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MERS: Middle East Respiratory Syndrome

  • Published: 2013-06-22 (Revised/Updated 2017-12-24) : Author: Disabled World : Contact:
  • Synopsis: CDC states MERS virus was first reported in 2012 in Saudi Arabia and has been found in European nations among people who have traveled to the Middle East.

The World Health Organization has received reports of laboratory confirmed cases of MERS that have originated in countries in the Middle East to include Saudi Arabia, Qatar, and the United Arab Emirates. As of July 23rd 2014, the World Health Organization has reported a total of 837 human cases of MERS-CoV infection, including at least 291 deaths.

A viral respiratory illness, MERS is caused by a coronavirus called "Middle East Respiratory Syndrome Coronavirus" (MERS-CoV). MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. MERS-CoV has been shown to spread between people who are in close contact.

Symptoms: Most people infected with MERS-CoV develop severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. Some people were reported as having a mild respiratory illness.

Treatment: There are no specific treatments for illnesses caused by MERS-CoV. Around 50% of those who contracted the illness died. Medical care is supportive and to help relieve symptoms.

The nations of Germany, France, Tunisia, Italy and the United Kingdom have also reported laboratory confirmed cases; the people who are experiencing MERS in these nations were either transferred there for care or returned from the Middle East and then became ill. In Italy, France, Tunisia and the United Kingdom there has been limited local transmission among people who had not been to the Middle East yet had been in close contact with people who had laboratory confirmed or probable cases.

Based upon the current situation and the information it has available, the World Health Organization (WHO) is encouraging Member States to continue surveillance for, 'severe acute respiratory infections (SARI),' and to carefully review any unusual patterns. Healthcare providers are being advised to maintain vigilance. People who are returning from the Middle East who develop SARI should be tested for MERS-CoV. Specimens from people's lower respiratory tracts should be taken and diagnosed where possible. A MERS-CoV infection should be considered even with atypical symptoms and signs such as diarrhea in people who are immunocompromised.

Health care facilities are being reminded of the importance of systematic implementation of infection prevention and control. Facilities that provide care for people who are suspected of having or confirmed with having MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other people, including visitors and healthcare workers. The World Health Organization is also reminding Member States to promptly assess and notify them of any new cases of MERS-CoV infections along with information about potential exposures to others that might have resulted in infection, as well as a description of the clinical course. Investigation into the source of exposure should be promptly initiated to identify the mode of exposure so that further transmission of this virus may be prevented.

More about the MERS Virus

According to the U.S. Centers for Disease Control and Prevention (CDC), the MERS virus was first reported in 2012 in Saudi Arabia. The virus is different from other corona-viruses found in people. Since then, cases have been found in a number of nations in Europe among people who have traveled to the Middle East. One of the people who contracted the virus was a 14 year old girl from Saudi Arabia.

The symptoms of MERS include a cough, fever, and shortness of breath. Half of the people who have contracted this virus have died; others have experienced a mild case which might mean there are a number of unreported cases. The disease can spread from one person to another, especially if they are in close contact with each other. At this time there is no vaccine or treatment for MERS.

Protecting yourself from the MERS virus is the same as protecting yourself from any other form of respiratory disease. There are some different steps you can take, to include the following:

The MERS virus is not the same as the SARS virus.

MERS is not the same coronavirus that caused severe-acute respiratory syndrome (SARS) in 2003. Like the SARS virus; however, MERS-CoV is most similar to corona-viruses to be found in bats. As of June 20th, 2013 there have been 64 deaths due to MERS:

MERS-CoV has been demonstrated to spread from person to person among those who are in close contact. Transmission from infected people to healthcare personnel has also been observed. Clusters of cases in Saudi Arabia, Jordan, France, the United Kingdom, Tunisia, France, as well as Italy are under investigation. In the world today, airplanes fly everywhere.

The CDC is concerned about MERS-CoV because the virus has caused severe illness in the majority of those who have become infected and approximately half of them have died. The virus spreads from person to person and has spread between countries. The CDC is aware of the potential for the virus to spread even further and cause more people to become ill and cluster on a global basis, to include in America. At this point, there have yet to be any reports of anyone in America becoming infected with MERS-CoV.

