Middle East Respiratory Syndrome (MERS) is a respiratory illness caused by a coronavirus (MERS-CoV) and was first identified in Saudi Arabia in 2012. The virus is zoonotic, meaning it can be transmitted between animals and people.
Most MERS cases have been detected in countries in or near the Arabian Peninsula. However, the disease has been imported into other countries outside the region and then spread. There have been few examples of person to person transmission of the disease among people living in the same household. However, in health care settings the risk of spread is greater.
The range of infections goes from no symptoms or mild respiratory symptoms to severe acute respiratory disease and death. Symptoms usually appear five or six days after a person is exposed, but can appear as early as two days and up to 14 days after exposure.
Common symptoms of MERS include:
MERS can be a life-threatening illness. Most people with confirmed MERS-CoV infection have had severe respiratory illness. Pneumonia is a common finding, but patients may not always develop this condition. Additional complications such as kidney failure have also occurred.
Older people, people with weakened immune systems and those with chronic diseases are at a greater risk of developing severe disease. These conditions include diabetes, cardiovascular disease, chronic lung disease, chronic kidney disease and cancer.
MERS-CoV is a zoonotic virus, which means it is transmitted between animals and people. The virus is mostly found in dromedary camels, and direct physical contact with camels can lead to transmission to humans – however, experts are unclear how the virus jumps from animals to humans.
Human-to-human transmission is possible, and has occurred predominantly among close contacts and in healthcare settings. The largest outbreaks have occurred in health care facilities in Saudi Arabia, the United Arab Emirates and South Korea.
There is no specific antiviral treatment for MERS. Treatment involves managing symptoms, such as medicine to help lower your temperature or ease any pain and help with breathing. People with MERS are usually treated in isolation in hospital.
There is no vaccine available to protect against MERS, however there are candidates in development. WHO advises that anyone visiting places where there are camels should wash their hands before and after and avoid contact with sick camels. Those who are at greatest risk of developing severe disease should avoid all contact with camels.
MERS was first identified in Saudi Arabia in 2012 and since then 27 countries have reported outbreaks, with sporadic cases occurring every year since then. The largest outbreak of MERS outside the Middle East took place in South Korea in 2015 after a man brought the disease into the country. There were 186 laboratory confirmed cases, including 38 deaths. The outbreak highlighted the risk of spread in health care settings – 44 per cent of those affected had picked it up this way. The epidemic lasted for two months and the government quarantined nearly 17,000 people for two weeks to control the outbreak.
who.int/middle-east-respiratory-syndrome
nhs.uk/middle-east-respiratory-syndrome-mers
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