Middle East Respiratory Syndrome Coronavirus (MERS-CoV or MERS)

Last Updated: May 29, 2019
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Electron micrograph showing particles of MERS-CoV. Photo credit: NIAID

General Information


  • MERS, a viral respiratory illness, was first identified in Saudi Arabia in 2012; the majority of cases have occurred in the Arabian Peninsula.
  • Travel-associated cases of MERS have been identified in the United Kingdom, France, Tunisia, Italy, Malaysia, Greece, Egypt, Philippines, the United States, and the Republic of Korea.
  • Camels appear to be the source of infection in humans, but much is unknown about how this occurs.  However, once a human has the illness, MERS can spread human-to-human through close contact, such as caring for or living with an infected person.
  • Symptoms:  
    • Most people infected with MERS-CoV develop acute respiratory illness, including fever, cough, shortness of breath, and sometimes diarrhea.
    • About one-third of the cases are fatal, most often in older persons with underlying medical problems.  Mild and asymptomatic cases have also been reported, and may be more common than previously recognized.

Prevention: There is no vaccine for MERS so prevention is critical.

  • All travelers can take these actions to help prevent the spread of germs and protect against colds, flu, and other illnesses: 
    • Wash your hands frequently with soap and water for at least 20 seconds.
    • Use an alcohol-based sanitizer if soap and water are not available. Cover your nose and mouth when sneezing and throw the used tissue in the trash. Do not reuse tissues. Clean and disinfect commonly used surfaces, such as doorknobs, light switches, handrails, or toys. Avoid close contact, such as kissing or sharing eating utensils, with sick individuals. Avoid touching your eyes, nose, or mouth with unwashed hands.
    • Avoid unnecessary visits to hospitals.   
  • Anyone visiting farms, markets, barns, or other places where animals are present should: 
    • Wash hands before and after touching animals
    • Avoid contact with sick animals 
  • Older people, healthcare workers, and those with diabetes, kidney failure, chronic lung disease, or a weakened immune system are at high risk for severe MERS and should take additional precautions: 
    • Avoid contact with camels
    • Do not drink raw camel milk or raw camel urine
    • Do not eat undercooked meat, particularly camel meat 

If you become ill:  If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after traveling to a country on the Arabian Peninsula or another county an ongoing MERS outbreak, call ahead to a healthcare provider and mention your recent travel.
For more information:

USAPHC: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Fact Sheet

CDC: Middle East Respiratory Syndrome (MERS)  External Link

CDC: Middle East Respiratory Syndrome podcast  External Link

CDC: Frequently Asked Questions and Answers  External Link

WHO: Global Alert and Response - Middle East respiratory syndrome coronavirus  External Link

WHO: Middle East respiratory syndrome coronavirus (MERS-CoV) Fact Sheet N°401  External Link  

WHO: Frequently Asked Questions on Middle East Respiratory Syndrome Coronavirus (MERS‐CoV)  External Link


Situation in Republic of Korea


  • In May 2015, the Republic of Korea (ROK) reported an outbreak of MERS. It is the largest known outbreak of MERS outside the Middle East. The index case had travelled recently to several countries in the Arabian Peninsula.
  • USFK medical leaders are working closely with US public health experts and ROK public health authorities to contain this MERS outbreak.
  • All patients in Korea acquired their illness in hospital settings where they came in direct or indirect contact with MERS patients.
  • Contacts of MERS patients are being monitored for 14 days to ensure early detection of illness.
  • Aggressive contact tracing and testing for infection may help explain the rapid expansion of the outbreak. There is no evidence of sustained transmission in the community.


                                         Poster from CDC External LinkCDC MERS Poster

For more information:

U.S. Department of State: Security Message for U.S. Citizens: Seoul (South Korea), Middle East Respiratory Syndrome Coronavirus (MERS-CoV)  External Link

WHO Disease Outbreak News: Middle East respiratory syndrome coronavirus (MERS-CoV) – Republic of Korea, 6 June 2015  External Link

WHO Situation Assessment: Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea  External Link

Korea Centers for Disease Control and Prevention  External Link – General information on the organization. 


Military Treatment Facilities

CDC Guidance: Interim Guidance for Healthcare Professionals  External Link

Preparation - Infection prevention and control are critical to prevent the spread of MERS-CoV in health care facilities. Review infection control practices.

Patient Evaluation

Treatment - There is no specific antiviral treatment for MERS-CoV infection. Individuals with MERS can seek medical care to help relieve symptoms. For severe cases, current treatment includes care to support vital organ functions.

Infection control: CDC: Interim Infection Prevention and Control Recommendations for Hospitalized Patients with MERS-CoV  External Link

  • Use airborne precautions when evaluating potential MERS patients or when treating patients with probable or confirmed MERS. Patients should be placed in an airborne infection isolation room, and any healthcare personnel should wear gloves, gowns, eye protection, and a fit-tested NIOSH-certified disposable N95 filtering respirator. Standard procedures should be followed for cleaning and disinfecting patient rooms or items used while in isolation.
  • Recommendations for personal protective equipment, source control, and environmental infection control measures are applicable to any healthcare setting.

Case Reporting

  • Report suspected MERS cases to the APHC Disease Epidemiology Program  telephonically at
    (410) 417-2377 or (800) 222-9698
  • Report suspected MERS cases in DRSi
  • Inform the local health department

Laboratory Testing