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Middle East Respiratory Syndrome (MERS) - Symptoms, Causes, Diagnosis, and Treatment

Published on May 14, 2020 and last reviewed on Jan 09, 2022   -  4 min read


Middle East respiratory syndrome (MERS) is a respiratory illness caused by the virus MERS-CoV. Learn about its symptoms, causes, diagnosis, and treatment.

Middle East Respiratory Syndrome (MERS) - Symptoms, Causes, Diagnosis, and Treatment


The Middle East respiratory syndrome, also called MERS, is a respiratory disease that was first found in Saudi Arabia in 2012. It is caused by the Middle East respiratory syndrome coronavirus (MERS‐CoV). This virus belongs to the large family of viruses called coronaviruses, which are responsible for Severe Acute Respiratory Syndrome (SARS) and the COVID-19 pandemic.

Like the other strains of coronavirus, MERS-CoV also causes fever, cough, and shortness of breath. The other not so common symptoms are pneumonia, diarrhea, nausea, vomiting, and abdominal cramps. Some patients who were tested positive for this infection did not show any symptoms or where asymptomatic.

Dromedary (Arabian camels) are thought to be the major reservoir host for MERS-CoV. The virus is believed to be spread to humans from infected camels and human-to-human transmission. The spread occurs through close contact, especially while giving unprotected care to patients. Healthcare-associated outbreaks are responsible for the outbreaks in Saudi Arabia, the UAE, and the Republic of Korea.

MERS-CoV continues to cause localized outbreaks. Until now, 2,519 cases and 866 deaths have been reported. This infection can be fatal if it progresses to respiratory or kidney failure. Data also shows 1 in 3 people (35%) die from MERS. The risk of severe illness is high in older adults and immunocompromised individuals. Treatment focuses on relieving symptoms with the help of rest, painkillers, fluids, and oxygen therapy.

What Causes MERS?

As MERS-CoV is transmitted between animals and humans, it is called a zoonotic virus. This virus is said to have originated in bats, which then infects dromedary camels. Researchers have identified MERS-CoV in camels in many countries.

The modes of transmission are:

  1. Animals to humans - As mentioned before, dromedary camels are the animal source of infection in humans. Scientists have isolated strains of MERS-CoV from Arabian camels in Egypt, Qatar, Saudi Arabia, and many other countries.

  2. Human-to-human - Providing unprotected care to an infected patient is the main source of human-to-human transmission. Many clusters of such cases have been reported in healthcare facilities.

Since it was first identified in 2012, 27 countries so far have reported MERS cases. The countries include Algeria, Bahrain, China, Egypt, France, Germany, Iran, Italy, Kuwait, Malaysia, Oman, Qatar, Saudi Arabia, United Kingdom, United States, United Arab Emirates, and others. Saudi Arabia has reported the maximum number of cases.

How Does the Virus Spread?

MERS spreads from a person to another through infected respiratory droplets. These droplets are generated when an infected person coughs or sneezes without covering his or her mouth. You can get infected if you breathe in these infected droplets, or if the droplet comes in contact with your mouth, nose, or eyes. Humans can get infected from camel through respiratory droplets, and it’s meat, milk, and urine.

What Are the Signs and Symptoms of MERS?

The incubation period that is the time between exposure to the virus and symptoms is 2 to 14 days (usually 5 days). The symptoms of MERS range from asymptomatic to mild symptoms to severe respiratory disease. The typical symptoms include:

  1. Fever.

  2. Cough.

  3. Shortness of breath.

  4. Diarrhea.

Severe symptoms like kidney failure, pneumonia, and respiratory failure have also been reported.

Who Is at Risk of Developing Severe Illness Due to MERS-CoV?

Death due to kidney and respiratory failure are more common in:

How Is MERS Diagnosed?

This virus is detected using the polymerase chain reaction (PCR) test. This test is done on a sample of respiratory secretions or blood. If your doctor suspects that you might be infected with MERS-CoV, based on your travel history and symptoms, you might be asked to get this test done. ELISA (enzyme-linked immunosorbent assay) and IFA (immunofluorescence assay) detect the antibodies to MERS-CoV. Apart from this, your doctor might suggest you get:

  1. Chest X-ray - to check for pneumonia.

  2. CT scan - to get detailed images of the lungs.

  3. Blood test - to check how well your kidneys are functioning.

How Is MERS Treated?

As of now, no cure or vaccine is available for MERS. Vaccine and treatment both are under development. Doctors provide medicines and therapies focusing on specific symptoms, such as:

  1. Paracetamol or Acetaminophen - to relieve fever.

  2. Analgesics - to reduce pain.

  3. Oxygen therapy - to ease breathing.

  4. Antibiotics - to treat superimposed bacterial infection.

  5. IV (intravenous) fluids and electrolytes - to prevent dehydration.


You can reduce the risk of MERS by following these preventive tips:

  1. Wash your hands frequently with soap and water (for 20 seconds) or an alcohol-based hand sanitizer. Make sure you wash your hands when they are visibly soiled, after using the toilet, before and after eating or cooking.

  2. Avoid eating undercooked meats.

  3. Make sure you cover your mouth and nose with a tissue or your forearm while sneezing or coughing.

  4. Wash fruits and vegetables properly before eating.

  5. If you have a cough, cold, or other respiratory symptoms, avoid going out and stay home.

  6. Do not come in contact with people who are exhibiting respiratory symptoms.

  7. Wear a mask when you go to crowded places.

If you recently visited a country with MERS outbreak, and develop fever, cough, or breathing difficulty within 14 days, seek immediate medical attention. Do not consume raw camel meat or milk. It is safe to consume properly cooked camel meat and pasteurized camel milk.

COVID-19 and MERS:

MERS and COVID-19 are caused by different strains of the coronavirus. COVID-19 is caused by the SARS-CoV-2 virus. SARS-CoV-2, like MERS-CoV, is said to have originated in bats. Even though COVID-19 results in similar symptoms like MERS, the death rate is only 3 to 4 %.

As most cases of COVID-19 are either asymptomatic or show mild symptoms, it spreads more easily in the community. Since it was first identified in late 2019, SARS-CoV-2 has infected people from almost all countries around the world, and WHO declared it as a global pandemic in January 2020.

For more information on MERS or COVID-19, consult an infectious disease specialist online now!

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Last reviewed at:
09 Jan 2022  -  4 min read




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