MERS (Middle East Respiratory Syndrome)

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What is MERS?

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by a coronavirus (CoV).  Public health officials often refer to the virus as MERS-CoV. It was first reported in Saudi Arabia in September 2012. It is different from other coronavirus previously found in people. We don’t know where the virus came from or exactly how it spreads. However, it likely came from camels. Between 2012 and July 6, 2016, the illness was reported 27 countries including Arabian Peninsula, Europe, Malaysia, US, China and South Korea. Over the same period, the World Health organization was informed of 1,769 laboratory-confirmed cases of MERS-CoV infection and 630 deaths1.


Most people infected with MERS-CoV develop severe acute respiratory illness with symptoms of fever (greater than 100.4°F (38.0°C). cough, and shortness of breath. Some people were reported as having a mild respiratory illness2.


There is very little information on disease transmission, but MERS-CoV has been shown to spread between people who are in close contact. Transmission from infected patients to healthcare personnel has been observed. Multiple clusters of cases have occurred in which human-to-human transmission is evident. These clusters have been observed in health-care facilities, among family members and between co-workers.1

The mechanism by which transmission occurred in all of these cases, whether respiratory (e.g. coughing, sneezing) or direct physical contact with the patient or contamination of the environment by the patient, is unknown.2 Droplet precautions and contact precautions should be observed when people cough or sneeze. Respiratory droplets can be propelled up to a distance of three feet.  Virus droplets cause illness when they contaminate mucous membranes in the mouth, nose or eyes.


Since MERS is thought to primarily spread via close personal contact, attention to personal hygiene is key, including proper handwashing, use of alcohol-based hand sanitizers, covering coughs and sneezes and avoiding touching eyes, nose and mouth. Standard infection control procedures, droplet precautions, and the use of personal protective equipment and other appropriate infection prevention and control measures related to the scope of the illness should be followed.2

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.1