I. What is Middle East Respiratory Syndrome (MERS)?
Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (MERS-CoV), which was first identified in Saudi Arabia in 2012. Coronaviruses are a group of viruses that can cause morbidity in humans and animals, and are often capable of causing a variety of illnesses in humans ranging from the common cold to severe acute respiratory syndrome (SARS).
II. Where is Middle East Respiratory Syndrome occurring?
Cases of Middle East Respiratory Syndrome have been reported in the following countries: Saudi Arabia, the UAE, Jordan, Kuwait, Oman, Qatar and Yemen in the Middle East; Egypt and Tunisia in Africa; France, Germany, the Netherlands, Greece, Italy and the United Kingdom in Europe; the Philippines, Malaysia and Lebanon in Asia and the United States in North America.
The virus appears to be circulating widely throughout the Arabian Peninsula. All recently reported cases outside the Middle East were initially infected in the Middle East and then imported outside the Middle East. These travel-associated cases do not appear to have infected others within their own countries. imported cases in France and the United Kingdom in 2013 resulted in limited human-to-human transmission.
C. What are the symptoms of Middle East respiratory syndrome?
Typical cases often present with symptoms such as fever, cough and shortness of breath, and pneumonia manifestations are often found on examination. Gastrointestinal symptoms, such as diarrhea, have also been reported. Severe cases can lead to respiratory failure, requiring mechanical ventilation and supportive therapy in the intensive care unit. Organ failure, especially renal failure and infectious shock, can occur in some cases. The morbidity and mortality rate is approximately 27%. The virus appears to cause more severe disease in immunocompromised populations, in the elderly, and in those with chronic conditions such as diabetes, cancer, and chronic lung disease.
Can I get the virus and not get sick?
Yes, some people who are infected with the virus do not develop symptoms. They are detected because the Middle East respiratory syndrome coronavirus was detected in a follow-up study of people in close contact with infected cases.
V. How do humans become infected with the virus?
It is not known exactly how humans become infected with the virus. In some cases, the virus appears to be transmitted through close contact. This is often seen in family members, patients, and health care workers. Recently, there has been an increase in reports of infections among health care workers. No possible source of infection has been found in some community cases. It is possible that they were infected by exposure to animals, people, or other sources of infection.
VI. Can it be transmitted from person to person?
Yes, but only to a limited extent. The virus does not seem to spread easily from person to person unless there is close contact, such as unprotected care of a patient. Interpersonal transmission is easier in clustered cases within hospitals, especially when infection prevention and control measures are inadequate. To date, there is no evidence of sustained intra-community transmission.
VII. What are the sources of infection of the virus —- bats, camels, domestic animals?
The full source of infection is not fully known. However, strains of the virus matching human strains have been isolated from camels in Egypt, Qatar, and Saudi Arabia. Many studies have identified antibodies to the virus in camels in Africa and the Middle East. Viral gene sequence data from humans and camels suggest a close association between the two. Other hosts may also exist.
VIII. Should humans avoid contact with camels or camel products? Is it safe to visit farms, markets or camel fairs?
As a general precaution, anyone who currently visits farms, markets, barns, or other places where animals are present should take general hygiene measures, such as washing hands frequently before and after contact with animals and avoiding contact with diseased animals.
Consumption of raw or undercooked animal products (e.g., milk and meat) poses a high risk of infection with a variety of pathogenic microorganisms. Animal products that have been properly processed by cooking or pasteurization are safe for consumption, but they also need to be handled with care to avoid cross-contamination with uncooked food. Camel meat and milk are nutritious products that can be consumed sustainably after heat sterilization, cooking, or other heat treatments.
Until more information is available, people with diabetes, chronic lung disease, kidney failure, or immunocompromise are considered to be at high risk for MERS-CoV. Therefore, these populations should avoid contact with camels or eating meat that has not been cooked.
Workers on camel farms and slaughterhouses should practice good personal hygiene practices, such as frequent hand washing after contact with animals, feasible facial protection, and wearing protective clothing (which needs to be removed and washed daily after work). Workers should also avoid exposing family members to soiled work clothes, shoes or other items contaminated by camels or camel excrement. Do not slaughter or consume sick animals. Avoid direct contact with animals that have been confirmed to be infected with MERS-CoV.
Is there a vaccine available to prevent MERS-CoV infection? What is the treatment?
There is no vaccine or specific treatment available. Treatment is supportive and based on the clinical status of the patient.
X. Are medical personnel at risk of MERS-CoV infection?
Yes. Transmission has occurred in hospitals in some countries, including from cases to health care workers. Because it is not always possible to detect cases of MERS in the early stages of the disease or without testing, because the symptoms and other clinical manifestations of the disease are not specific, it is important for health care workers to ensure that standard precautions are always taken when treating all patients. When treating patients with symptoms of acute respiratory infection, droplet protection should be used in addition to standard protective measures. When treating suspected or confirmed MERS cases, additional contact precautions and eye protection should be taken. Airborne protective measures are also required when performing aerosol-producing operations.
Is it safe to travel to the Middle East and does WHO have any recommendations on travel or trade restrictions for MERS-CoV?
WHO does not recommend any travel or trade restrictions for this virus at ports of entry.
How is WHO responding to the outbreak of Middle East Respiratory Syndrome?
WHO is working with clinicians and scientists to collect and share scientific evidence to better understand MERS-CoV and its cause, MERS, and to identify outbreak response priorities, treatment strategies, and clinical management approaches. meetings, development of guidelines and training for health administrations and health technology agencies on interim surveillance, laboratory testing of cases, prevention and control of infection and clinical management. The Director-General convened an emergency committee within the framework of the International Health Regulations to discuss whether the incident constitutes a public health emergency of international concern and the public health measures to be taken. The Emergency Committee will be reconvened as needed to address the situation of the outbreak.