A closer look at MERS Due to its respiratory presentation , Middle East Respiratory Syndrome ( MERS ) is often misdiagnosed as community acquired pneumonia or other common viral illnesses like influenza
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JULY , 2023 | THE HEALTH
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A closer look at MERS Due to its respiratory presentation , Middle East Respiratory Syndrome ( MERS ) is often misdiagnosed as community acquired pneumonia or other common viral illnesses like influenza
SEPSIS ALERT
BY ASSOC PROF DR TAN TOH LEONG
AND DR EVELYN CHAU YI WEN
TO DATE , more than 700 million people worldwide have contracted Covid-19 . Within the family of coronaviruses , there are three notable diseases : Severe Acute Respiratory Syndrome ( SARS ), Coronavirus Disease - 2019 ( Covid-19 ) and Middle East Respiratory Syndrome ( MERS ). Among these three diseases , MERS has been reported to have the highest worldwide mortality rate of 34.4 per cent , followed by SARS-CoV2 ( 9.5 per cent ) and Covid-19 ( 2.13 per cent ).
WHAT IS MERS ?
MERS was first reported in Saudi Arabia in September 2012 . It is caused by a virus called Middle East Respiratory Syndrome Coronavirus ( MERS-CoV ) which is one of the seven known coronaviruses , four of which are common and typically only cause mild respiratory symptoms . However , the other three coronaviruses , namely SARS-CoV , MERS-CoV and SARS-CoV-2 , triggered global health crises in 2002 , 2012 and 2019 , respectively .
TYPES OF HUMAN CORONAVIRUSES
HUMAN CORONAVIRUS
WHO IS AT RISK ?
The source of MERS-CoV remains unknown . Individuals at risk of MERS have direct and indirect exposure to dromedary camels in the Middle East , Africa and South Asia . Examples include individuals who , within 14 days , have had direct contact with
DISEASES
dromedary camels or have consumed or been exposed to dromedary camel products ( such as raw meat , unpasteurized milk or urine ) in countries where MERS is known to be circulating in dromedary camels .
MERS does not usually transmit from person-to-person unless there is close contact within the same household or health care personnel providing care to a patient without proper infection control measures .
WHAT ARE THE SYMPTOMS ?
The presentation of MERS ranges from asymptomatic infection and mild respiratory symptoms to acute respiratory distress , multi-organ failure , septic shock and even death . The incubation period is between two and 14 days . Like SARS and Covid-19 , the initial symptoms of MERS are usually non-specific , including cough , sore throat , body ache , low-grade fever , headache and chills .
Some individuals may also experience gastrointestinal symptoms such as nausea , vomiting and diarrhoea . Severe cases and higher
SARS-CoV Severe Acute Respiratory Syndrome ( SARS ) MERS-CoV Middle East Respiratory Syndrome ( MERS ) SARS-CoV2 Coronavirus Disease-2019 ( Covid-19 )
HCoV-NL63 HCoV-229E HCoV-OC43 HKU1
Usually , mild respiratory illness mortality rates are common in older populations , immunocompromised individuals and those with chronic diseases such as lung disease , diabetes mellitus and heart disease . Up to 50 per cent of symptomatic adult patients have required ICU admission , with 40-70 per cent requiring mechanical ventilation within the first week .
Due to its respiratory presentation , MERS is often misdiagnosed as community-acquired pneumonia or other common viral illnesses like influenza . Therefore , a high index of suspicion is needed , particularly when there is a travel history to the Middle East and contact with dromedary camels .
This is crucial as additional infection control measures need to be upgraded . Diagnosis is based on
Assoc Prof Dr Tan Toh Leong is an Emergency Medicine Physician and Medical lecturer with the Department of Emergency Medicine , Faculty of Medicine , Universiti Kebangsaan Malaysia ( UKM ) and President & Founder of Malaysian Sepsis Alliance ( MySepsis ), while Dr Evelyn Chau Yi Wen is Lecturer and Emergency Physician , UKM Medical Center , UKM and member of MySepsis . clinical symptoms , travel history and laboratory tests ( such as molecular detection , serology tests or viral culture ).
PREVENTION AND TREATMENT
Currently , there is no specific treatment for MERS . The mainstay of therapy is symptomatic and supportive treatment . While antiviral drugs like ribavirin , human immunodeficiency virus protease inhibitors like lopinavir and ritonavir and pegylated interferon ( IFN ) — α2a have been used , there is no definitive cure .
Prevention is better than cure . General precaution and personal hygiene measures should be practised when visiting farms or fields where dromedary camels are present . Avoid consumption of undercooked animal products like milk and meat .
Seek medical consultation immediately if any symptoms develop after visiting MERS-related countries , having close physical contact with MERS-infected individuals while ill , or contacting dromedary camels . – The Health