Middle East Respiratory Syndrome
Middle East Respiratory Syndrome (MERS) also known as camel flu is an illness caused by a virus (more specifically, a coronavirus) called the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
Most MERS patients developed severe respiratory illness with symptoms of fever, cough, and shortness of breath. The disease is typically more severe in those with other health problems. Mortality is about one-third of diagnosed cases.
MERS-CoV is a beta coronavirus derived from bats. Camels have been shown to have antibodies to MERS-CoV but the exact source of infection in camels has not been identified. Camels are believed to be involved in its spread to humans but it is unclear how.
Health officials first reported the disease in Saudi Arabia in September 2012. Through retrospective investigations, they later identified that the first known cases of MERS occurred in Jordan in April 2012.
So far, all cases of MERS have been linked through travel to, or residence in, countries in and near the Arabian Peninsula. The largest known outbreak of MERS outside the Arabian Peninsula occurred in the Republic of Korea in 2015. The outbreak was associated with a traveler returning from the Arabian Peninsula.
Spread between humans typically requires close contact with an infected person. Its spread is uncommon outside of hospitals. Thus, its risk to the global population is currently deemed to be fairly low.
MERS-CoV can lead to respiratory or kidney failure and is sometimes fatal. You’re most at risk of serious illness if you’re an older adult or if you have a weakened immune system or a chronic disease, such as diabetes or lung disease.
As of the year 2020, there is no specific vaccine or treatment for MERS; a number of antiviral medications were being studied. The World Health Organization recommends that those who come in contact with camels wash their hands frequently and do not touch sick camels and that camel-based food products be appropriately cooked. Treatments that help with the symptoms may be given to those infected.
Middle East Respiratory Syndrome Symptoms
The symptoms of MERS start to appear about 5 or 6 days after a person is exposed, but can range from 2 to 14 days. Most people confirmed to have MERS-CoV infection have had severe acute respiratory syndrome (SARS) with symptoms of:
- Fever
- Cough
- Shortness of breath
Some people also had diarrhea and nausea/vomiting. For many people with MERS, more severe complications followed, such as pneumonia and kidney failure.
Pre-existing conditions among people who got MERS have included:
- Diabetes
- Cancer
- Chronic lung disease
- Chronic heart disease
- Chronic kidney disease
Middle East Respiratory Syndrome Causes
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Virology
The Middle East respiratory syndrome is caused by the newly identified MERS coronavirus (MERS-CoV), a species with single-stranded RNA belonging to the genus betacoronavirus which is distinct from SARS coronavirus and the common-cold coronavirus.
MERS-CoV, like other coronaviruses, likely spreads from an infected person’s respiratory secretions, such as through coughing. However, still, there has been no understanding of the precise ways that it spreads.
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Transmission
Animals to Human: MERS-CoV is a zoonotic virus, which means it is a virus that is transmitted between animals and people. Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels.
The route of transmission from animals to humans is not fully understood, but dromedary camels are the major reservoir host for MERS-CoV and an animal source of infection in humans.
Human to human transmission: The virus does not pass easily from person to person unless there is close contact, such as providing unprotected care to an infected patient. There have been clusters of cases in healthcare facilities, where human-to-human transmission appears to have occurred, especially when infection prevention and control practices are inadequate or inappropriate. Human to human transmission has been limited to date and has been identified among family members, patients, and health care workers.
Middle East Respiratory Syndrome Prevention
There are no vaccine or specific treatment currently available, however, several MERS-CoV specific vaccines and treatments are in development. Treatment is supportive and based on the patient’s clinical condition.
You can help reduce your risk of getting respiratory illnesses:
- Wash your hands often with soap and water for at least 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
- Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue in the trash.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Avoid personal contact, such as kissing, or sharing cups or eating utensils, with sick people.
- Clean and disinfect frequently touched surfaces and objects, such as doorknobs.
Middle East Respiratory Syndrome Treatment
There is no specific antiviral treatment recommended for MERS-CoV infection. Individuals with MERS often receive medical care to help relieve symptoms. For severe cases, current treatment includes care to support vital organ functions.
Frequently Asked Questions about MERS
What is MERS?
Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by a virus called the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
What is the source of MERS-CoV?
MERS-CoV likely came from an animal source in the Arabian Peninsula. Researchers have found MERS-CoV in camels from several countries. Studies have shown that direct contact with camels is a risk factor for human infection with MERS-CoV. But we need more information to understand the interactions between humans and camels that are important for transmission.
What are the symptoms and complications that MERS can cause?
The most common symptoms of MERS are:
- Fever
- Cough
- Shortness of breath
Associated symptoms may include:
- Chills
- Chest pain
- Body aches
- Sore throat
- Malaise, a general feeling of being unwell
- Headache
- Diarrhea
- Nausea and vomiting
How does the virus spread?
MERS-CoV, like other coronaviruses, likely spreads from an infected person’s respiratory secretions, such as through coughing.
How can I help protect myself from MERS?
You can help reduce your risk of getting respiratory illnesses:
- Wash your hands often with soap and water for at least 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
- Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue in the trash.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Avoid personal contact, such as kissing, or sharing cups or eating utensils, with sick people.
- Clean and disinfect frequently touched surfaces and objects, such as doorknobs.
What should I do if I had close contact with someone who has MERS?
If you have had close contact with a confirmed MERS case within the last 14 days without using the recommended infection control precautions, you should contact a healthcare provider for an evaluation.
Is there a vaccine for MERS?
Currently, there is no vaccine available to protect against MERS.
Is MERS-CoV the same as the SARS virus?
No, they are not. MERS-CoV is not the same coronavirus that causes severe acute respiratory syndrome (SARS). However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats.