What is MERS, and what precautions should expats take?

In this post we define what MERS is, and outline some precautionary measures which should be taken to help prevent infection.

At the most recent meeting of the International Health Regulations Emergency Committee (EC) regarding MERS, on 2 September 2015. The Committee felt it important to alert all relevant authorities, to the continued and significant public health risks posed MERS. 

The virus appears to be circulating throughout the Arabian Peninsula, primarily in Saudi Arabia, where the majority of cases (>85%) have been reported since 2012. 

To date, 26 countries have reported cases, including countries in the Middle East: Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia (KSA), United Arab Emirates (UAE) and Yemen; in Africa: Algeria, and Tunisia; in Europe: Austria, France, Germany, Greece, Italy, the Netherlands, Turkey and the United Kingdom; in Asia: China, the Republic of Korea, Malaysia, Philippines and Thailand; and in North America: the United States of America (USA). 

MERS is a viral respiratory disease caused by a novel coronavirus that was first identified in Saudi Arabia in 2012.

Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).

Because MERS is part of the coronavirus family, the symptoms are often similar to those of the common cold, only more severe.

A typical case of MERS includes symptoms of fever, cough, and/or shortness of breath. Pneumonia is a common finding on examination. Gastrointestinal symptoms, including diarrhea, have also been reported. Severe illness can cause respiratory failure that requires mechanical ventilation and support in an intensive‐care unit. Some patients have had organ failure, especially of the kidneys, or septic shock. The virus appears to cause more severe disease in people with weakened immune systems, older people, and those with such chronic diseases as diabetes, cancer and chronic lung disease.

Non-human to human transmission: The route of transmission from animals to humans is not fully understood, but camels are likely to be a major reservoir host for MERS and an animal source of infection in humans. Strains of MERS that are identical to human strains have been isolated from camels in several countries, including Egypt, Oman, Qatar, and Saudi Arabia.

Human-to-human transmission: The virus does not appear to pass easily from person to person unless there is close contact, such as providing unprotected care to an infected patient. There have been clusters of cases in healthcare facilities, where human-to-human transmission appears to be more probable, especially when infection prevention and control practices are inadequate.

No vaccine or specific treatment is currently available. Treatment is supportive and based on the patient’s clinical condition.

The infographic below produced by the WHO, provides practical advice for individuals. It includes warning signs as well as advice on how to protect yourself from contracting MERS.

To help protect yourself from respiratory illnesses, the following precautionary measures should be taken:

• Wash your hands regularly with soap and water, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
  
• Cover your nose and mouth with a tissue when you cough or sneeze, then discard the tissue responsibly.
  
• Wear a simple face mask in crowded public places.
  
• People caring for MERS infected patients should wear eye protection and gloves.
  

No vaccine or specific treatment is currently available. Treatment is supportive and based on the patient’s clinical condition.

The infographic below produced by the WHO, provides practical advice for individuals. It includes warning signs as well as advice on how to protect yourself from contracting MERS.

If you are living or working in a region where MERS is circulating and have an international health insurance plan which includes coverage in that region, check your international health plan documentation to ensure you are covered if you contract MERS.

Expats should be aware of the risks, and take all necessary precautions to avoid infection. WHO does not recommend the application of any travel restrictions at this point. Based on countries’ risk assessment, precautions aimed at raising awareness of MERS and its symptoms among travelers to and from affected areas, can be taken. 

Most countries do have the appropriate medical facilities required to deal with MERS, so evacuation will not usually be necessary.

If you or a family member does contract MERS, you should contact your international medical insurer who can offer expert advice and take all necessary steps for the care of the patient.

All insured members of  Allianz Worldwide Care  are fully covered for all necessary treatment related to MERS.

Further information on MERS can be found on the World Health Organisation website.