Middle East Respiratory Syndrome (MERS)
What is MERS?
Middle East respiratory syndrome (MERS) is an illness that affects your respiratory system. It is caused by a common type of virus called coronavirus. These viruses cause mild to moderate respiratory illness. But in some cases the symptoms are severe and can lead to death.
MERS was first reported in 2012. It has been mostly found in countries in the Middle East, such as Saudi Arabia, Jordan, and Yemen. Some cases have also been found in Europe, and in people who have traveled to the Middle East. Only a few cases have been reported in the U.S.
In addition to infecting people, the virus has also been found in camels.
What are the symptoms of MERS?
In some cases, MERS may not cause symptoms. But most often, symptoms of MERS can start within 1 to 2 weeks after being infected by the virus. They most often start about 5 days after being exposed to the virus, but can happen up to 14 days later.
These are common symptoms:
Less common symptoms include:
Nausea and vomiting
What are possible complications from MERS?
In some cases, MERS can cause severe problems. These are more of a risk for older adults. They are also a risk for people who have a weak immune system or a chronic illness like diabetes, cancer, or lung disease. The problems can include:
Lung infection (pneumonia)
Breathing (respiratory) failure and need for a breathing machine (ventilator)
Failure of the kidneys and other organs
Widespread infection and low blood pressure (septic shock)
These severe complications are more likely to lead to death from MERS.
How is MERS diagnosed?
The healthcare providers will ask about your medical history. They will also ask about when you were exposed to MERS. They may ask about your recent travel and contact with sick people. They may also ask about recent contact with camels.
You will have tests to check for the cause of your symptoms. The symptoms of MERS can also be caused by other illnesses. You may have tests such as:
Chest X-ray. X-rays use a small amount of radiation to make images of the inside of your body. A chest X-ray is done to check for problems in your lungs.
Blood tests. Blood is taken from a vein in your arm or hand. This is done to check for certain chemicals that can show if you have the MERS virus or other illness.
Nasal or throat swab. A stick with a small piece of cotton at the tip is wiped inside your nose or throat. This is done to check for viruses in your nasal mucus.
Stool culture. A small sample of stool is collected from your rectum or from a bowel movement. The sample is checked for the virus.
Sputum culture. A small sample of mucus coughed from your lungs is collected. It is checked for the virus.
How is MERS treated?
Currently no medicine is available to cure MERS. Treatment for MERS is done to help support your body while it fights the disease. This is known as supportive care. Supportive care may include:
Pain medicines. These include acetaminophen and ibuprofen. They are used to help ease pain and reduce fever.
Bed rest. This helps your body fight the illness.
Care during severe illness may include:
IV fluids. These are given through a vein to help keep your body hydrated.
Oxygen. Supplemental oxygen or assisted ventilation may be given. This is done to keep enough oxygen in your body.
Vasopressor medicine. These help to raise blood pressure that is too low from shock.
Are you at risk for MERS?
If you’ve been to a place where people have been sick with MERS, you may be at risk for infection. You are at risk if you:
Recently traveled in or near the Arabian Peninsula
Had contact with a sick person who recently traveled to the Arabian Peninsula
Had contact with camels, or their milk, urine, or meat
Had contact with a person who was diagnosed with MERS
Had contact with a health care worker who has been in contact with MERS patients
How can MERS be prevented?
It is not yet known how MERS is passed along. It may be passed from an infected person. It may be passed along by an infected camel. There is currently no vaccine for MERS. Prevention is done by avoiding contact with the virus, and taking special care around the virus. If you are in an area with MERS:
Wash your hands often. Or, use an alcohol-based hand sanitizer often.
Only touch your eyes, nose, or mouth with clean hands.
Wash your hands after touching animals. Avoid contact with sick animals.
Avoid contact with camels.
Don’t drink raw (unpasteurized) camel milk.
Don’t eat undercooked camel meat.
Try to have less contact with people who are sick.
Don’t share eating or drinking tools with sick people.
Don’t kiss someone who is sick.
Clean surfaces regularly with disinfectant.
What to do if you are at risk for MERS
If you have had close contact with someone who has been diagnosed with MERS:
Call your healthcare provider. He or she can talk with local health staff to see what action may be needed.
Follow all instructions from your healthcare provider. This may include having blood tests.
Take your temperature every morning and evening for at least 14 days. This is to check for fever.
Keep watch for symptoms of MERS. Tell your healthcare provider if you have symptoms.
If you have a fever or other MERS symptoms:
Don’t panic. Keep in mind that other illnesses can cause similar symptoms.
Stay away from work, school, and public places. This is to help prevent the virus from spreading.
Call the nearest hospital emergency room. Explain that you have been exposed to MERS and have symptoms. Do this before going to the hospital. This will help the hospital staff prepare for your arrival.
Keep in mind that hospital staff may wear protective equipment, such as masks, gowns, gloves, and eye protection. This is to prevent the possible virus from spreading.
Tell the staff about recent travel, including local travel on public transport. Staff may need to find other people you have been in contact with.
Follow all instructions the hospital staff gives you.
The Ministry of Health of Saudi Arabia advises that some people should not travel to Mecca, Saudi Arabia. This includes:
Adults age 65 years or older
Children age 12 or younger
You should also avoid that area if you are pregnant or you have:
A chronic health condition like heart disease, asthma, or diabetes
An immune deficiency disorder
For more information
To learn more about MERS, visit the CDC website.
March 22, 2017
Middle East respiratory syndrome coronavirus: Clinical manifestations and diagnosis, Up To Date, Middle East respiratory syndrome coronavirus: Treatment and prevention, Up To Date, Middle East respiratory syndrome coronavirus: Virology, pathogensis, and epidemiology,Up To Date
Freeborn, Donna, PhD, CNM, FNP,Lentnek, Arnold, MD