MERS-CoV overview | International SOS

Last updated: January 2018


What is MERS-CoV? 

A virus that causes respiratory illness became known to the world in 2012. It was named as "Middle East Respiratory Syndrome Coronavirus" (MERS-CoV) reflecting the geographical area affected.

Although unconfirmed at this time, it’s suspected that dromedary camels are a host of the MERS virus, and the animal source of the condition. Human to human transmission has occurred in a limited fashion, but only through close contact like that often found in health care settings. The first known cases are believed to have originated in Jordan in 2012.1

MERS symptoms include shortness of breath, fever and a cough.
Saudi Arabia

Human infections 

Globally, more than two thousand cases of MERS-CoV have been confirmed2 since 2012. Approximately a third of those who were infected have died. All the cases identified have been linked to countries in the Arabian Peninsula – either in residents, travellers, migrants or close contacts of the travellers. Around 65% of cases are males. All age groups have been affected, but most individuals were aged between 40 to 50 years.Cases have originated in most of the countries on the Arabian Peninsula. Some people who were infected on the Arabian Peninsula travelled to other countries and were diagnosed with MERS-CoV there (imported cases). (For the full list of countries click here.)

Who is at risk of contracting MERS-CoV? 3

Individuals at risk include:

  • People with exposure to dromedary camels or their raw products. How the infection gets transmitted is not yet known, but MERS-CoV has been found in some dromedary camels. Research has shown direct contact with other animals such as goats or sheep or their raw/undercooked products (milk, meat) may also play a part in carrying the disease.
  • Healthcare workers in contact with confirmed or suspected cases.
  • Close contacts of confirmed cases.

MERS CoV symptoms4

Some confirmed cases of MERS-CoV showed mild symptoms consistent with the common cold, or did not present symptoms of MERS at all, and recovered.

Most confirmed cases of the MERS-CoV infection show signs of severe acute respiratory illness. Symptoms include:

  • fever
  • cough
  • shortness of breath.

Some patients diagnosed with MERS-CoV have also displayed symptoms of a gastrointestinal nature, such as nausea and vomiting, and diarrhoea.

The risk increases if the individuals have pre-existing co-morbidities such as diabetes, kidney failure or chronic lung disease, or weakened immune systems. Severe complications can include pneumonia.

About 35% 5 of lab-confirmed MERS cases have proved fatal – most of those casualties had an underlying medical condition.

MERS CoV treatment 

To date there is no cure for MERS-CoV, nor is there a vaccination to protect against the risk of exposure6 . However, as with other respiratory illnesses, public health bodies routinely publish advice on standard preventative actions for the spread of disease. Advice from the CDC 7 includes washing hands thoroughly with soap and water, and the regular cleaning and disinfecting of communal objects like doorknobs and desks.

Those diagnosed with mild to moderate cases can get help for treatment of MERS symptoms, while emergency services remain available for severe cases, including life support.

(For more information on the MERS CoV incubation period, diagnosis, treatment and prevention, click here.)

Human to human spread

There has been limited human-to-human transmission causing small outbreaks in communities and larger outbreaks in healthcare settings (these are secondary cases). However, WHO has stated ‘there is no evidence of sustained human-to-human transmission in the community.’ Moreover, the secondary infections are milder than those seen in primary cases. The rise in secondary cases in 2015 was attributed mainly to inadequate infection control measures in hospitals.

Any of the following scenarios could occur with MERS-CoV:

  • It could continue to be localised to the Middle East with sporadic export of cases to other countries.
  • Detection of primary cases could be found in countries outside the Middle East.
  • The virus could slow or stop – source of the virus could be identified and its transmission to humans reduced or stopped.
  • It could become more adapted to humans and able to transmit easily from person to person (could cause a regional epidemic or if it spreads to other continents, could become a pandemic). 
Business travellers in aiport

Snapshot of global MERS-CoV activity

Countries affected in the Middle East

  • In 2016 - Saudi Arabia, Bahrain, Oman, Qatar and United Arab Emirates.
  • In 2015 - Saudi Arabia, Iran, Jordan, Oman, Qatar and United Arab Emirates.

Countries affected in other parts of the world 

  • In 2016 - Austria and Thailand.
  • In 2015 - China, Germany, Philippines, South Korea and Thailand.