3 Key Questions Answered About the MERS Virus

Source: Cynthia Goldsmith/Azaibi Tamin

Source: Cynthia Goldsmith / Azaibi Tamin

By now, you have likely heard about MERS, a virus far more common in the Middle East than it is currently in the U.S., but may not know exactly what the illness is and who is at the greatest risk. With only three cases reported in the U.S. so far, the Centers for Disease Control (CDC) places the risk as very low to the general public. As healthcare officials continue to study this relatively new disease, it is beneficial to know the signs and symptoms of MERS, how it spreads, the history behind the virus, and where it has been reported so far — information that the CDC and World Health Organization (WHO) have been updating regularly.

What is MERS?

MERS stands for Middle East Respiratory Syndrome, and the first case of MERS are identified as occurring in Saudi Arabia in 2012. It was caused by a new coronavirus, MERS-CoV, so it is not the same as the coronavirus that causes SARS, which is SARS-CoV. The CDC says the name was selected in 2013 by the Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses.

Both, however, are caused by coronaviruses, which the CDC says generally cause mild to moderate upper respiratory illnesses, and many people will be infected with one form in their lifetime. Young children are the most susceptible to coronaviruses, and people can be infected several times throughout their lives. While most illnesses from coronaviruses are mild to moderate, others, like MERS, are more severe. Again, like SARS, MERS is believed to be most like coronaviruses found in bats, but the CDC is still gathering information about MERS.

What are the symptoms and who is at risk?

WHO lists shortness of breath, cough, and fever among the symptoms associated with MERS. When people who have MERS are examined, they often have pneumonia, as well. Some patients have reported gastrointestinal symptoms like diarrhea. In severe cases, respiratory failure occurs and patients need to be admitted to an intensive care unit and require mechanical ventilation to breathe. There have also been cases in which organ failure occurs, in particular kidney failure. Approximately 27 percent of reported cases have been fatal.

People with weakened immune systems — such as the elderly or someone who has a chronic disease (like diabetes or lung cancer) — are most at risk for having a severe case. Exactly how the disease is transmitted is still unknown. MERS is contagious and appears to be spread from person to person when close contact occurs. This places health care providers at a higher risk; the CDC says that people studying MERS have not seen continuous MERS-CoV spreading within communities.

Where has MERS been reported?

All of the cases reported so far have also been traced back to the Arabian Peninsula as the point of origin, and as of May 16, 572 cases laboratory cases had been confirmed. WHO says that “Jordan, Kuwait, Oman, Qatar, Saudi Arabia, the United Arab Emirates, and Yemen (Middle East); France, Germany, Greece, Italy, and the United Kingdom (UK) (Europe); Tunisia and Egypt (Africa); Malaysia and the Philippines (Asia); and the United States of America (Americas)” have reported cases of MERS.

However, the majority of cases are located in the Middle East, and people who have recently visited or traveled through the Arabian Peninsula are at the highest risk. On May 2, the first case (Indiana) was reported in the U.S. A second, unrelated case (Florida) was confirmed on May 11. In both cases, the patient had recently traveled in Saudi Arabia. On May 16, a resident of Illinois who had come in close contact with the Indiana case tested positive for MERS, but no medical attention has been needed. After isolated hospital care, the Indiana and Florida patients have recovered; both are healthcare workers.

The Illinois resident’s case highlights another aspect of MERS: People can be infected with the virus but display no signs of illness. “It’s possible that as the investigation continues others may also test positive for MERS-CoV infection but not get sick,” David Swerdlow, the leader of the CDC’s MERS-CoV response, said in a press release. “Along with state and local health experts, CDC will investigate those initial cases and if new information is learned that requires us to change our prevention recommendations, we can do so.”

Again, given the virus’s history of transmission, health care providers — particularly in the Middle East — are at the highest risk of contracting the disease because they are also the most likely to encounter MERS. Travelers are not being cautioned against traveling to the Arabian Peninsula, but they should be aware of MERS. If they come in contact with someone infected with MERS, standard precautions like not sharing utensils and regularly washing hands are recommended.

“In this interconnected world we live in, we expected MERS-CoV to make its way to the United States,” CDC Director Tom Frieden said when MERS was first confirmed in the U.S. “We have been preparing since 2012 for this possibility.”

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