MERS Middle East respiratory syndrome
Epidemiology
Approximately 35% of MERS-CoV patients that have been reported have died. Despite the fact that the majority of human MERS-CoV infections have been attributed to human-to-human transmissions in health-care settings, recent scientific evidence suggests that dromedary camels are a key reservoir host for MERS-CoV and an animal source of MERS infection in people. The specific involvement of dromedaries in viral transmission and the particular route(s) of infection, however, is uncertain.
Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels.
MERS-CoV has been identified in dromedaries in several countries in the Middle East, Africa and South Asia. The origins of the virus are not fully understood but, according to the analysis of different virus genomes, it is believed that it may have originated in bats and was transmitted to camels sometime in the distant past.
Some laboratory-confirmed cases of MERS-CoV infection are reported as asymptomatic, meaning that they do not have any clinical symptoms, yet they are positive for MERS-CoV infection following a laboratory test.
Most of these asymptomatic cases have been detected following aggressive contact tracing of a laboratory-confirmed case.
Severe illness can cause respiratory failure that requires mechanical ventilation and support in an intensive care unit. The virus appears to cause more severe disease in older people, people with weakened immune systems, and those with chronic diseases such as renal disease, cancer, chronic lung disease, and diabetes.
Since 2012, 27 countries have reported cases of MERS including Algeria, Austria, Bahrain, China, Egypt, France, Germany, Greece, Islamic Republic of Iran, Italy, Jordan, Kuwait, Lebanon, Malay sia, the Netherlands, Oman, Philippines, Qatar, Republic of Korea, Kingdom of Saudi Arabia, Thailand, Tunisia, Turkey, United Arab Emirates, United Kingdom, United States, and Yemen. Approximately 80% of human cases have been reported by Saudi Arabia. What we know is that people get infected there through unprotected contact with infected dromedary camels or infected people. Cases identified outside the Middle East are usually travelling people who were infected in the middle east and travelled outside later.
Causative agent
MERS-CoV is a zoonotic virus
It is a viral respiratory disease caused by a novel coronavirus (Middle East respiratory syndrome coronavirus, or MERS COV) that was first identified in Saudi Arabia in 2012.
Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).
Symptoms
The clinical spectrum of MERS-COV infection ranges from no symptoms (asymptomatic) or mild respiratory symptoms to severe acute respiratory disease and death.
fever, cough and shortness of breath.
Pneumonia is common. but not essentially be present.
Gastrointestinal symptoms, including diarrhoea, have also been reported.
Mode of Transmission :
It is a virus that is transmitted between animals and people.
Non-human to human transmission:
The route of transmission from animals to humans is not fully understood, but dromedary camels are the major reservoir host for MERS-CoV and an animal source of infection in humans. Strains of MERS-CoV that are identical to human strains have been isolated from dromedaries in several countries, including Egypt, Oman, Qatar, and Saudi Arabia.
Human-to-human transmission:
The virus does not pass easily from person to person unless there is close contact, such as providing unprotected care to an infected patient. There have been clusters of cases in healthcare facilities, where human-to-human transmission appears to have occurred, especially when infection prevention and control practices are inadequate or inappropriate. Human to human transmission has been limited to date, and has been identified among family members, patients, and health care workers. While the majority of MERS cases have occurred in healthcare settings, thus far, no sustained human to human transmission has been documented anywhere in the world.
Prevention and treatment
- There is presently no vaccination or specific therapy for MERS-CoV, however various vaccines and therapies are being developed. Treatment is supportive and personalized to the patient’s specific needs.
- Anyone visiting farms, marketplaces, buildings, or other locations where domestic camels and other animals are present should adopt normal hygiene procedures, such as hand washing before and after touching animals and avoiding contact with sick animals as a precaution.
- Raw or undercooked animal products, such as milk and meat, provide a significant risk of infection from a number of organisms that can cause disease in humans. Animal products that have been properly cooked or pasteurized are safe to eat, but they should be handled with caution to avoid cross-contamination with raw foods.
- Camel meat and camel milk are nutritious goods that can be ingested after being pasteurized, cooked, or exposed to various forms of heat.
- Until MERS-CoV is better understood. Diabetes, renal failure, chronic lung disease, and immunocompromised people are all thought to be at a high risk of MERS-CoV infection causing serious illness. These persons should avoid coming into contact with camels, ingesting raw camel milk or urine, or eating the undercooked meat.
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