Middle East respiratory syndrome

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by a coronavirus called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The symptoms of MERS can range from mild to severe and include:

• Fever
• Chills
• Coughing
• Sore throat
• Runny nose
• Trouble breathing
• Muscle aches

According to the World Health Organization, a typical presentation of MERS disease is fever, cough, and shortness of breath. Pneumonia is a common finding, but not always present [1]. The virus can cause severe respiratory illness that mainly involves the upper respiratory tract [6].

MERS-CoV is a zoonotic pathogen, meaning it can be transmitted from animals to humans. In this case, the virus is believed to have originated in dromedary camels and can be transmitted to humans through close contact with infected animals or contaminated surfaces [8]. Nosocomial transmission has also been reported, particularly in hospital outbreaks in Saudi Arabia and United Arab Emirates [7].

The Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonotic pathogen that was first identified in humans in Saudi Arabia and Jordan in 2012 [9]. It is essential to note that MERS can cause severe illness, especially in older adults or those with underlying health conditions.

References: [1] Context result 3 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 9

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness that can cause severe symptoms in some individuals. The signs and symptoms of MERS can vary from person to person, but here are the most common ones:

• Respiratory symptoms: These are the most common symptoms of MERS, and they include:
  • Fever [1]
  • Coughing [5][9][10]
  • Shortness of breath or difficulty breathing [4][8][9][10]
• Gastrointestinal problems: Some people may also experience gastrointestinal issues, such as:
  • Diarrhea [2][6]
  • Nausea and vomiting [2][3][5]
• Other symptoms: In some cases, MERS can cause other symptoms, including:
  • Sore throat [1][2][5]
  • Muscle aches [5]
  • Runny nose [5]

It's worth noting that not everyone who contracts MERS will experience all of these symptoms. Some people may only have mild symptoms, while others may develop severe respiratory problems.

References:

[1] What Are the Symptoms of MERS? · Shortness of breath · Fever · Cough with or without blood · Sore throat · Muscle and stomach pain and soreness · Vomiting · Diarrhea. [2] May 20, 2024 — Other signs and symptoms can include sore throat, coryza, productive cough, dizziness, nausea and vomiting, diarrhea, and abdominal pain. Chest ... [3] Typically, people with MERS develop respiratory symptoms that include: ... Some people have also reported diarrhea, nausea and vomiting. MERS symptoms usually ... [4] Aug 5, 2022 — A typical presentation of MERS is fever, cough and shortness of breath. Pneumonia is a common finding, but MERS patients may not always develop ... [5] What are the symptoms of MERS? · Fever · Chills · Coughing · Sore throat · Runny nose · Trouble breathing · Muscle aches. [6] Symptoms. The most common symptoms of MERS are a fever, a cough, and shortness of breath. People may also have gastrointestinal problems, such as diarrhea, ... [7] Mar 16, 2024 — It causes fever, coughing, and shortness of breath. About 35% of people who have gotten this illness have died. Some people only have mild ... [8] Aug 9, 2024 — What Are the Symptoms of MERS? · Fever · Cough · Shortness of breath. [9] Symptoms of Middle East respiratory syndrome (MERS) · a high temperature · a cough · shortness of breath or difficulty breathing. [10] Result: fever | cough | shortness of breath

Diagnostic Tests for Middle East Respiratory Syndrome (MERS)

Middle East Respiratory Syndrome (MERS) is a viral respiratory illness caused by the MERS-CoV virus. Diagnosing MERS requires a combination of clinical evaluation and laboratory testing.

• Clinical Evaluation: If your doctor suspects MERS, you will undergo a series of tests to evaluate your condition. These may include:
  • Chest X-ray: To assess any abnormalities in your lungs.
  • Blood tests: To check for certain chemicals that can indicate the presence of the MERS virus or other conditions.
  • Respiratory samples (lung secretions): To collect specimens from your respiratory tract for further testing.

Laboratory Testing

Several laboratory tests are used to diagnose MERS-CoV infection. These include:

• Respiratory tract sampling: Collecting specimens from your lower and upper respiratory tracts is the gold standard in diagnosing MERS-CoV infection.
• Blood tests: Blood samples can be tested for PCR (Polymerase Chain Reaction) if respiratory tract or stool specimens are positive for MERS-CoV by PCR.

