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Definition, Symptoms, and Treatment • Hello Sehat

MERS disease

What is Middle East respiratory syndrome coronavirus (MERS)?

MERS or Middle East Respiratory Syndrome coronavirus (commonly called Middle East respiratory syndrome, MERS, or MERS-CoV) is a viral infectious disease that attacks the respiratory system. This disease is caused by a type of coronavirus, namely MERS-CoV.

MERS disease was first identified in Saudi Arabia in 2012. There were more than 1,600 cases of MERS with a mortality rate of 36%. The most recent MERS occurred in South Korea in 2015, where there were more than 180 cases and more than 35 deaths.

Although it is a condition that is deadly and kills at least 36% of people infected with MERS, the transmission of this disease is not as easy as the common cold. The virus that causes it cannot spread without direct contact with the source of infection.

How common is this disease?

MERS infectious disease can affect patients of all ages. The MERS outbreak first broke out in the Arabian Peninsula countries.

So far, other countries that have contracted this disease are Algeria, Austria, China, Egypt, France, Germany, Greece, Italy, Malaysia, the Netherlands, the Philippines, Korea, Thailand, Tunisia, Turkey, England and the United States.

In Indonesia until now there have been no reports of the emergence of MERS cases. However, the transmission of this disease still needs to be watched out for.

MERS signs and symptoms

People who are infected sometimes have no symptoms, but they can still be contagious.

In symptomatic cases, symptoms such as fever and cough usually appear after an incubation period of approximately 5 days.

Later symptoms can progress to worsening in less than a week. Patients can even experience respiratory failure.

The general symptoms of the MERS coronavirus disease are similar to the symptoms of other viral infections of the respiratory tract. The characteristics of MERS are:

Some people also experience diarrhea and nausea or vomiting. However, as with other respiratory diseases, the severity of symptoms can vary from person to person, depending on their immune condition.

This virus is easier to cause severe illness in the elderly, people with weak immune systems, and those with chronic diseases, such as:

  • Diabetes
  • Cancer
  • Chronic lung disease
  • Chronic heart disease
  • Chronic kidney disease

In severe conditions, this disease can lead to heart failure, pneumonia, and respiratory failure requiring a ventilator and intensive care in the ICU.

According to WHO, about 3-4 out of 10 patients with MERS disease are reported to have died. However, this estimate may be overestimating the true death rate.

Most of the deaths are caused by health conditions that weaken the immune system, including chronic illnesses like the above or having a condition that was treated late.

When to go to the doctor

The symptoms of MERS are generally similar to those of other respiratory illnesses such as flu and colds. In fact, this disease can have a more fatal impact.

Therefore, if you experience symptoms after less than 14 days of contact with an infected person or traveling to an MERS outbreak area, seek medical consultation immediately. You need to have tests that detect the presence of the MERS-CoV virus in the body.

Cause of MERS

MERS disease is caused by a coronavirus infection called MERS-CoV. Coronavirus itself consists of other viruses that cause diseases such as SARS (severe acute respiratory syndrome/ severe acute respiratory syndrome) and COVID-19 which is currently endemic.

Before spreading from human to human, this virus is passed from animal to human.

Unlike the flu or cold virus, the MERS disease virus does not spread easily. MERS-CoV is more susceptible to spread from an infected person to a person living with or caring for an infected person.

The source of the virus

MERS-CoV is a zoonotic virus, which means it is transmitted from animals to humans. The origin of the virus is not fully known.

Research from Annals of Saudi Medicine, stated that initially humans were suspected of contracting the MERS-CoV virus from camels through direct or indirect contact.

This virus is found in the body of one-humped camel in several countries in the Middle East, Africa and South Asia. Even so, no human cases of MERS were found in the surrounding environment.

In studies that followed up on genetic analysis, it was discovered that the virus probably originated in bats and was passed on to camels in the past.

How is MERS transmitted?

There are two types of transmission of the MERS-CoV virus identified by WHO, namely:

  • Non-human-to-human transmission

The transmission of the virus that causes MERS from animals to humans is not fully understood. However, camels with one hump are believed to be the main source of the virus.

Strain from MERS-CoV which is exactly the strains humans have been isolated from several countries, including Egypt, Oman, Qatar, and Saudi Arabia.

  • Human-to-human transmission

This virus cannot easily pass from one person to another, unless there is close contact such as providing unprotected care to an infected patient.

There are many cases in health facilities where human-to-human transmission of the virus has occurred. This may be due to the use of tools or controls that are not according to procedures.

Human-to-human transmission has been limited to date and has been identified among family members, patients and health care workers.

Although cases of transmission have occurred on medical equipment, there have been no reports of human-to-human transmission anywhere in the world.

It is estimated that 80% of cases reported from Saudi Arabia occur because people did not use any protection when coming into contact with humans or camels infected with MERS-CoV. Cases that occur outside of Saudi Arabia are thought to have originated from people who had traveled from there.

