MERS Middle East Respiratory Syndrome

What is MERS?

The Middle East Respiratory Syndrome (MERS) is a serious respiratory disease caused by a virus called the MERS-coronavirus (MERS-CoV). It is sometimes referred to as camel flu since camels appear to be a major source of infection for humans. 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 perhaps by exposure to camel secretions including unpasteurized camel milk. This disease was first reported in Saudi Arabia in 2012 and sporadic cases and minor outbreaks have been reported in several other countries in the Middle East. The largest known outbreak of MERS outside the Arabian Peninsula occurred in the Republic of Korea in 2015. The outbreak was associated with a traveller returning from the Arabian Peninsula.

How do you get MERS?

Infected dromedary camels play a major role in the transmission of this virus. Camels have been shown to have antibodies to MERS-CoV. Close contact with camels and exposure to secretions from infected camels is a major source of transmission to humans. The virus does not seem to spread easily from person to person. Spread between humans typically requires close contact with and caring for an infected person who is coughing, usually in the family setting. In the past, there have been outbreaks in hospital settings in Saudi Arabia and South Korea when infection control procedures have not been followed rigorously. Its spread is uncommon outside of hospitals or family settings. No sustained human to human transmission has been documented anywhere in the world. Thus, its risk to the global population is currently deemed to be fairly low.

Susceptibility and Resistance

All persons of all ages are susceptible. Severe illness is more common in persons with pre-existing medical conditions such as diabetes, cancer, and chronic lung, heart, and kidney disease. Individuals with weakened immune systems are also at higher risk for getting MERS or having a severe case.

Incubation Period

The incubation period for MERS is 2-15 days.

What are the Symptoms?

Most people infected with MERS-CoV develope a severe acute respiratory illness with a fever, cough, shortness of breath and muscle aches and pains. There were also frequent gastrointestinal symptoms with diarrhea, vomiting, and abdominal pain. However, MERS infection can range from asymptomatic disease (no symptoms) to severe pneumonia and respiratory failure.

Preventative Measures

Avoid close contact with camels in the Middle East, especially in Saudi Arabia where most of the human infections have occurred. If caring for or coming into contact with a person with a respiratory illness in the family setting, wash hands thoroughly and maintain a distance of about 1 meter from the infected person who is coughing.

Treatment

There is no specific treatment or vaccine for this infection. Approximately 1 out of every 3 infected persons dies from this disease.

Where Does It Commonly Occur?

Outbreaks and small clusters of cases of MERS have been reported almost exclusively in Saudi Arabia where 80% of all the cases in the world have occurred. Travellers have carried the illness to other countries where small outbreaks have occurred, e.g., South Korea, Oman, Iran, Jordan and Kuwait. As many as 27 other countries have reported isolated cases in travellers with no spread into the community.