What is MERS-CoV?

MERS-CoV stands for Middle East Respiratory Syndrome Coronavirus. It is a severe infectious disease caused by a coronavirus, belonging to the same family as the virus responsible for SARS, although it is a different strain. MERS-CoV primarily causes severe respiratory illness and was first identified in the Kingdom of Saudi Arabia in 2012.

Epidemiology

As of May 7, 2014, a total of 496 confirmed cases of MERS-CoV infection had been reported worldwide, with 93 deaths. Most cases were associated with pilgrims traveling to the Middle East and healthcare workers. The infection had been reported in 17 countries, particularly in Middle Eastern nations such as Jordan, Saudi Arabia, Qatar, and the United Arab Emirates.

At that time, no cases had been reported in Thailand. However, the country remained at risk due to Thai pilgrims traveling to the Middle East for the Hajj pilgrimage and tourists from the Middle East visiting Thailand. Therefore, continuous surveillance and monitoring were considered essential.

Surveillance Guidelines

The Bureau of Epidemiology established surveillance guidelines for MERS-CoV infection in Thailand. The following groups were identified for close monitoring:

1. Patients with Severe Pneumonia

• Severe pneumonia or acute respiratory failure with no identified cause.

2. Pneumonia Patients with Risk Factors

• Individuals who lived in or traveled from Middle Eastern countries within 14 days before symptom onset.

• Healthcare workers who cared for pneumonia patients within 14 days before becoming ill.

• Individuals who had close contact with suspected or confirmed cases within 14 days before or after illness onset.

3. Clustered Pneumonia Cases

• Two or more pneumonia cases occurring within the same community, with symptom onset occurring within 14 days of one another.

4. Upper Respiratory Tract Infection Cases

• Individuals with upper respiratory tract infections who had close contact with suspected or confirmed cases within 14 days before or after illness onset.

Transmission

The exact mode of transmission was not fully understood at the time. However, evidence suggested that person-to-person transmission could occur, particularly in limited settings such as among healthcare workers and family members caring for infected patients.

Common Symptoms

MERS-CoV infection typically presents with acute respiratory symptoms, including:

• Fever

• Cough

• Flu-like symptoms

In severe cases, patients may develop:

• Shortness of breath

• Difficulty breathing

• Acute respiratory failure

More than 30% of infected individuals were reported to develop severe disease that could result in death.

Treatment

Currently, there is no specific antiviral treatment approved exclusively for MERS-CoV infection.

For patients presenting with high fever and severe pneumonia of unknown viral origin, antiviral medication such as oseltamivir (commonly used for influenza treatment) may be considered according to clinical guidelines. In general, treatment is primarily supportive and focuses on relieving symptoms and managing complications.

Prevention and Self-Care Recommendations

To reduce the risk of infection, the following preventive measures are recommended:

Practice Good Hygiene

• Consume properly cooked food.

• Use serving utensils when sharing meals.

• Wash hands frequently with soap and water for at least 20 seconds.

• Alcohol-based hand sanitizers may be used when soap and water are unavailable.

Avoid Close Contact with Sick Individuals

• Stay away from people who are coughing or sneezing whenever possible.

Avoid Crowded Places

• Limit exposure to crowded environments.

• If entering crowded areas is unavoidable, wear a face mask to reduce the risk of infection.

Wear a Mask When Ill

• Individuals experiencing cough or sneezing should wear a face mask to help prevent the spread of respiratory infections.

References

1. Centers for Disease Control and Prevention (CDC). Middle East Respiratory Syndrome (MERS). 2014.

2. Bureau of Emerging Infectious Diseases, Department of Disease Control, Thailand. Novel Coronavirus 2012 Information. 2014.

3. Department of Disease Control, Ministry of Public Health, Thailand. Current Situation and Progress Report on MERS-CoV 2012. 2014.

4. Bureau of Epidemiology, Department of Disease Control, Thailand. Coronavirus 2012 Surveillance Report. 2014.

5. Ministry of Public Health Medical Working Group and Medical Faculties. Guidelines for Diagnosis, Treatment, and Infection Control of MERS-CoV Patients. October 30, 2013.