Middle East Respiratory Syndrome (MERS)

A viral respiratory illness unique to humans. 


The infection is linked to MERS-CoV (corona virus).

A zoonotic disease with dromedary camel’s the likely animal reservoir.

Presentation is typically fever with symptoms of lower respiratory tract infection and radiographic evidence of pneumonia or ARDS.


Additional manifestations might include: renal failure, anorexia, nausea, vomiting, diarrhea, abdominal pain, and disseminated intravascular coagulation.

Transmission risk factors include respiratory exposure to camel secretions, drinking raw camel milk, eating undercooked camel meat.

Healthcare workers are disproportionately infected.

Increased risk in individuals with occupational exposure to camels

MERS-CoV is transmissible person to person, but sustained community transmission has not been described.

Healthcare settings pose the highest risk.

Incubation period is from 1-14 days.

Less contagious then SARS-CoV and higher fatality rates.

Hospital related outbreaks have been recorded.

Typical presentation is a nonspecific febrile respiratory tract infection.


MERS As of November 2019 cost a total of 2494 cases and 858 deaths, the majority in Saudi Arabia.


MERS Natural reservoir is thought to be bats.


MERS is associated with atypical pneumonia but more prominent gastrointestinal symptoms, and acute kidney failure.


MERS necessitates mechanical ventilation in 50-89% of patients and has a case fatality of 36%.

Can progress to respiratory failure although it may never become severe.

Children rarely contract or die from the disease process.

Risk factors include comorbidity with lung disease, kidney disease, diabetes, and immune deficiency diseases.

A combination of recombinant interferon beta-1b and lopinavir-ritonavir lead to lower mortality and placebo among patients hospitalized with MERS.


Diagnosis is made by identifying the virus in respiratory samples by PCR testing.

Treatment is largely supportive, focusing on management of complications of sepsis and ARDS..

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