MERS CORONAVIRUS

MERS stands for Middle East Respiratory Syndrome and is the name given to an infection of the respiratory system caused by the MERS Coronavirus (MERS-CoV), which was first identified in 2012. The course of infection can vary widely: some people may notice nothing or have only slight symptoms while others can develop a very severe – and sometimes fatal – respiratory disorder. To date, cases of MERS-CoV infection have been reported primarily from the Arabian Peninsula and for the most part in Saudi Arabia. In all cases of the disease reported outside the Arabian Peninsula to date, the patient had previously spent time in this region or had had close contact with other MERS patients.

From animals to humans

Dromedary camels are the pathogen's most likely natural reservoir. Transmission to humans is possible from close contact with these animals. Not enough is yet known about the types of contact favourable to transmission or whether animal products also have any role to play.

The disease usually starts with flu-like symptoms such as fever, coughing and shortness of breath. Gastrointestinal symptoms – and diarrhoea in particular – can also occur. Pneumonia-like symptoms frequently develop. In later stages, complications can include acute respiratory distress syndrome and renal failure. The disease is often fatal

The length of time between infection and the first signs of illness is usually one to two weeks. Once symptoms appear, patients can then pass the disease on to others. It is not yet known how long patients stay infectious. Infected people who do not develop any signs of disease may be able to infect other people, but there is as yet no evidence one way or the other.

• Those at greatest risk of infection are visitors to the countries of the Arabian Peninsula, especially after contact with dromedary camels.
• There is also an increased risk of infection for people in close contact with MERS patients, and healthcare workers in particular.
• Older individuals and people with a weakened immune system (e.g. following an organ transplant or in the case of cancer) or systemic diseases such as diabetes and chronic lung or kidney disorders are particularly at risk of developing severe forms of the disease.

• If you are planning a trip to the Arabian Peninsula or to other countries where MERS-CoV infections have occurred, then you are strongly advised to discuss this with your GP, especially if you suffer from a systemic disease such as diabetes.

• During your stay on the Arabian Peninsula, avoid direct contact with animals, and with dromedary camels in particular.
• If you visit an animal farm or a livestock market, take standard precautions for hand hygiene if you have touched any animals – especially dromedary camels.
• Do not consume any raw meat, raw or inadequately pasteurised milk, or urine (e.g. if consumed for medicinal purposes) – especially from camels. Avoid all raw foodstuffs, and especially those that could possibly have come into contact with raw animal products, excreta or secretions. As a rule, you should wash, peel or boil raw fruit and vegetables thoroughly before consumption.
• Any individuals with a weakened immune system, diabetes or chronic lung/kidney disorders should take especial care to avoid all contact with dromedary camels and raw animal products.