According to the U.S. Centers for Disease Control and Prevention (CDC), as of June 19, 2013, a new virus formerly known as novel coronavirus and recently renamed Middle East Respiratory Syndrome Coronavirus (MERS-CoV) has infected 64 people and resulted in 38 deaths, a mortality rate of over 50%. The virus also appears to be able to be spread from person to person, if they are in close contact, and has spread between countries. The severity of this virus and fear of a potential pandemic have health officials concerned, although at this point there is no evidence that MERS-CoV can be generally transmitted in communities.
The new coronavirus was first detected in Saudi Arabia last year. While the CDC and the World Health Organization (WHO) are continuing to study it, what is known about MERS-CoV is that it is different from any other coronavirus that has been previously found in people. Coronaviruses can cause a range of illness from the common cold to severe acute respiratory syndrome (SARS). However, MERS-CoV is not the same type of coronavirus that was responsible for the 2003 outbreak of SARS. Health authorities still do not understand how the MERS-CoV virus first originated.
The most common symptoms of MERS-CoV have included fever, cough, and shortness of breath with most of those infected developing severe acute respiratory illness. According to the WHO, while MERS-Cov can be passed between humans, so far that seems to require prolonged contact (e.g., family members, health care providers), and there is no current indication that the virus can cause significant outbreaks in communities. Both the CDC and WHO say countries need to be on alert about the virus as health authorities learn more about its origin and exactly how it is transmitted.
To date, the largest number of cases (49) has been in Saudi Arabia. Qatar, Jordan, and the United Arab Emirates have also reported cases. The United Kingdom, Italy, France, and Tunisia have reported cases among people who returned from Middle Eastern countries where there have been cases of the virus and among some of their close contacts. So far, there have been no reports of illness or death from MERS-Cov in the United States, and neither the WHO nor the CDC has issued travel advisories for countries that have had MERS-CoV cases.
Other important facts about MERS-CoV include:
- The median age of patients is 56 years.
- More men than women have been infected.
- Several patients also had gastrointestinal symptoms, including abdominal pain and diarrhea.
- Some of the cases of MERS-Cov have occurred among people with chronic underlying medical conditions or weakened immune systems.
- There is no specific treatment for MERS-CoV other than supportive care and symptom relief and no vaccine available at this time.
The CDC, in consultation with the WHO, currently recommends that people be evaluated for MERS-CoV infection if they develop fever and symptoms of lower respiratory illness, such as cough and shortness of breath, or develop severe acute lower respiratory illness within 14 days of returning from Middle Eastern countries. They should see their health care practitioner and provide a detailed history of their recent travel.
There are no FDA-approved laboratory tests for detecting MERS-CoV in clinical specimens; however, the FDA has granted emergency use authorization of CDC's "Novel Coronavirus 2012 Real-time Reverse transcription–PCR assay" for testing patients' respiratory, blood, or stool samples for MERS-CoV. The CDC currently is performing testing, and this assay will be distributed to Laboratory Response Network (LRN) labs across the U.S. The U.S. Department of Health and Human Services announced that it will fast-track approval of treatments and tests for the virus as they become available.
For the latest updates on MERS-CoV, see the CDC and WHO web pages below.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Centers for Disease Control and Prevention. Middle East Respiratory Syndrome (MERS). Available online at http://www.cdc.gov/Features/novelcoronavirus/ through http://www.cdc.gov. Accessed June 2013.
Centers for Disease Control and Prevention. Coronavirus. Available online at http://www.cdc.gov/coronavirus/ through http://www.cdc.gov. Accessed June 2013.
New coronavirus can spread between humans, says WHO official. The Guardian. May 13, 2013. Available online at http://www.guardian.co.uk/world/2013/may/13/new-coronavirus-spread-humans through http://www.guardian.co.uk. Accessed June 2013.
Wilson, Megan R. Administration declares Mideast flu a potential public health emergency. The Hill. 06/04/13. Available online at http://thehill.com/blogs/healthwatch/public-global-health/303441-administration-declares-mideast-flu-a-public-health-emergency#ixzz2VS0Tzba7 through http://thehill.com. Accessed June 2013.
MacKenzie, Debora. Threatwatch: Is the Saudi virus a new SARS? NewScientist. Updated 21 May 2013. Available online at http://www.newscientist.com/article/dn23503-threatwatch-is-the-saudi-virus-a-new-sars.html through http://www.newscientist.com. Accessed June 2013.
Office of the Federal Register. HHS Declaration on MERS-COV for testing purposes. PDF available for download at http://www.ofr.gov/(S(w2qmxmwvomli54azuaimwev5))/OFRUpload/OFRData/2013-13333_PI.pdf through http://www.ofr.gov. Accessed June 2013.
Centers for Disease Control and Prevention. FAQ on MERS-CoV. Available online at http://www.cdc.gov/coronavirus/mers/overview.html through http://www.cdc.gov. Accessed June 2013.
Centers for Disease Control and Prevention. Update: Severe Respiratory Illness Associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) — Worldwide, 2012–2013. MMWR June 7, 2013/ 62(Early Release);1-4. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0607a1.htm through http://www.cdc.gov. Accessed June 2013.