Middle Eastern Respiratory Syndrome virus (MERS) is a nasty infection and one you definitely don’t want to get. A recent outbreak of Middle Eastern Respiratory Syndrome virus (MERS) in Korea has a lot of people on edge, and for good reason. But what are the chances that you, sitting at home in the United States and other countries where MERS is not active, will get MERS? What are the chances that it will spread like wildfire and make many people sick and kill even more? And is it really that deadly? Let’s take these questions one by one and separate fact from worry.
According to the Centers for Disease Control and Prevention (CDC), the signs and symptoms of MERS are fever, cough, and shortness of breath. Those symptoms sound similar to just about any upper respiratory tract infection, but complications from MERS include kidney failure and severe pneumonia. Partly due to these complications, between 30% and 40% of patients with MERS cases have died, which is a very high mortality rate. Currently there isn’t a specific treatment for MERS, much like a cold or a stomach bug, treatment is supportive (fluids, fever reducers, pain killers etc…). The high mortality rate is why public health agencies across the world are on high alert.
Good for us (bad for MERS) unlike the flu or the measles, it turns out MERS isn’t easy to catch.
The MERS virus is a variant of the corona virus, a virus that has many different strains and causes different kinds of respiratory and gastrointestinal diseases. You’ll sometimes see “MERS” written as “MERS-CoV,” with “CoV” meaning “coronavirus.” Because the MERS strain of coronavirus is relatively new to humans, scientists are still working on fully understanding how it is transmitted.
One thing is for sure, close contact between people leads to transmission. Close contact can include healthcare providers caring for people with MERS and not using appropriate personal protective equipment or infectious disease precautions. Some of these providers not using those precautions have been infected. Also, people hospitalized with MERS patients have been infected, suggesting that the virus is spread via aerosols (e.g. sneezes and coughs) or is airborne (e.g. through breathing the same air).
I mentioned before that MERS has a mortality rate between 30% and 40% and the high hospital transmission rate may be over-inflating the virus’ actual mortality rate. People who are already in the hospital for another illness or condition and contract MERS are likely to have more complications and worse outcomes (and a higher mortality rate).
Because MERS is so new (and until now has been relatively contained) disease surveillance systems have been only picking up cases that are hospitalized. It will likely take a while before systems are in place to detect sub-clinical cases (i.e. cases who don’t become sick enough to seek hospital care).
With that said, you may remember the H1N1 pandemic several years ago. In the US alone, thousands of people became so sick they sought care from their doctors and hospitals. We aren’t seeing this with MERS, which tells us that MERS is either a mild virus in those who are otherwise healthy or isn’t easily transmitted at the community level.
According to the Korean Ministry of Health, the first person identified in the current outbreak (what we call in public health the index case) was reported as having traveled recently to the Middle East. Seven days after his arrival, the index case sought care at different healthcare facilities in Korea, likely spreading the virus in those settings.
Taking all of this into consideration, it is very possible that MERS could spread to other parts of the world past Korea, in fact, there have already been cases in the United States. These cases in the US were unconnected and over 500 people were potentially exposed, but no one contracted the virus outside of the index cases.
We live in a world where a jet can depart the Middle East and be in any part of the world in a matter of hours. Combine that with the incubation time (time for symptoms to develop from the initial exposure) that MERS is displaying of about 2 to 14 days, and you could have plenty of cases popping up all over the globe.
So what is keeping that from happening?
First, it seems that exposure to camels or camel products (like milk) were the primary source of MERS infections in the Middle East. Second, modern healthcare facilities have strict infection control protocols that may be keeping infections from occurring within them. Third, as I mentioned above, the person-to-person transmission in the community – outside of healthcare facilities – seems to be limited.
In the United States, between 3,000 and 49,000 people die from influenza each year. Half a million of us die from smoking-related diseases like lung cancer, high blood pressure, and heart disease. Another half a million will die from heart disease associated with poor diet and lack of physical activity. And over 30,000 will die from traffic-related accidents. At this time and in the United States, MERS is on our public health radar, but in your day-to-day life it should be your least concern.
The best things you can do for your health (and others) are to wash your hands, eat a balanced diet, wash your hands, get plenty of exercise and plenty of rest, wash your hands, and follow your healthcare providers advice at all times, buckle-up in the car, and wash your hands. Also, don’t forget to wash your hands.
Edited by Leslie Waghorn
- Information on MERS Risk
- Information on MERS Symptoms and Complications
- Information on MERS Prevention at Home and In the Community