Middle East Respiratory Syndrome (MERS)

By Tina M. St. John, MD. May 7th 2016

A decade after the SARS epidemic in 2003, health officials have discovered a similar, potentially fatal new viral illness called MERS.

Short for Middle East respiratory syndrome, MERS has currently spread to nearly two dozen countries around the world. There was an increased number of new cases reported during April 2014, and in May 2014, the first U.S. case was confirmed. 

MERS first emerged in 2012, but the virus still remains somewhat of a mystery. Scientists don’t yet have the full picture of exactly where MERS came from, how it spreads and how to treat it, and the recent rise of new cases has raised concerns about a possible epidemic.

“[MERS] is a possibly deadly viral illness for which we have no vaccine and no specific treatment,” explains David Swerdlow, MD, associate director for science at the Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases and leader of the CDC’s MERS response activities.

The good news, however, is that more than 70 percent of people with MERS recover from the illness. In fact, there have been some cases of people infected with the virus who didn’t actually get sick. And while concerns of a possible epidemic are appropriate, it’s important to understand what health officials do know about MERS in order to keep the potential threat in perspective.

What Is MERS?

MERS is a potentially deadly respiratory illness first reported in the Arabian Peninsula region of the Middle East in 2012. It is caused by a new type of coronavirus called MERS-CoV. Coronaviruses are a family of viruses that can infect humans and animals. They are fairly common, typically infecting your nose and upper airways and causing cold symptoms, such as a runny nose, sore throat and low fever. In fact, coronaviruses are the second leading cause of the common cold.

MERS, however, differs from most other human coronaviruses in that it tends to attack the lower airway tissues of your lungs, causing pneumonia or widespread lung damage known as acute respiratory distress syndrome.

While health officials don’t know exactly how MERS first developed, researchers from the CDC, the World Health Organization (WHO) and other public health agencies believe MERS-CoV probably originated from an animal source — possibly camels or bats — although this hasn’t been confirmed as of the time of publication.

To date, there have been more than 600 confirmed cases of MERS worldwide, and about 30 percent people infected with the virus have died. So far, in the U.S., there have been two people diagnosed with MERS after contracting it in Saudi Arabia, and a third person was infected with the MERS-CoV virus but didn’t get sick.

MERS Symptoms

Typical symptoms of the MERS virus include:

  • A general feeling of being unwell,
  • Fever (100 degrees Fahrenheit or higher),
  • Cough,
  • Shortness of breath, which can be severe, and
  • Digestive system symptoms, such as abdominal pain and diarrhea (in some cases).

It’s important to note that not everyone who contracts MERS-CoV gets sick.

“We’ve definitely seen health care workers … who have tested positive for the virus without any symptoms. But it’s too early to know what that means and whether those people are contagious,” says Swerdlow.

Risk Factors

MERS is primarily spread through close personal contact with someone who has the virus. Researchers are still learning about the disease, so it’s difficult to pinpoint who is most at risk of developing MERS, but here’s what health officials currently know about the virus:

  • Many of the confirmed MERS infections have occurred in health care workers, especially those working in the Arabian Peninsula.
  • MERS cases have been reported in people from ages 1 through 94. However, the majority of cases to date have occurred in people older than 40.
  • More cases have occurred in men than women.
  • People with preexisting health problems, a weakened immune system or chronic conditions, such as cancer, diabetes, HIV/AIDS or lung disease, may be at increased risk for MERS and potentially fatal complications.

How to Protect Yourself From MERS

Currently, there isn’t a vaccine for MERS, but researchers have identified a number of drugs that may be useful in treating the virus in the future. And there are ways you can protect yourself and loved ones from MERS and other infectious diseases:

  • Wash your hands with soap and water frequently, especially after handling food or animals and after using the bathroom.
  • Keep your hands away from your face, mouth and eyes.
  • Regularly disinfect commonly touched surfaces in your home, such as counter and table tops and doorknobs.
  • If possible, stay away from sick people. Avoid any type of close contact, such as kissing, hugging, or eating or drinking after someone who is sick.

Could MERS Become an Epidemic?

With any new virus, there is always a concern that the virus could change, or mutate, and become highly contagious. While the marked uptick of new MERS cases is alarming, the WHO doesn’t currently believe the recent outbreak is a public health emergency.

“There are several possible explanations for the increased number of MERS cases in April 2014. But to date, we have no evidence of viral changes that would make the virus more easily transmissible,” explains Swerdlow.

One possible reason for the recent increase of cases may be an unconfirmed seasonal pattern of the virus. Another reason could be the fact that health officials are better at identifying and reporting MERS cases, meaning that while it may appear there is a rise in MERS cases, in actuality, it’s just that there aren’t as many MERS cases going undetected.

As of May 2014, the CDC considers the U.S. public to be at very low risk of MERS, and neither the WHO nor CDC has recommended any travel restrictions to the Arabian Peninsula.

Public health agencies around the world will continue to actively monitor new cases of MERS and remain vigilant for any changes that may indicate the illness could become more widespread.

To stay up-to-date on the latest information about MERS, visit the Centers for Disease Control and Prevention or the World Health Organization’s websites.

Next Steps

Though the CDC doesn’t believe people in the U.S. are currently at high risk for developing MERS, it’s always a good idea to take precautions.

  • If you or a loved one develop a fever, cough or shortness of breath and have traveled to the Arabian Peninsula or been exposed to someone with MERS within the past 14 days, call your doctor right away.
  • If you’re having difficulty breathing, go to the nearest emergency room. Be sure to tell the staff about your recent MERS exposure and/or travel to the Middle East.
  • If you’re planning to travel to the Middle East, check the CDC’s latest health advisory notices for travelers, and talk with your doctor about whether you should take any precautions.  
  • If you or your loved has diabetes, kidney failure or a chronic lung disease, the WHO recommends staying away from:
    • Camels,
    • Raw camel milk or raw camel urine, and
    • Undercooked meat, particularly camel meat.

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