Middle East Respiratory Syndrome (MERS) has been making headlines since 2012 when it was first discovered in Saudi Arabia. A recent outbreak of MERS has occurred in the Republic of Korea affecting 150 people and claiming the lives of over a dozen to date. Close to 3,000 people in South Korea are under quarantine. Two unrelated cases of MERS were diagnosed in the United States in 2014 and both patients have made a full recovery.
While not considered a public health emergency by the World Health Organization, viruses can mutate and could cause a global pandemic. As a healthcare provider, it is important that you have an understanding of MERS and appropriate infection control practices in order to identify and prevent its further spread. As an educator, you play a critical role in informing patients about the signs and symptoms of MERS and strategies to avoid contracting this highly contagious disease.
What is MERS?
MERS is caused by a coronavirus (CoV), a group of viruses that are responsible for illnesses ranging from the common cold to Severe Acute Respiratory Syndrome (SARS). Almost 1,200 cases of human MERS-CoV infection have been reported and over 440 deaths (35% mortality rate) have been attributed to it. The origin of the virus is unknown but is suspected to have come from an animal source. MERS-CoV is thought to spread from an infected person’s respiratory secretions, such as through coughing. The incubation period for MERS (time from exposure to MERS-CoV to symptoms) is typically five to six days but can range from two to 14 days. There are no specific treatments for patients aside from supportive therapy to relieve the symptoms. Patients with mild to no symptoms have made a full recovery.
- Fever, cough, shortness of breath, runny nose, severe acute respiratory disease
- Chills, chest pain, body aches, sore throat, malaise, headache
- Diarrhea, nausea, vomiting, abdominal pain
Severe complications include:
Who’s susceptible or at high risk?
- People with pre-existing medical conditions such as diabetes, kidney failure, chronic lung disease
- People with weakened immune systems such as cancer patients receiving chemotherapy or organ transplant patients receiving immunosuppressive drugs
Need-to-know information for nurses
- If your patient exhibits fever and symptoms of respiratory illness, assess if he or she has
- traveled to a country in or near the Arabian Peninsula within 14 days of symptoms onset.
- been in contact with someone who has traveled to the Arabian Peninsula within 14 days of symptoms onset.
- a history of being in a healthcare facility (as a patient, worker or visitor) in the Republic of Korea within 14 days of symptom onset.
- been in close contact with a confirmed MERS patient while the patient was ill.
- MERS is a reportable disease and local health departments should be notified of any suspected MERS cases.
- Strict infection-control measures should be used while managing suspected and confirmed cases of MERS, including hand hygiene; contact, droplet and airborne precautions along with full personal protective equipment – gown, gloves, mask and eye protection (goggles or face shield). MERS patients should be placed in a negative pressure room.
Please visit the Centers for Disease Control and Prevention (CDC) for complete recommendations and Interim Guidance for Healthcare Professionals
in the detection, evaluation and care of MERS patients.
Myrna B. Schnur, RN, MSN