Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Background
The World Health Organization (WHO) announced the first case of a novel coronavirus (later called the Middle East respiratory syndrome coronavirus, MERS-CoV) in a resident of the Middle East in September 2012. Since then, several laboratory-confirmed cases had been reported in countries including Saudi Arabia, Jordan, Qatar, United Kingdom, Germany, France, etc.. Human to human transmission has been observed to a limited extent in households. The typical symptoms include fever, cough, and shortness of breath. Severely ill patients may develop pneumonia, renal failure, pericarditis, disseminated intravascular coagulation or even death. A number of fatal cases had an underlying medical condition (diabetes, renal failure, chronic lung disease, and immunocompromised persons). The source of the virus is not confirmed. However, current scientific evidence suggests that camels are likely the reservoir host for the virus and an animal source of infection that transmits to humans through close contact.
Epidemiology
Since the first confirmed case was identified in 2012, cases have been reported in the Middle East, Africa, Europe and Asia, with the majority (>85%) reported to have epidemiological links in the Middle East. The outbreak in the Republic of Korea is the largest outbreak outside of the Middle East, and while concerning, there is no evidence of sustained human to human transmission in the Republic of Korea. Most of reported cases were associated with nosocomial outbreaks, and they are asymptomatic or with mild symptoms. So far, no confirmed case has been reported in Taiwan.
MERS-CoV Surveillance in Taiwan
- Taiwan National Infectious Disease Statistics System-MERS-CoV
- Fever screening at international airports and seaports.
- Self–reporting through the toll–free 1922 hotline or local public health authority.
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Prevention and Control
- People who plan to travel to the Middle East should heighten vigilance and practice good personal hygiene, including regular hand washing with soap and water before and after touching animals or contact with those with respiratory symptoms. In addition, avoid visiting local farms, contact with camels, or drinking raw milk. People with underlying diseases should be more cautious.
- Travelers returning from the Middle East are advised to call the toll-free hotline 1922 (or 0800-001922) to seek medical attention if any symptoms such as fever or acute respiratory syndrome develop and inform the doctor of any recent travel and exposure history.
- Practice hand hygiene and cough etiquette:
- (1) Cover nose and mouth with a tissue when you cough or sneeze, and throw the used tissue in the trash can.
- (2) Clean your hands with soap and water or alcohol-based hand rubs.
- (3) Offer masks to persons who are coughing.
FAQs
- What is the source of MERS-CoV?
- The source of MERS-CoV is not confirmed. Genetic analysis has shown virus isolated from camels in the Middle East has high genome similarity to human cases. MERS-CoV likely came from an animal source in the Arabian Peninsula. In addition, MERS-CoV has been found in camels in several countries. Based on epidemiological investigation, some people likely became infected after having contact with camels. However, more information is needed.
- How does the virus spread?
- The precise ways the virus spreads are not currently well understood. MERS-CoV is thought to spread from droplets of an infected person’s respiratory secretions. MERS-CoV might spread from ill people to others through close contact such as caring for or living with an infected person. Human-to-human transmission occurs primarily in nosocomial outbreaks. No evidence of sustained community transmission has been reported so far.
- What are the treatments?
- There is no specific antiviral treatment recommended for MERS. People with MERS should seek medical care to help relieve symptoms. There is currently no vaccine to protect against MERS.
- How to prevent infect MERS-CoV?
- (1) People who plan to travel to the Middle East should heighten vigilance and practice good personal hygiene, including regular hand washing with soap and water before and after touching animals or contact with those with respiratory symptoms. In addition, avoid visiting local farms, contact with camels, or drinking raw milk. People with underlying diseases should be more cautious.
- (2) Travelers returning from the Middle East should call the toll-free hotline 1922 (or 0800-001922) to seek medical attention if any symptoms such as fever or acute respiratory syndrome develop and inform the doctor of any recent travel and exposure history.
- (3) Cover nose and mouth with a tissue when you cough or sneeze, and throw the used tissue in the trash. Clean your hands with soap and water or alcohol-based hand rubs. Offer masks to persons who are coughing.
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