There is no vaccine or specific treatment available for MERS; treatment is directed at reducing symptoms and providing supportive care. Patients with severe symptoms require hospitalization. Anyone with possible exposure to a patient with MERS should consider isolating themselves from others and seek immediate medical care if symptoms develop; the CDC should be notified of any patients suspected of having MERS.
This new MERS outbreak resembles another coronavirus-caused disease, SARS (severe acute respiratory syndrome), which was first documented in 2003. With strict isolation techniques, SARS was limited to infecting about 8,098 people worldwide with 774 deaths; no more SARS infections were reported after 2004. With similar techniques and public cooperation, perhaps we can limit and eliminate MERS.
Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease
Switzerland. World Health Organization. "MERS-CoV Summary Updates." <http://www.who.int/csr/disease/coronavirus_infections/archive_updates/en/>.
United States. Centers for Disease Control and Prevention. "Illinois resident who had contact with Indiana MERS patient tests positive for MERS coronavirus." May 17, 2014. <http://www.cdc.gov/media/releases/2014/p0517-mers.html>.
United States. Centers for Disease Control and Prevention. "Middle East Respiratory Syndrome (MERS)." May 21, 2014. <http://www.cdc.gov/coronavirus/mers/index.html>.
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