The CDC has developed molecular diagnostics that permit scientists to accurately identify people with MERS. They have also developed assays to detect MERS-CoV antibodies. The lab tests help scientists to tell whether a person is or has been infected with MERS-CoV. The CDC has the ability to evaluate genetic sequences as they become available, something that can help scientists to further describe the characteristics of MERS-CoV. The CDC is also providing MERS-CoV testing kits to state health departments and updating guidance for public health departments, laboratories, and healthcare providers.

Update Aug. 2013: MERS virus discovered in bat near site of outbreak in Saudi Arabia

A 100% genetic match for Middle East Respiratory Syndrome (MERS) has been discovered in an insect-eating bat in close proximity to the first known case of the disease in Saudi Arabia. The discovery points to the likely animal origin for the disease, although researchers say that an intermediary animal is likely also involved.

In this case we have a virus in an animal that is identical in sequence to the virus found in the first human case. Importantly, it's coming from the vicinity of that first case.

There is no evidence of direct exposure to bats in the majority of human cases of MERS. Given that human-to-human transmission is inefficient, we speculate that an as-yet-to-be determined intermediate host plays a critical role in human disease. In the coming days, the group will be reporting the results of its investigation into the possible presence of MERS in camels, sheep, goats, and cattle.

The current study, titled "Coronavirus diversity and evidence for MERS-CoV infection in bats in Saudi Arabia " appears online in the journal Emerging Infectious Diseases:

Update Sept. 2014:NIH study supports camels as primary source of MERS-CoV transmission

National Institutes of Health (NIH) and Colorado State University (CSU) scientists have provided experimental evidence supporting dromedary camels as the primary reservoir, or carrier, of Middle East respiratory syndrome coronavirus (MERS-CoV). The study, designed by scientists from CSU and NIH's National Institute of Allergy and Infectious Diseases, involved three healthy camels exposed through the eyes, nose and throat to MERS-CoV isolated from a patient.

Samples taken from the camels showed high levels of infectious virus in secretions, primarily from the nose, for up to a week after infection; the scientists detected components of the virus for up to 35 days. Although the camels quickly recovered from infection without apparent complications, the researchers say the nasal secretions provide a likely source of transmission to people who handle the animals.

The researchers theorize that vaccinating camels could reduce the risk of MERS-CoV transmission to people and other camels; NIAID and others are supporting research to develop candidate vaccines for potential use in people and camels.

D Adney et al. Replication and Shedding of MERS-CoV in Upper Respiratory Tract of Inoculated Dromedary Camels. Emerging Infectious Diseases DOI: 10.3201/eid2012.141280.

Update June 3rd 2015:Middle East respiratory syndrome (MERS) Seminar

Middle East respiratory syndrome (MERS) has recently returned to the headlines as new cases have been exported to Korea and China. Experts are concerned that MERS cases continued to be detected in Saudi Arabia throughout the past year, and there appears to be little reduction in the number of cases since its first discovery three years ago. As the month of Ramadan approaches, with 1 million pilgrims expected to arrive in Saudi Arabia in June and July 2015, MERS remains a threat to global health security. The Lancet today publishes a new Seminar on MERS, outlining the current state of knowledge on the virus, and urgent priorities for research and control.

As of May 31, 2015, 1149 laboratory-confirmed cases (431 deaths; 38% mortality) have been reported to WHO. Both community acquired and hospital-acquired cases have been reported with little human-to-human transmission reported in the community. Although most cases of MERS have occurred in Saudi Arabia and the United Arab Emirates, cases have been reported in Europe, the USA, and Asia in people who traveled from the Middle East or their contacts. Clinical features of MERS range from asymptomatic or mild disease to acute respiratory distress syndrome and multiorgan failure resulting in death, especially in individuals with underlying comorbidities. No specific drug treatment exists for MERS and infection prevention and control measures are crucial to prevent spread in health-care facilities. MERS-CoV continues to be an endemic, low-level public health threat. However, the virus could mutate to have increased inter-human transmissibility, increasing its pandemic potential.

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