About Middle East Respiratory Syndrome (MERS)

Overview
Middle east respiratory syndrome (MERS) is a viral respiratory illness caused by a specific type of coronavirus called Middle East respiratory syndrome coronavirus (MERS-CoV). It was first identified in Saudi Arabia in 2012 and has since spread to other countries. MERS-CoV primarily affects the respiratory system, leading to severe respiratory symptoms such as fever, cough, and shortness of breath. Approximately 3 to 4 out of every 10 patients with MERS have died. The virus is believed to be transmitted to humans through contact with infected camels or consumption of unpasteurized camel milk. It can also be transmitted between people through close contact, such as caring for an infected individual. MERS has been reported in various regions, including the Arabian Peninsula, Europe, North Africa, North America, and Asia.
Causes and Risk Factors

MERS is caused by a virus called MERS-CoV. MERS-CoV is primarily transmitted to humans through contact with infected camels or consumption of unpasteurized camel milk. It can also be transmitted between people through close contact, such as caring for an infected individual.

Non-modifiable risk factors are factors that cannot be changed or controlled. The non-modifiable risk factors for MERS include:

  • Age: Older adults and individuals with weakened immune systems are at higher risk of developing severe illness from MERS.

Modifiable risk factors are factors that can be influenced or changed. The modifiable risk factors for MERS include:

  • Close contact with infected individuals: This may include normal everyday activity with an infected individual or through working in healthcare facilities where MERS patients are treated.
  • Close contact with camels or consumption of camel meat or milk
  • Travel: Traveling to or residing in countries where MERS cases have been reported increases the risk of contracting the virus.

It's important to note that these risk factors can be mitigated by following proper infection control measures, such as practicing good hand hygiene, wearing personal protective equipment, and avoiding close contact with infected individuals. Remember to consult your healthcare professional for personalized advice and guidance.

Symptoms

The most common early symptoms of MERS include:

  • Fever
  • Chills
  • Headache
  • Runny nose
  • Dry cough
  • Sore throat
  • Shortness of breath
  • Muscle pain

As the disease progresses or becomes more severe, other symptoms that may occur include:

  • Nausea, vomiting, abdominal pain, and diarrhea
  • Thick mucus production, wheezing, and chest pain
  • Rapid worsening of respiratory symptoms
  • Pneumonia and organ failure

It's important to note that MERS can vary in severity from mild cases with no symptoms or mild respiratory illness to severe cases with life-threatening complications. If you experience any of these symptoms or suspect you may have been exposed to MERS, it's important to seek medical attention promptly.

Diagnosis

To diagnose MERS, the following examinations, tests, and procedures are commonly performed:

  • The CDC conducts laboratory tests to detect MERS-CoV infection. These tests can be categorized into two types:
    • Molecular tests: These tests look for evidence of active infection by detecting the genetic material of the MERS-CoV virus.
    • Serology tests: These tests look for antibodies to MERS-CoV, indicating previous infection. However, serology tests are mainly used for surveillance or investigational purposes rather than for diagnostic purposes.

To determine the stage or severity of MERS, additional examinations, tests, and procedures may be performed, including:

  • Radiological imaging: Chest X-rays or computed tomography (CT) scans can help evaluate the extent of lung involvement and assess the severity of respiratory symptoms.
  • Clinical assessment: Healthcare professionals will evaluate the patient's clinical signs and symptoms, such as fever, cough, shortness of breath, and respiratory distress.
  • Other blood tests: Blood samples may be taken to assess various parameters like white blood cell count, liver function, kidney function, and markers of inflammation.

It's important to note that the specific diagnostic approach may vary depending on the healthcare provider's judgment and available resources. Consulting with a healthcare professional is crucial for an accurate diagnosis and determination of the stage or severity of MERS.

Treatment Options

The goals of treatment for MERS are to manage symptoms, prevent complications, and support the body's immune system. Currently, there is no specific antiviral therapy for MERS, so treatment mainly focuses on supportive care. Treatment approaches for MERS include:

  • Supportive care: This includes rest, intravenous fluids, and analgesics to alleviate symptoms and maintain hydration and comfort.
  • Broad-spectrum antimicrobials: These medications may be used to minimize the risk of co-infection with opportunistic pathogens if needed.
  • Therapeutic procedures: In severe cases, respiratory failure may require mechanical ventilation using a ventilator to support breathing.
  • Health behavior changes such as:
    • Practicing good hand hygiene
    • Avoiding close contact with infected individuals
    • Avoiding eating raw camel meat or drinking unpasteurized camel milk
    • Avoiding contact with camels in general if immune compromised
    • Covering your mouth and nose when coughing or sneezing
    • Staying home if infected and wearing a mask

It's important to note that the effectiveness of these treatments in achieving the goals of MERS treatment is still being studied.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.