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What is MERS-CoV?

Corona viruses are a large family of viruses that cause illness in humans and animals. MERS-CoV is a new corona virus which stands for Middle East Respiratory Syndrome Corona virus.

Where has MERS-CoV infections been reported?

To date, the Republic of Korea's first case was confirmed on 20 May 2015 and notified to WHO the same day. The case occurred in a 68 year old national of the Republic of Korea with recent history of travel to four countries in the Middle East. The case was asymptomatic during his return flight to Korea on May 4. He developed symptoms on May 11 and subsequently sought care at 2 out-patient clinics and two hospitals, creating multiple opportunities for exposure among health care workers and other patients.

Countries in or near the Arabian Peninsula with MERS cases: Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, United Arab Emirates (UAE), and Yemen.

Countries with travel-associated MERS cases: Algeria, Austria, China, Egypt, France, Germany, Greece, Italy, Malaysia, Netherlands, Philippines, Republic of Korea, Tunisia, Turkey, United Kingdom, and United States of America.

What are the symptoms of MERS-CoV?

Symptoms commonly noted include acute, serious respiratory illness with fever, cough and shortness of breath and breathing difficulties. Pneumonia is also commonly noted. A lot of MERS-CoV cases experience gastrointestinal symptoms, including diarrhea. some patients have had kidney failure. Around half of people infected with MERS-CoV have died. Atypical presentation may be noted in people with immune deficiencies.

Understanding of this illness is based on a limited number of cases and current investigations are being held to gather more information about this virus.

How do people become infected with this virus?

It is still unclear how people become infected with this virus. Investigations are ongoing to determine the source of the virus, the types of exposure that lead to infection, the mode of transmission, and the clinical pattern and course of disease.

Should people avoid contact with animals or animal products?

There is no specific advice from World Health Organization yet, however, contact with any obviously sick animals (including birds) should be avoided and basic hygiene measures taken, especially frequent hand washing and changing of clothes and shoes or boots, after handling animals or animal products. Also sick animals should never be slaughtered for consumption. The consumption of raw or undercooked animal products, including milk and meat, carries a high risk of infection from a variety of organisms that might cause disease in humans. Animal products processed appropriately through cooking or pasteurization are safe for consumption but should also be handled with care to avoid cross-contamination with uncooked food. Other hygiene measures include avoiding unwashed fruits or vegetables, and drinks made without safe water.

Can the virus be transmitted from person to person?

Yes. Person-peson transmission has been observed in health-care facilities, among family members and between co-workers; however, the mechanism of transmission occurred in all of these cases, whether respiratory (coughing, sneezing) or direct physical contact with the patient or contamination of the environment by the patient, is unknown. Thus far, no sustained community transmission has been observed.

Is there a vaccine or treatment for MERS-CoV?

No vaccine is currently available. Treatment is largely supportive and should be based on the patient's clinical condition.

Are health workers at risk from MERS-CoV?

Yes. Transmission has been noted in health-care facilities, including spread from patients to health-care providers. WHO recommends that health-care workers consistently apply appropriate infection prevention and control measures. Airborne and contact precautions are applied. Practice proper hand hygiene at all times. Cover your mouth when coughing or sneezing.

Has the WHO recommended any travel or trade restrictions related to this new virus?

No. The WHO has not recommended any travel or trade restrictions with respect to MERS-CoV. The WHO will continue to review all recommendations as more information becomes available.

Excerpt from Health Alert, a bulletin from the Infection Control Service, St. Luke's Medical Center.