What is MERS-CoV?

The Middle East Respiratory Syndrome (MERS) has been all over the news lately, so I thought it important to post about.

My dad actually called me about it a few weeks ago, asking if it was something I was concerned about, since one of the cases was found only an hour from my home. My response: I’m not at all concerned. But, that doesn’t mean YOU shouldn’t be concerned; should you find yourself traveling to one of countries where MERS can be more commonly found, you may want to pay attention.

MERS wasn’t something I studied in my graduate studies, due to the fact that it’s such a new virus and a non-native virus to the U.S. So, I came up with some questions about MERS and researched out the answers.

What is the MERS?

MERS is an illness that is caused by a virus called MERS-CoV. The virus is of the family coronavirus, thus the “CoV”.

Most corona viruses infect the upper respiratory and gastrointestinal tract causing the common cold, however there are several “novel” (new, not resembling something seen or known) coronavirues. MERS-CoV is considered a novel coronavirus, as was the SARS-CoV, which caused Severe Acute Respiratory Syndrome (SARS).

Where did the virus come from and where can it be found currently?

It is not entirely certain where the virus originally came from, however it is very likely it began in an animal source. MERS-CoV has been found in camels, and a bat. According to WHO, camels are most likely the source for this virus.²

The MERS-CoV was first seen in Saudi Arabia in 2012. And so far, all of the cases of MERS-CoV have been linked to travel to the Arabian Peninsula.

According to the CDC, these countries in the Arabian Peninsula have patients with confirmed cases: Saudi Arabia, United Arab Emirates (UAE), Qatar, Oman, Jordan, Kuwait, Yemen, and Lebanon.

And these countries have patients with travel-associated confirmed cases: United Kingdom, France, Tunisia, Italy, Malaysia, Turkey, Greece, Egypt, United States of America, and the Netherlands.

How does the virus spread?

The virus spreads to people in close contact, and may spread from patients to healthcare providers. But, the virus does not seem to be spreading through communities via passing contact. Research into transmission of the virus is still underway.

What are the symptoms of MERS?

Most people with confirmed cases of MERS-CoV have a fever, cough, and shortness of breath. Many patients who develop the symptoms of the infection will develop severe acute respiratory illness, which may lead to complications such as pneumonia, kidney failure, and septic shock.

Of course, some people only reported mild respiratory illness, i.e. cold-like symptoms, or even no symptoms at all. And some had gastrointestinal symptoms including diarrhea and nausea/vomiting. Most of these cases recovered fully.

About 30% of people who develop severe acute respiratory illness die from the virus.¹ However, most of these people had some other pre-existing medical condition and/or already weakened immune system.

What is the incubation period?

The amount of time it takes from exposure to the virus to when the patient experiences symptoms is about 2-14 days.

How do I to protect myself?

You can protect yourself from MERS-CoV just like you would from other respiratory illnesses:

Wash your hands frequently and keep unwashed hands away from your face.
Cover your nose and mouth with a tissue when you sneeze and/or cough.
Avoid close contact with people who are clearly sick.
And disinfect frequently touched surfaces often.
And, as a precaution, you may want to limit contact with camels when visiting the Arabian Peninsula. You may also want to avoid undercooked camel meat and unpasteurized camel milk. And always wash hands and practice good hygiene after all contact with animals.

What if I get sick?

There is a specific lab test to determine if you have been infected with MERS-CoV. This test is done with a respiratory sample. There is also a blood test used to determine if you have antibodies to MERS-CoV, which you may have if you had been previously infected with the virus.

There is no specific treatment for the virus, just supportive treatment to relieve symptoms. But if you think you have contracted MERS-CoV, please seek medical attention.

There is no vaccine, however there has been the discussion of the development of one.

Can you currently still safely travel to countries in the Arabian Peninsula from the U.S.?

Sure! However, the CDC advises people traveling to countries in or near the Arabian Peninsula to follow precautions such as proper hand washing and avoiding contact with those who are clearly ill. If you plan to travel to one of these countries, please check out the CDC’s precautions first, MERS in the Arabian Peninsula.

If you should travel to one of these countries and develop the above mentioned symptoms within about 14 days after traveling, please seek medical attention and make sure to mention your recent travel to the Arabian Peninsula.

What’s the status of MERS-CoV in the U.S. as of the end of May 2014?

May 2, 2014 – confirmed case of MERS-CoV in someone who traveled to Saudi Arabia and back to the U.S. This person traveled from Saudi Arabia, then to London, then to Chicago, and finally to Indiana. The patient lives and works in Saudi Arabia and after being isolated and treated, was released fully recovered.
May 11, 2014 – second case reported in U.S. in another person who traveled to Saudi Arabia and back to the U.S. (This case was not linked to the first case.) This person is also a healthcare worker who flew from Saudi Arabia to London, then to Boston, Atlanta, and finally Orlando, Florida. This person is being monitored and isolated in a hospital in Orlando and is doing well.
May 16, 2014 – A person who had contact with the person infected with the first case of the virus, tested positive for MERS-CoV. This patient is an Illinois resident who met with the first patient on two occasions shortly before the first patient became sick. This person never sought medical attention, however he was monitored by public health officials.

The latest information on cases can be found in WHO Disease Outbreak News as well as at the CDC’s info page for MERS in the U.S.

If you live in the U.S., should you be concerned?

According to the CDC and other public health officials, MERS-CoV currently poses little risk to the general U.S. public. However, the CDC and partners are continuing to investigate and respond to any change in situation to prevent the spread of the virus to the general public.

So, there you have it. Unless you have plans to travel into the Arabian Peninsula, there’s no need to worry. (If you live in the U.S.) Hopefully that helped calm your nerves a bit. I know I can rest assured knowing the likelihood of contracting MERS in the U.S. is very, very low.

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