Middle East Respiratory Syndrome Coronavirus (MERS-CoV): The Bottom Line for Clinicians
by Susan Yox/Medscape
Middle East respiratory syndrome (MERS) is a respiratory illness caused by a coronavirus, usually referred to as the Middle East Respiratory Syndrome Coronavirus, or MERS-CoV. A coronavirus also caused the outbreak of severe acute respiratory syndrome (SARS), which led to almost 800 deaths in 2003.
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MERS-CoV was first reported in Saudi Arabia in September 2012. In a press release issued May 2, 2014, the Centers for Disease Control and Prevention (CDC) identified 401 confirmed cases of MERS-CoV infection in 12 countries, with all reported cases originating in the Arabian Peninsula. Most patients developed severe acute respiratory illness, with fever, cough, and shortness of breath, and 93 patients have died. The case fatality rate in symptomatic patients is 30%.
On April 24, 2014, the World Health Organization (WHO) issued a statement indicating, “although camels are suspected to be the primary source of infection for humans, the exact routes of direct or indirect exposure remain unknown. Investigations to identify the source of infection and routes of exposure are still ongoing.” (See also a recent article from Emerging Infectious Diseases, “Human Infection With MERS Coronavirus After Exposure to Infected Camels.”)
On May 2, 2014, the first confirmed case of MERS-CoV was reported in the United States: A healthcare worker who was working in Saudi Arabia and who traveled back to the United States on April 24 fell ill on April 27, went to an unidentified hospital emergency department in Indiana on April 28, and was admitted to the hospital that same day. On May 2, CDC testing confirmed that the patient had MERS-CoV, and he/she remains in the hospital, in isolation and in stable condition. (See our news story, “First MERS Case Reported in United States.”)
A second case was reported in the United States on May 12, 2014, at a Florida hospital, also in a healthcare worker who had traveled to Florida from Saudi Arabia. (See our news story, “Second MERS Case Reported in United States.”)
For clinicians practicing in the United States who may have questions, here is the latest guidance, directly from the CDC and the WHO, on MERS-CoV. (Be sure to check the links provided for the most recent information, because this guidance may change rapidly.)
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Image pictured above:
SR0222 (MERS coronavirus, TEM)