Risk factors

Some conditions that increase your risk of developing MERS include:

  • If you are an older or very young adult
  • If your immune system is weakened or you have chronic diseases, such as diabetes or lung disease, you are prone to disease
  • An organ transplant recipient who is taking immunosuppressants
  • If you are taking immunosuppressants, for example, to treat autoimmune diseases
  • Consuming raw animal products (camel milk, meat, etc.)
  • If you interact with tourists on the Arabian Peninsula or in neighboring countries, the patient has contracted MERS, and is using medical equipment without proper procedures.

Diagnosis

The doctor will examine the patient and ask about the symptoms he feels. The doctor may also ask you about recent activities that you are doing, including traveling.

The doctor will use a test reverse transcription polymerase chain reaction (RT-PCR) to identify traces of viral DNA.

A sample will be taken from your respiratory tract or from your blood to find antibodies for the virus.

The test will detect antibodies 10 days after starting illness. If the test is negative 28 days after the onset of symptoms, the person is considered not to have MERS.

A blood test may be done if you have been infected before, by checking for antibodies to the virus.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

Unfortunately, there is no antiviral treatment for MERS-CoV to date. However, WHO said experts were developing several vaccines and treatments specific to MERS.

Treatment of MERS-CoV disease mostly aims to provide supportive care, control symptoms, and prevent complications.

Your doctor may also advise you and your nurse on how to avoid spreading the virus.

How to prevent transmission

Lifestyle and home remedies can help treat this disease, as well as prevent its spread.

Here are general ways you can avoid MERS:

  • Wash your hands with soap and water for at least 20 seconds.
  • If you sneeze or cough, cover your mouth and nose with a tissue and throw the tissue in the trash immediately and wash your hands. Putting the tissue carelessly might spread the virus to other objects.
  • Do not infect objects that are used by you and others, such as door handles or table surfaces.
  • Avoid touching your face, mouth and nose with unwashed hands.
  • Do not share glasses, utensils, or other objects with other people.
  • Don’t explore places where the plague is plague.

In general, if you visit a farm, market, or other place where there are camels or other animals, take general hygiene steps, including washing your hands before and after touching the animals. Avoid contact with sick animals.

Eating undercooked or raw animal products puts you at high risk for infection with some organisms that may cause disease.

Camel meat and milk can be consumed after pasteurization, cooking, or heating.

If you have diabetes, kidney failure, chronic lung disease, and an immune disorder, you are at greater risk of developing these diseases.

That is why, always avoid contact with camels, drinking raw camel milk, or meat that is not cooked properly to prevent the dangers of raw food.

Can I travel to a risky location?

Until now, WHO is still monitoring the development of the virus that causes MERS disease.

If you are traveling to the Arabian Peninsula or other neighboring countries and you experience fever and symptoms of developing MERS-CoV within 14 days of returning, see your doctor immediately.

Close contact with sick Arab Peninsula tourists

Get your health checked if you are in close contact with someone who has just returned from a country near the Arabian Peninsula for 14 days. Moreover, when the person shows symptoms of a respiratory disease, such as coughing and shortness of breath.

If you have fever and symptoms of respiratory illness, contact your doctor. During the consultation, tell me about your last interaction with a friend who just returned from a country around the Arabian Peninsula.

Close contact with patients with MERS disease

If you have any interactions with someone who has MERS-CoV, you should immediately call your doctor for an evaluation.

The doctor may ask for a medical test and make recommendations, according to the evaluation and the symptoms you are experiencing.

You may be asked about your health condition in the past 14 days, starting from the last day you interacted with a patient with MERS disease. Watch for these symptoms:

  • Fever, check your temperature twice a day
  • Cough
  • Shortness of breath
  • Other early symptoms include flu, pain, sore throat, headache, diarrhea, nausea or vomiting, and a runny nose.

If you experience these symptoms, contact your doctor immediately and share your interactions with the patient. The move will reduce the ability to transmit the virus to more people.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Hajjar, SA, Memish, ZA, & McIntosh, K. (2013). Middle East Respiratory Syndrome Coronavirus (MERS-CoV): a perpetual challenge. Annals of Saudi medicine, 33 (5), 427–436. https://doi.org/10.5144/0256-4947.2013.427

Ramadan, Nour, and Houssam Shaib. “Middle East respiratory syndrome coronavirus (MERS-CoV): A review.” Germs vol. 9.1 35-42. March 1 2021, https://do.org/:10.18683/germs.2019.1155

WHO. (2019). Middle East respiratory syndrome coronavirus (MERS-CoV). Retrieved 22 December 2021, from https://www.who.int/en/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-(mers-cov)

CDC. (2019). Middle East Respiratory Syndrome (MERS). Retrieved 22 December 2021, from https://www.cdc.gov/coronavirus/mers/index.html

NFID. (2020). Coronaviruses.Retrieved 22 December 2021, from https://www.nfid.org/infectious-diseases/coronaviruses/