What Is MERS?

According to the U.S. Centers for Disease Control and Prevention (CDC), Middle East respiratory syndrome is a viral illness caused by a coronavirus called MERS-CoV. MERS-CoV, which was first reported in 2012 in Saudi Arabia, is similar to the virus that causes SARS (severe acute respiratory syndrome)—SARS-CoV.

Coronaviruses are common throughout the world. They usually cause mild-to-moderate upper respiratory illness—runny nose, cough, sore throat, fever—and resolve on their own without medical treatment. Complications from the viruses—pneumonia, for example—are more common in older adults and people with chronic heart or lung problems or a compromised immune system.

However, some coronaviruses (e.g., MERS-CoV, SARS-CoV) can cause serious illness. Since April 2012 and as of May 2014, more than 400 confirmed cases of MERS have been reported, resulting in 93 deaths. In May 2014, the first case of MERS in the United States was confirmed.

MERS Symptoms

Symptoms of MERS usually develop within about 10 days of exposure to the virus. The illness may be mild, but MERS-CoV infection typically results in severe respiratory symptoms. MERS symptoms include the following:

- Cough
- Fever
- Shortness of breath

According to the World Health Organization (WHO), people with a compromised immune system—for example, those with HIV—who contract MERS-CoV may experience additional symptoms, such as diarrhea.

Transmission of MERS-CoV

More research is needed to determine exactly how coronaviruses like MERS-CoV are spread. Likely methods of transmission include through the air—by coughing or sneezing—and through close personal contact—like touching or shaking hands. Infection also may spread by touching contaminated objects or surfaces and then touching your eyes, nose, or mouth.

MERS-CoV can spread among people who are in close contact—including from patients to health care professionals. As of May 2014, people who had contracted the virus had either recently returned from the Middle East, or had been in close contact with other confirmed or suspected cases.

From 2012 to May 2014, MERS has been confirmed in the following countries:

- Saudi Arabia
- United Arab Emirates (UAE)
- Qatar
- Oman
- Jordan
- Kuwait

Countries with at least one confirmed travel-associated case include:

- United Kingdom (UK)
- France
- Tunisia
- Italy
- Malaysia
- United States

Clusters of infection—within families, for example—are being investigated in Saudi Arabia, Jordan, the UK, France, Tunisia, and Italy. As of May 2014, CDC does not recommend that anyone change their travel plans because of MERS. The current CDC travel notice is an Alert (Level 2), which provides special precautions for travelers.

Because spread of MERS has occurred in health care settings, the alert advises travelers going to countries in or near the Arabian Peninsula to provide health care services to practice CDC’s recommendations for infection control of confirmed or suspected cases and to monitor their health closely. Travelers who are going to the area for other reasons are advised to follow standard precautions, such as hand washing and avoiding contact with people who are ill. As of May 2014, the CDC and WHO have not issued any travel warnings related to MERS—including to those countries listed above.

If you recently traveled to the Arabian Peninsula or bordering countries, or have been in close contact with someone who has traveled to an affected area, and develop respiratory symptoms within 10 days, contact your health care provider.

In April 2014, a study conducted by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH) found that MERS-CoV can remain stable for at least 72 hours in unpasteurized camel milk—identifying a possible source of infection. Additional studies are being conducted.

MERS Diagnosis and Treatment

At this time, a laboratory test for MERS-CoV is available only at international labs, state health departments, and from the CDC. Contact your health care provider for additional information about MERS diagnosis.

The goals of treatment for Middle East respiratory syndrome and other coronaviruses are to prevent complications and relieve symptoms. Supportive care includes getting plenty of rest, drinking plenty of fluids, and using pain and fever medications as directed.

Contact your health care provider if you develop respiratory symptoms and think you may be at risk for MERS.

MERS Prevention

To reduce your risk for MERS and other viral illnesses, the CDC recommends the following measures:

- Wash your hands often with soap and water. Rub vigorously for at least 20 seconds. If clean water and soap are not available, use hand sanitizer with an alcohol base.

- Use a tissue to cover your nose and mouth when you sneeze or cough.

- Avoid touching your eyes, nose, and mouth as much as possible.

- Avoid close contact with anyone who is sick. Don’t share cups or eating utensils.

- Clean and disinfect surfaces like doorknobs, toys, counter tops, etc.