Understanding Middle East Respiratory Syndrome (MERS)

Middle East respiratory syndrome (MERS) is an illness that affects your respiratory system. It is caused by a common type of virus called coronavirus (MERS-CoV). This virus generally causes a moderately severe respiratory illness. But, in some cases the symptoms are very severe and can lead to death.

MERS was first reported in 2012. It has been mostly found in countries in the Middle East, including Saudi Arabia, Jordan, and Yemen. Some cases have also been found in Europe, and in people who have recently traveled to the Middle East. Only a few cases have been reported in the U.S.

How the virus spreads to people is not yet fully understood.  Camels and bats can carry the virus.  In addition, it likely can also spread from person to person. 

What are the symptoms of MERS?

In some cases, MERS causes no symptoms. But most often, symptoms of MERS start about 5 days after being exposed to the virus, but can develop up to 14 days later.

Common symptoms include:

  • Fever

  • Chills

  • Coughing

  • Sore throat

  • Runny nose

  • Trouble breathing

  • Muscle aches

Less common symptoms include:

  • Bloody coughing

  • Nausea and vomiting

  • Diarrhea

  • Shortness of breath

What are possible complications from MERS?

In some cases, MERS can cause severe problems. Like many other infections, MERS is probably more severe in the very young, the very old, those with underlying illness such as diabetes or heart failure, and those who have weak immune systems.  However, these links are still uncertain. Complications can include:

  • Lung infection (pneumonia)

  • Breathing (respiratory) failure and need for a breathing machine (ventilator)

  • Failure of the kidneys and other organs

  • Widespread infection and low blood pressure (septic shock)

These severe complications are more likely to lead to death from MERS.

How is MERS diagnosed?

Your healthcare provider will ask about your medical history. He or she will also ask about your recent travel and contact with sick people. The provider may also ask about recent contact with camels.

You will have tests to check for the cause of your symptoms. The symptoms of MERS are very similar to illnesses caused by other viruses, such as influenza (the flu). You may have tests such as:

  • Chest X-ray. X-rays use a small amount of radiation to make images of the inside of your body. A chest X-ray is done to check for problems in your lungs.

  • Blood tests. Blood is taken from a vein in your arm or hand. This is done to check for certain chemicals that can show if you have the MERS virus or other illness.

  • Nasal or throat swab. A cotton-tipped swab is wiped inside your nose or throat. This is done to check for viruses in your nasal mucus.

  • Sputum culture. A small sample of mucus coughed from your lungs is collected. It is checked for the virus.

How is MERS treated?

Currently no medicine is available to treat MERS directly. Treatment for MERS consists of supporting your body while it fights the disease. This is known as supportive care. Supportive care may include:

  • Pain medicine. These include acetaminophen and ibuprofen. They are used to help ease pain and reduce fever.

  • Bed rest. This helps your body fight the illness.

Care during severe illness may include:

  • IV fluids. These are given through a vein to help keep your body hydrated.

  • Oxygen. Supplemental oxygen or ventilation with a breathing machine (ventilator) may be given. This is done to keep enough oxygen in your body.

  • Vasopressor medicine. These help to raise blood pressure when it is too low from shock.

Are you at risk for MERS?

If you’ve been to a place where people have been sick with MERS, you are at risk for infection. You are at risk if you:

  • Recently traveled in or near the Arabian Peninsula

  • Had contact with a sick person who recently traveled to the Arabian Peninsula

  • Had contact with camels, or their milk, urine, or meat

  • Had contact with a person who was diagnosed with MERS

  • Had contact with a healthcare worker who has been in contact with people who have MERS

How can MERS be prevented?

It is not yet known how MERS is passed along. It may be passed from an infected person. It may be passed along by an infected camel or bat. There is currently no vaccine for MERS. Prevention is done by avoiding contact with the virus, and taking special care around the virus. If you are in an area with MERS:

  • Wash your hands often. Or, use an alcohol-based hand sanitizer often.

  • Only touch your eyes, nose, or mouth with clean hands.

  • Wash your hands after touching animals. Avoid contact with sick animals.

  • Avoid contact with camels.

  • Don’t drink raw (unpasteurized) camel milk.

  • Don’t eat undercooked camel meat.

  • Try to have less contact with people who are sick.

  • Don’t share eating or drinking tools with sick people.

  • Don’t kiss someone who is sick.

  • Clean surfaces regularly with disinfectant.

What to do if you are at risk for MERS

If you have had close contact with someone who has been diagnosed with MERS:

  • Call your healthcare provider. He or she can talk with local health staff to see what action may be needed.

  • Follow all instructions from your healthcare provider. This may include having blood tests.

  • Take your temperature every morning and evening for at least 14 days. This is to check for fever.

  • Keep watch for symptoms of MERS. Tell your healthcare provider if you have symptoms.

If you have a fever or other MERS symptoms:

  • Don’t panic. Keep in mind that other illnesses can cause similar symptoms.

  • Stay away from work, school, and public places. This is to help prevent the virus from spreading.

  • Call your healthcare provider. Explain that you have been exposed to MERS and have symptoms. Do this before going to the hospital.  Your provider  may be able to see you at their clinic or they may send you to the Emergency Room

  • Keep in mind that medical staff may wear protective equipment, such as masks, gowns, gloves, and eye protection. This is to prevent the possible virus from spreading.

  • Tell the medical staff about recent travel, including local travel on public transport. Staff may need to find other people you have been in contact with.

  • Follow all instructions the medical staff gives you.

Travel precautions

The Ministry of Health of Saudi Arabia advises that some people should not travel to Mecca, Saudi Arabia. This includes:

  • Adults age 65 years or older

  • Children age 12 or younger

You should also avoid that area if you are pregnant or you have:

  • A chronic health condition like heart disease, asthma, or diabetes

  • An immune deficiency disorder

  • Cancer

  • Terminal illness

For more information

To learn more about MERS, visit the CDC website.