Middle East respiratory syndrome coronavirus infection (patient information)

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Middle East respiratory syndrome coronavirus


What are the symptoms?

What are the causes?

When to seek urgent medical care?



What to Expect (Outlook/Prognosis)?


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]


Middle east respiratory syndrome (MERS) is a viral respiratory illness. MERS is caused by a coronavirus called “Middle East Respiratory Syndrome Coronavirus” (MERS-CoV). MERS-CoV is a beta coronavirus. It was first reported in 2012 in Saudi Arabia. MERS-CoV used to be called “novel coronavirus,” or “nCoV”. It is different from other coronaviruses that have been found in people before.[1]

What are the Symptoms of Middle East Respiratory Syndrome Coronavirus Infection?

Most people who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. Some people were reported as initially having a mild respiratory illness.[1]

What Causes Middle East Respiratory Syndrome Coronavirus Infection?

  • MERS-CoV has been shown to spread between people who are in close contact. Transmission from infected patients to healthcare personnel has also been observed. Clusters of cases in several countries are being investigated.
  • We don’t know for certain where the virus came from. However, it likely came from an animal source. In addition to humans, MERS-CoV has been found in camels in Qatar, Egypt and Saudi Arabia, and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV, indicating they were previously infected with MERS-CoV or a closely related virus. However, we don’t know whether camels are the source of the virus. More information is needed to identify the possible role that camels, bats, and other animals may play in the transmission of MERS-CoV.[1]

When to Seek Urgent Medical Care?

If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries, you should see your healthcare provider and mention your recent travel.[1]


Lab tests (polymerase chain reaction or PCR) for MERS-CoV are available at state health departments, CDC, and some international labs. Otherwise, MERS-CoV tests are not routinely available. There are a limited number of commercial tests available, but these are not FDA-approved.[1]


There are no specific treatments recommended for illnesses caused by MERS-CoV. Medical care is supportive and to help relieve symptoms.[1]

What to Expect (Outlook/Prognosis)?

Approximately 30% of patients infected with MERS-CoV died.[1]


  • Preventive measures might include:[2]
  • washing hands with soap, during at least 20 seconds. Particular attention should be give to children, who should act accordingly. In case water and soap are not available, then an alcohol-based solution should be used instead
  • avoiding touching the eyes, nose and mouth by unwashed hands
  • covering the nose and mouth when coughing or sneezing with a tissue that should be disposed afterwards
  • avoiding personal physical contact or sharing of eating utensils with sick people
  • frequent cleaning of touched surfaces, such as doorknobs
  • avoid drinking raw milk or eating food that may be contaminated with animal secretions or products, unless they have been properly washed, peeled, or cooked.
  • for the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.
  • WHO recommends increasing efforts to raise awareness of MERS among travelers going to and traveling from MERS-affected countries, but otherwise does not advise special screening at points of entry with regard to this event nor does WHO currently recommend the application of any travel or trade restrictions.


Currently there is no vaccine available for the prevention of MERS infection.[2][3][4]

Pre-Travel Medical Consult

  • Before traveling individuals should consult their primary care physician, at least 4 to 8 weeks prior to the due date. However, last minute consults are also beneficial. *During the consult the physician will address important health risks, evaluate the need for vaccinations and/or antimalarial medication and at the same time identify medical items the person should carry with her.[2][5]

Travel Guidance

  • Prior to travel, individuals should review CDC recommendations for infection control in endemic regions.
  • All individuals should monitor their health condition closely during the travel and in the weeks after their return. The peak travel season to Saudi Arabia is July through November, coinciding with the religious pilgrimages of Hajj and Umrah.
  • CDC encourages pilgrims to consider recommendations from the Saudi Arabia Ministry of Health regarding persons who should postpone their pilgrimages this year, including persons aged ≥65 years, children, pregnant women, and persons with chronic diseases, weakened immune systems , or cancer. It is also recommended that individuals who travel to countries in the Arabian Peninsula or nearby countries, take protective measures in order to avoid respiratory illnesses, by practicing good hand hygiene and avoiding contact with ill patients. In case of symptom onset, including: cough, fever or dyspnea, anytime during the trip or in the 14 days after the return to the US, patients should seek medical attention and warn their health-care provider about the recent trip.

The WHO advises persons with pre-existing medical conditions to consult a health-care provider before deciding whether to make a pilgrimage.[2]

Close contacts with confirmed or probable cases of MERS




  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 "CDC-MERS-Frequently Asked Questions".
  2. 2.0 2.1 2.2 2.3 "MERS Prevention and Treatment".
  3. Abdel-Moneim, Ahmed S. (2014). "Middle East respiratory syndrome coronavirus (MERS-CoV): evidence and speculations". Archives of Virology. doi:10.1007/s00705-014-1995-5. ISSN 0304-8608.
  4. 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.
  5. "International travel and health".