MERS-CoV: Origin, transmission, how to recognize and treat

Translation and synthesis by Dr. Nguyen Hong Thanh – Share99 Research Institute of Stem Cell and Gene Technology

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MERS stands for Middle East Respiratory Syndrome, which occurred in 2012, causing acute respiratory failure that leads to death in many countries around the world. MERS can be transmitted from person to person, especially in epidemic areas, in hospital and other healthcare facilities.

1. When does MERS appear?

Between June 2012 and June 30, 2019, there were 2449 positive cases of MERS-CoV virus that causes Middle East respiratory syndrome. Of these, 84% of cases were recorded in Saudi Arabia. MERS-CoV has spread to 27 countries in the Middle East, North Africa, Europe, Asia and the US. As of the January 2019 report, there were a total of 845 MERS deaths worldwide, accounting for 34.5% of infections.

2. Viral properties, origin, toxicity

MERS-CoV virus, belonging to the family Coronaviridae, is capable of infecting and causing diseases to humans, mammals and some birds. The MERS virus has been identified as a new strain of coronavirus capable of causing rapidly progressive respiratory infections in humans, especially in the elderly and young children, who may be weak or suffering from other chronic diseases. MERS-CoV has been identified as different from all strains of coronavirus that have been found in humans, and is also different from the SARS-CoV strain that caused the SARS epidemic in 2002-2003. However, similar to SARS-CoV, MERS-CoV is also derived from bats that infect humans through camel-medial intermediates.

Coronavirus causes SARS

Coronavirus causes MERS with crown-shaped proteins on the surface (source:

3. Million eggs recorded

Many cases that have been positive for MERS-CoV have progressed rapidly into serious respiratory diseases, especially causing severe pneumonia. Symptoms include fever, cough, and shortness of breath. There may also be many millions of eggs that have been reported in some cases including muscle pain and aches, diarrhea, vomiting.

Some cases have been positively identified, however there are no symptomatic manifestations of MERS-CoV-ins or mild symptomatic manifestations. These cases have been prescribed inspections due to close contact with severe cases of illness.

4. Transmission route

There is already evidence that MERS-CoV originated originally from bats, which infect humans through camels. A multinational team of researchers including Germany, Britain, Russia and Saudi Arabia found MERS-CoV existed in nearly 23% of camel research groups in Saudi Arabia, showing high rates of viral presence and a high risk for camel caregivers. The team also found that MERS-CoV appeared more in camels of Saudi domestic origin, compared to camels of African origin (Azhar 2014; El-Kafrawy 2019).

As a result, WHO has issued recommendations for the transmission of MERS-CoV from camels to humans in the Arabian Peninsula with the risk of human-to-human infection, mainly in hospitals or other medical facilities, mainly in Saudi Arabia. In addition, there exists the risk of spreading to the community through trade and tourism activities between countries in the region and the world. There is no clear evidence that the virus can be transmitted from an infected person but there is no manifestation of the disease to the healer.


Camels, intermediate animals transmit MERS-CoV to humans (source:

5. Diagnosis and treatment

Diagnosis through clinical symptoms (as guided by the Ministry of Health):

  • Common oncology symptoms are fever, cough, sore throat, myalges, bone and joint aches. The patient then develops shortness of breath and rapid progress to pneumonia.
  • About a third of patients have digestive symptoms such as vomiting and diarrhea.
  • Half of the patients progress rapidly to pneumonia and 10% will progress to acute respiratory distress syndrome (ARDS).
  • Chest X-ray results are consistent with viral pneumonia and ARDS.
  • Blood formula tests often show leukocytes, especially lymphocyte leukocytes.

Suspected cases:

  • Travel to an epidemiological area or live in an epidemiological area with MERS-CoV about 10 days before symptoms appear.
  • Have close contact with identified/possible cases.
  • Patients presenting with acute respiratory infections, including fever above 38 degrees Celsius, cough, shortness of breath, damage to lung mesthesis, pneumonia, or clinically based advanced respiratory distress syndrome (ARDS) or X-ray imaging.
  • Not explained by other infections or ants, including all cases where testing is in place to diagnose community pneumonia.

Cases may:

  • The person in direct contact with the case has been diagnosed with a determination by testing, including those who care for the patient; health workers or family members; people who live with the patient or visit the patient during the period of manifestation of the disease.
  • Patients with clinical, XQ, or anatotomical tests of pulmonary parenary pathology (e.g., pneumonia or ARDS) cons match the definition of the above case, but are not confirmed by testing because: specimens are not taken, or testing is not done to diagnose other respiratory infections.
  • Unexplained by other infections or other ants.

Defining cases:

  • The case is clinically present as mentioned above and confirmed by a positive PCR test for the novel coronavirus.
  • The technique of identifying Corona Virus is real time RT – PCR technique with patients being respiratory, sputum, intt management services taken in accordance with the procedure and preserved in the appropriate environment. Note: For the first cases of suspected new coronavirus infection, units need to store samples and transfer samples to testing facilities authorized by the Ministry of Health.

Differentive diagnosis:

The clinical condition caused by Mers-CoV consists of various symptoms, but mainly acute respiratory failure and acute renal failure, so it is necessary to distinguish from the following cases:

  • Severe influenza (influenza A/H1N1 or A/H5N1…..).
  • Atypical pneumonia.
  • Sepsis causes renal failure and respiratory failure.


For suspected cases or may be required to be examined at the hospital, a specific test is performed to diagnose the risk of MERS-CoV infection. For cases with identified MERS-CoV infection, hospitalization is required for follow-up and complete isolation. There are no specific treatment drugs, so mainly only symptomatic treatment, timely detection and treatment of respiratory failure, kidney failure.



  • Epidemic developments and prevention of MERS-CoV
  • The origin and symptoms of MERS CoV
  • Is 2019-nCoV the same as the virus that causes MERS and SARS?
  • Information to know about MERS CoV virus epidemic


  • Acute respiratory failure in babies: What to know
  • How dangerous is acute respiratory failure?
  • How does temperature affect the rate of spread of infectious disease viruses?

About: Minh Quynh

b1ffdb54307529964874ff53a5c5de33?s=90&d=identicon&r=gI am the author of I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.


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