General Information:

• Middle East Respiratory Syndrome (MERS) is a viral illness caused by the coronavirus MERS-CoV.
• First reported as a novel species in Saudi Arabia in September 2012, it has an estimated fatality rate of 40%.
• MERS can present like a URI or can be as severe as pneumonia and ARDS.
• More than half of the laboratory-confirmed secondary cases have been associated with health care settings.

Area of the world affected:

• A second spike of cases occurred over the past few weeks in the Arabian Peninsula and has spread to Northern Africa and Europe.
• All cases outside of the Middle East involve patients that have either been to the Middle East or have been in contact with someone returning from the region.

Relevance to the US physician:

• Inbound travel to the US from the Middle East increases significantly between April and September. The WHO’s Global Alert Response recommends that countries with travelers from the Arabian Peninsula maintain a high level of vigilance.

Bottom Line:

Evaluate patients for MERS-CoV infection if they develop fever and pneumonia within 14 days after traveling to countries in or near the Middle East or if they had close contact with someone from this area.

University of Maryland Section of Global Emergency Health

Author: Walid Hammad, MB ChB

References

1. International Society of Infectious Disease, Mers-Cov - Eastern Mediterranean (35): Greece Ex Saudi Arabia, Saudi Arabia, Uae. Massachusetts: The Program for Monitoring Emerging Diseases, April 2014. Available at: http://www.promedmail.org/direct.php?id=2415087 Accessed on April 22, 2014
2. World Health Organization, Middle East respiratory syndrome coronavirus (MERS CoV) Summary and literature update – as of 27 March 2014. Geneva: World Health Organization, 2014. Available at: http://www.who.int/csr/disease/coronavirus_infections/MERS_CoV_Update_27_March_2014.pdf?ua=1. Accessed: April 22, 2014.
3. Centers for Disease Control and Prevention, Middle East Respiratory Syndrome (MERS) February 2014. Avaialble at: http://www.cdc.gov/coronavirus/MERS/index.html. Accessed: April 22, 2014