Interim Guidance

The CDC recommends collecting specimens from lower and upper respiratory tracts, as well as blood, to aid in the diagnosis of MERS-CoV infection.

• Timing: It is essential to request diagnostic testing as soon as possible. Samples should be obtained and sent to a primary MERS testing laboratory within 24 hours.
• Sample collection: Blood for PCR may be tested if respiratory tract or stool specimens are positive by PCR, and will be considered in other situations after consultation with the CDC.

References

1. Aug 5, 2024 — All MERS diagnostic testing currently available in the United States is completed at CDC or at public health laboratories and is not available [1].
2. If your doctor suspects MERS, you will have a chest X-ray, blood tests, kidney function tests, and respiratory samples (lung secretions) for evaluation [2].
3. by S Al Johani · 2016 · Cited by 76 — Detecting the virus in respiratory tract samples remains the gold standard in diagnosing MERS-CoV infection [3].
4. Nov 7, 2022 — CDC recommends the collection of specimens from lower respiratory tract, upper respiratory tract, and blood [4].
5. Feb 28, 2024 — MERS diagnostic testing should be requested as soon as possible. Samples should be obtained and sent to a primary MERS testing laboratory within [24 hours] [5].

Current Status of Drug Treatment for MERS

As of now, there is no specific antiviral treatment recommended for Middle East Respiratory Syndrome (MERS) [5]. The focus of medical care is on managing symptoms and supporting the body while it fights the infection [7].

Existing Treatments Under Investigation

Several treatments are being explored to combat MERS-CoV:

• Repurposing existing clinically approved drugs: Researchers have been investigating the potential use of existing medications, such as mycophenolic acid (MPA) and interferon-beta (IFN-β), which have shown promise in vitro [2].
• Convalescent plasma therapy: This approach involves using plasma from recovered patients to provide antibodies against MERS-CoV [6].
• Ribavirin: Studies have been conducted on the effectiveness of ribavirin, a broad-spectrum antiviral medication, against MERS-CoV. While results are promising, further research is needed to establish its benefit [10].

Supportive Care

Since there is no approved treatment for MERS, medical care focuses on managing symptoms and supporting the body while it fights the infection. This includes providing supportive management of signs, symptoms, and complications [9].

Middle East Respiratory Syndrome (MERS) Differential Diagnosis

The differential diagnosis for MERS-CoV infection includes a range of conditions that present with similar symptoms, such as fever, cough, and pneumonia.

• Influenza virus infection: Influenza is a common respiratory illness that can cause symptoms similar to MERS-CoV. According to [2], patients who present with fevers, chills, myalgias, rhinorrhea, and pneumonia or who develop acute respiratory distress syndrome and have a history of travel to countries in or near the Arabian Peninsula within the past 14 days should be evaluated for Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) infection.
• Parainfluenza virus: Parainfluenza is another viral illness that can cause symptoms similar to MERS-CoV. According to [8], the differential diagnosis of MERS-CoV includes parainfluenza virus infection, among other conditions.
• SARS-CoV and SARS-CoV-2 (COVID-19): These are other coronaviruses that can cause respiratory illness and may be considered in the differential diagnosis for MERS-CoV. According to [9], SARS-CoV, SARS-CoV-2, and MERS-CoV should all be considered in the differential diagnosis.

Key Symptoms to Consider

When considering a differential diagnosis for MERS-CoV, it's essential to look out for symptoms such as:

• Fever
• Cough
• Pneumonia
• Acute respiratory distress syndrome (ARDS)
• History of travel to countries in or near the Arabian Peninsula within the past 14 days

References

[2] Diagnostic Considerations. Patients who present with fevers, chills, myalgias, rhinorrhea, and pneumonia or who develop acute respiratory distress syndrome and have a history of travel to countries in or near the Arabian Peninsula within the past 14 days should be evaluated for Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) infection.

[8] Differential Diagnosis. The differential diagnosis of MERS-CoV includes parainfluenza virus infection, among other conditions.

[9] Clinical Features. Fever, Chills; Myalgias; Headache; Non-productive cough. Differential Diagnosis. SARS-CoV, SARS-CoV-2 (COVID-19).