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==Natural History== | ==Natural History== | ||
The median incubation period for secondary cases associated with limited human-to-human transmission is approximately 5 days (range 2-13 days). In MERS-CoV patients, the median time from illness onset to hospitalization is approximately 4 days. In critically ill patients, the median time from onset to intensive care unit (ICU) admission is approximately 5 days, and median time from onset to death is approximately 12 days.<ref name=CDC2>{{cite web | title = Clinical Course | url = http://www.cdc.gov/coronavirus/mers/clinical-features.html }}</ref> | |||
==Complications== | ==Complications== | ||
Revision as of 16:16, 23 June 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Middle East Respiratory Syndrome (MERS) is a viral respiratory illness. It is caused by an emerging coronavirus, specifically a betacoronavirus called MERS-CoV (Middle East Respiratory Syndrome Coronavirus), first discovered in 2012. Being a relatively novel virus, there is no virus-specific prevention or treatment options for MERS patients. Attending to the fact that a vaccine hasn't been developed yet, enhancing infection prevention and control measures is critical to prevent the possible spread of MERS-CoV in hospitals and communities. To date, the mortality rate of MERS-CoV is approximately 30%. Cases have been reported where critically ill patients have developed complications such as: acute renal failure, pericarditis and disseminated intravascular coagulation .[1][2][3][4]
Natural History
The median incubation period for secondary cases associated with limited human-to-human transmission is approximately 5 days (range 2-13 days). In MERS-CoV patients, the median time from illness onset to hospitalization is approximately 4 days. In critically ill patients, the median time from onset to intensive care unit (ICU) admission is approximately 5 days, and median time from onset to death is approximately 12 days.[5]
Complications
There have been reported different stages of MERS-CoV infection in the discovered cases. These may range from asymptomatic patients to critically ill patients.[4][6] According to the underlying comorbidities of each patient, along with the evolution of the disease, some complications may develop, involving other organ systems, including:[6][7][8][9][10][11][12][13][14]
- Pneumonia
- Acute respiratory distress syndrome
- Acute kidney injury
- Pericarditis
- Disseminated intravascular coagulation
- Shock
- Death
Prognosis
References
- ↑ Drosten C, Seilmaier M, Corman VM, Hartmann W, Scheible G, Sack S; et al. (2013). "Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection". Lancet Infect Dis. 13 (9): 745–51. doi:10.1016/S1473-3099(13)70154-3. PMID 23782859.
- ↑ Dyall J, Coleman CM, Hart BJ, Venkataraman T, Holbrook MR, Kindrachuk J; et al. (2014). "Repurposing of clinically developed drugs for treatment of Middle East Respiratory Coronavirus Infection". Antimicrob Agents Chemother. doi:10.1128/AAC.03036-14. PMID 24841273.
- ↑ "Clinical management of severe acute respiratory infections when novel coronavirus is suspected: What to do and what not to do" (PDF).
- ↑ 4.0 4.1 "MERS Prevention and Treatment".
- ↑ "Clinical Course".
- ↑ 6.0 6.1 Memish, Ziad A.; Zumla, Alimuddin I.; Assiri, Abdullah (2013). "Middle East Respiratory Syndrome Coronavirus Infections in Health Care Workers". New England Journal of Medicine. 369 (9): 884–886. doi:10.1056/NEJMc1308698. ISSN 0028-4793.
- ↑ Zaki, Ali M.; van Boheemen, Sander; Bestebroer, Theo M.; Osterhaus, Albert D.M.E.; Fouchier, Ron A.M. (2012). "Isolation of a Novel Coronavirus from a Man with Pneumonia in Saudi Arabia". New England Journal of Medicine. 367 (19): 1814–1820. doi:10.1056/NEJMoa1211721. ISSN 0028-4793.
- ↑ "Novel coronavirus summary and literature update as of 17 May 2013".
- ↑ Drosten, Christian; Seilmaier, Michael; Corman, Victor M; Hartmann, Wulf; Scheible, Gregor; Sack, Stefan; Guggemos, Wolfgang; Kallies, Rene; Muth, Doreen; Junglen, Sandra; Müller, Marcel A; Haas, Walter; Guberina, Hana; Röhnisch, Tim; Schmid-Wendtner, Monika; Aldabbagh, Souhaib; Dittmer, Ulf; Gold, Hermann; Graf, Petra; Bonin, Frank; Rambaut, Andrew; Wendtner, Clemens-Martin (2013). "Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection". The Lancet Infectious Diseases. 13 (9): 745–751. doi:10.1016/S1473-3099(13)70154-3. ISSN 1473-3099.
- ↑ Assiri, Abdullah; McGeer, Allison; Perl, Trish M.; Price, Connie S.; Al Rabeeah, Abdullah A.; Cummings, Derek A.T.; Alabdullatif, Zaki N.; Assad, Maher; Almulhim, Abdulmohsen; Makhdoom, Hatem; Madani, Hossam; Alhakeem, Rafat; Al-Tawfiq, Jaffar A.; Cotten, Matthew; Watson, Simon J.; Kellam, Paul; Zumla, Alimuddin I.; Memish, Ziad A. (2013). "Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus". New England Journal of Medicine. 369 (5): 407–416. doi:10.1056/NEJMoa1306742. ISSN 0028-4793.
- ↑ Guery, Benoit; Poissy, Julien; el Mansouf, Loubna; Séjourné, Caroline; Ettahar, Nicolas; Lemaire, Xavier; Vuotto, Fanny; Goffard, Anne; Behillil, Sylvie; Enouf, Vincent; Caro, Valérie; Mailles, Alexandra; Che, Didier; Manuguerra, Jean-Claude; Mathieu, Daniel; Fontanet, Arnaud; van der Werf, Sylvie (2013). "Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission". The Lancet. 381 (9885): 2265–2272. doi:10.1016/S0140-6736(13)60982-4. ISSN 0140-6736.
- ↑ Assiri, Abdullah; Al-Tawfiq, Jaffar A; Al-Rabeeah, Abdullah A; Al-Rabiah, Fahad A; Al-Hajjar, Sami; Al-Barrak, Ali; Flemban, Hesham; Al-Nassir, Wafa N; Balkhy, Hanan H; Al-Hakeem, Rafat F; Makhdoom, Hatem Q; Zumla, Alimuddin I; Memish, Ziad A (2013). "Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study". The Lancet Infectious Diseases. 13 (9): 752–761. doi:10.1016/S1473-3099(13)70204-4. ISSN 1473-3099.
- ↑ Arabi, Yaseen M.; Arifi, Ahmed A.; Balkhy, Hanan H.; Najm, Hani; Aldawood, Abdulaziz S.; Ghabashi, Alaa; Hawa, Hassan; Alothman, Adel; Khaldi, Abdulaziz; Al Raiy, Basel (2014). "Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection". Annals of Internal Medicine. 160 (6): 389–397. doi:10.7326/M13-2486. ISSN 0003-4819.
- ↑ "Background and summary of novel coronavirus infection - as of 21 December 2012".