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Middle East Respiratory Syndrome (MERS)

By Craig R. Pringle, BSc, PhD, Professor Emeritus, School of Life Sciences, University of Warwick

Middle East respiratory syndrome is a coronavirus infection that causes severe flu-like symptoms.

The virus that causes Middle East respiratory syndrome (MERS) is a coronavirus similar to the virus that causes severe acute respiratory syndrome (SARS—see Severe Acute Respiratory Syndrome (SARS)). The MERS virus was first detected in Jordan and Saudi Arabia in 2012. As of May 2014, there were 658 confirmed cases of MERS and 202 deaths. Most occurred in Saudi Arabia, where new cases continue to appear. Cases have also occurred in France, Germany, Italy, Tunisia, and the United Kingdom in people who had been traveling or working in the Middle East. As of May 2014, three cases have been confirmed in the United States. Two involved people who had recently returned from the Persian Gulf, but the third person acquired the infection in the United States after contact with one of first two people.

Camels are suspected to be the primary source of infection for people, but how the virus spreads from camels to people is unknown.

The infection is more common among men and is more severe in older people and in people with an underlying chronic disorder such as diabetes or a heart or kidney disorder. The infection has been fatal in about one third of infected people.

This virus is spread through close contact with people who have MERS. People are not thought to be contagious until symptoms develop. Most cases of person-to-person spread have occurred in health care workers caring for infected people.

Symptoms usually appear about 2 to 14 days after people are infected. Most people have a fever, chills, muscle aches, and cough. About one third have diarrhea, vomiting, and abdominal pain.


  • Testing of fluids from the respiratory tract

  • Blood tests

Doctors suspect MERS in people who have a lower respiratory tract infection and have traveled to or reside in an area where they could have been exposed to the virus or who have had recent close contact with someone who may have had MERS.

To diagnose MERS, doctors take a sample of fluids from several places in the respiratory tract at different times and test it for the virus. They also do blood tests to detect the virus or antibodies to it. Blood tests are done on all people who have had close contact with someone who may have MERS.


  • Drugs to relieve fever and muscle aches

  • Isolation

There is no specific treatment. Acetaminophen or an NSAID such as ibuprofen are given to relieve fever and muscle aches.

Precautions are taken to prevent the spread of the virus. For example, the person is isolated, placed in a single room. People who go into the room must wear a mask, gown, cap, and gloves. The air in the room may be filtered.

People traveling to the Middle East should check the World Health Organization (WHO) web site for travel advice (see WHO World-travel advice on MERS-CoV for pilgrimages ).