Respiratory Illness striking some in the Middle East

More information about Middle East Respiratory Syndrome (MERS)

July, 2013 --  MERS is the term for a new severe respiratory illness very similar to SARS. This disease was first reported in 2012 in Saudi Arabia and has been confirmed to be caused by a new species of coronavirus . 

The virus itself has evolved from a species that is known primarily in bats. Since most patients with confirmed MERS have not had close contact with bats, it is thought that transmission is through an as-yet unknown vector (i.e. mosquitoes).

There are only very few cases where disease has been attributed to human-to-human transmission. For this reason, this new coronavirus is NOT considered a “human coronavirus”, and should not be referred to as such. The World Health Organization and the Saudi Ministry of Health have agreed upon the term “MERS-CoV” to refer to this new virus, and this is how it will be referred to by the CDC and other health agencies around the world.

MERS presents as a nonspecific but severe respiratory illness. A patient should be considered highly suspicious for MERS if they meet the following criteria:

• Acute onset of respiratory infection with fever (38C/100.4F) and cough

          AND

• Suspected pulmonary parenchymal disease (i.e. pneumonia, ARDS) with consolidation on chest xray

          AND

• History of travel from the Arabian Peninsula within the last 14 days

If any other source of fever is identified (UTI, other known community-acquired pneumonia, wound infection, etc…), the concern for MERS is significantly lessened.

Arabian Peninsula Most at Risk at This Time

Almost all cases of MERS have been in patients who are from or have recently traveled from or live in the Arabian Peninsula (Saudi Arabia, Jordan, the UAE, Qatar). The few cases diagnosed outside of this area (specifically in the UK) were in patients who had either recently travelled from the Arabian Peninsula or in prolonged close contact with someone who met this criteria. No cases have been identified in the U.S.

At this time, no agency (CDC, WHO, etc.) has recommended restricted travel for individuals or denying entry to ill passengers. However, personal protection to prevent viral transmission is recommended for all travelers.

The usual handwashing and droplet prevention (i.e. covering mouth and nose when sneezing or coughing) is important. Also, individuals who are already ill should postpone travel plans. 
http://www.cdc.gov/coronavirus/mers/index.html.

--Dr. Beth Phillips, MD
AirMed Director of Medical Operations