Middle Eastern Respiratory Syndrome (MERS) is a viral respiratory infection caused by coronavirus (MERS-CoV).
MERS-CoV was first identified in Saudi Arabia in 2012 and currently the virus appears to be circulating widely throughout the Arabian Peninsula.
The following countries have reported cases: Jordan, Kuwait, Oman, Qatar, Saudi Arabia, the United Arab Emirates, and Yemen; France, Germany, Greece, Italy, and the United Kingdom; Tunisia and Egypt; Malaysia and the Philippines; and the United States of America.
The virus is not yet fully understood and it isn’t clear what the source is or how people become infected; in some cases the virus has appeared to spread from an infected person to another in close contact e.g. providing unprotected care to a patient. There is currently no vaccine or specific treatment for MERS-CoV, the treatment is supportive and based on the clinical condition of the patient.
It is not always possible to identify patients with MERS-CoV because the symptoms may be non-specific, so it is important that all healthcare workers follow infection, prevention and (IPC) standard precautions consistently for all patients, with the addition of respiratory precautions for patients with symptoms of acute respiratory infection. Contact precautions and eye protection should be followed when treating a patient suspected or confirmed of having MERS-CoV. A fit tested FFP3 mask should be worn when performing aerosolising procedures e.g. suction, intubation.
The clinical symptoms include:
In addition to one of the following:
The MERS-CoV can in some cases lead to severe viral pneumonia and sometimes multi-organ failure, so treatment should follow the same guidelines as treating sepsis.
The risk of person to person infection is very low, but please take the following IPC precautions:
After transporting the patient to hospital, the ambulance will need to be left to ventilate for 20 minutes and cleaned afterwards, using standard disinfectants and detergents.
Published 18th April 2015