What is MERS-CoV?

Middle East Respiratory Syndrome (MERS), It is a Middle East respiratory syndrome, a viral respiratory illness.

• To be more accurate, MERS-CoV is a illness caused by coronavirus.
• MERS impacts lungs and respiratory trumpet (respiratory tract). Most of the MERS patients show symptoms of extreme respiratory related disease such as difficulties in breathing, coughing and fever. Three to four out of ten patients have died.
• The health related institution in Saudi Arabia reported this illness for the first time in September 2012. Based upon the tracing analysis, the relevant health institution found out the first MERS patient case that occurred in Jordan in April 2012.
• All MERS patients up until now were associated with the countries near the Arabian Peninsula.
 

Why is it called MERS-CoV?

MERS-CoV is an abbreviation of the “Middle East Respiratory Syndrome Coronavirus”, which refers to the virus that causes MERS.

• Center for Disease Control and Prevention in the U.S. uses this term to call the virus, not the illness.
• When mentioning about the illness, they call it MERS.
 

What is the cause of MERS?

It is not so sure where MERS came from, but it is supposed that the MERS has been originated from animals.

• In some countries, the coronavirus in MERS has been found in camels.
• There is some possibility that some of the people have been infected with MERS after contacting camel.
• There should be more data and information to prove that camels and other animals are the route to MERS infection.
 

What are symptoms of MERS and its complications?

Most of MERS confirmed patients displayed extreme respiratory symptoms including fever, coughing and breathing difficulties.

• Some people showed gastrointestinal related symptoms including diarrhea, nausea and vomiting.
• Some of the MERS infected patients can have complications, which include pneumonia and renal insufficiency. Three to four people out of ten patients have died after being infected, and 30 to 40% of these victims had chronic diseases. Some people, after infection, do not show particular symptoms, which are similar to simple cold.
• According to the research study findings as of now, those who suffer two chronic diseases are more susceptible to MERS-CoV infection or to more serious situation. These chronic diseases include cancer, chronic lung problems, heart disease and kidney disease.
• Those who have weak immunity system are at risk as well. According to the current data, the latent period (the period from the virus exposure to symptom occurrence) is five to six days, but it can be as long as two to 14 days.
 

How does the virus spread?

MERS-CoV is infected when the infected person comes in close contact with others, for instance, in the situation of living together or nursing.

• Researchers say there is less possibility of community-onset infection spread for MERS.
• All the reported cases are related to the Arabian Peninsula and its neighboring countries.
• Most of the infected patients are the ones that either live in the Arabian Peninsula or have recently visited the countries nearby the peninsula.
• A few people have been infected after contacting the infected ones. (There is no infectivity before the symptoms occur.)
 

What measures is Incheon taking against MERS?

Incheon Metropolitan City, in a bid to prevent MERS spread within the community, is holding vice governor-presided meeting on a daily basis and has established countermeasure system by fully leveraging the community capability involving the doctors’ association, hospital association, police and fire safety headquarters.

• The city is operating temporary MERS clinic and selective consultation center at 10 public clinics within the district and eight hospitals including Incheon Medical Center. In addition, the Incheon Medical Association supplies medical staffs and in case MERS related patients come to the emergency room, the medical staffs give treatment to these patients before others.
• Incheon Metropolitan Police Agency is supporting the MERS patient-contact people and home isolation. In addition, Incheon Fire & Safety Management Department has established keen cooperation system with relevant institutions within the community to conduct emergency measures for patient management such as MERS-suspect patient transfer.
• When the Korea Center for Disease Control and Prevention reports the list of people that came in contact with MERS patients, the city promptly conducts tracking analysis of the contacts via public clinics. Then, it distributes notification that contains daily life guidelines including wearing masks, using personal equipment and washing hands, as well as home isolation. It will conduct phone monitoring twice a day.
• Amidst the increase in number of MERS infected patients, Incheon Metropolitan Government will put its utmost into preventing MERS spread by enhancing health related capabilities including acquiring budget to purchase laboratory equipment, medical treatment equipment and personal protection devices for MERS suspected people.
 

Is there a possibility of getting infected from MERS in Incheon?

As of now, there is no MERS-positive among Incheon citizens.

• As it is reported via mass media, the MERS-coV-positive people are increasing in number. We recommend that you spend less time in the places where full of people and pay attention to personal sanitary conditions.
• The Center for Disease Control and Prevention in the U.S. gives below guidelines to prevent respiratory related illness.
• Wash the hands for over 20 seconds frequently. Help young children in washing their hands. If you cannot wash your hands, use alcohol sanitizer.
• When you sneeze or cough, cover your mouth and nose with tissue. You should throw away the used tissue in trash cans.
• Do not touch your eyes, mouth and nose with unwashed hands.
• Do not come in close contact – kissing and sharing eating tools - with the patients.
• Sterilize the surface of objects like doorknob and toys, which you come in frequent contact with.
 

What should I do if I have come in contact with MERS confirmed patients?

Call the MERS hotline (109 with no regional code), or consult with the nearby public clinic via phone.

• If you have respiratory symptoms like over 37.5˚C fever, breathing difficulties and coughing or digestive troubles like diarrhea, you will be classified as MERS-suspect, become isolated and go through MERS-coV tests.
 

Can I visit the MERS occurred countries or its neighboring countries?

Below are the guidelines for the travelers.

• The following people should refrain from traveling those areas: people with weaker immunity system including children under five years old, pregnant women and cancer patient, as well as people with chronic diseases such as glucosuria, high blood pressure and heart diseases.
• Avoid yourself from visiting farms or contacting animals, especially camels.
• Do not eat raw camel meat and camel milk.
• Abide by personal sanitary rules such as washing hands.
• Stay away from the places full of people, and wear a mask if you need to visit such places.
• Do not touch your eyes, nose and mouth with hands.
• Prevent close contact with those people who have fever or respiratory symptoms.
• Wear a mask if you have respiratory related symptoms.
 

I have recently visited the Arabian Peninsula and the Middle East. What should I do if I feel sick?

• Refer to the Korea Center for Disease Control and Prevention’s “Suspected patient diagnosis report standards”. Rather than visiting the nearby hospitals, you need to isolate yourself at home and contact the public clinic to inform them about the country you’ve visited, temperature and symptoms and follow their guidelines.
 

Standards for diagnosis report

MERS-confirmed patients: Those who have been confirmed MERS-CoV via lab diagnosis test.

Suspected MERS patients are those who have
  (1) Pneumonia or acute respiratory system syndrome (based on clinical or radiological evidence) and either a history of travel in the Middle East countries within 14 days before symptom onset, or close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling the Middel East countries
  (2) Fever and symptoms of respiratory illness (not necessarily pneumonia; e.g. cough, shortness of breath) and being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula in which recent healthcare-associated cases of MERS have been identified.
  (3) Fever or symptoms of respiratory illness (not necessarily pneumonia; e.g. cough, difficulties in breathing) and close contact with a confirmed MERS case while the case was ill.
  (4) Fever or symptoms of respiratory illness and a history of staying or visiting the MERS spread hospitals as staffs, patients and visitors within 14 days onset. * MERS spread hospitals: Occurrence of more than two MERS cases * Middle East refers to the Arabian Peninsula and its neighboring countries
(Bahrain, Iraq, Iran, Israel, West bank, the Gaza Strip, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, Arab Emirates, Yemen
* Close contacts refers to the following situations: When a person stayed within 2m from the MERS patients without wearing proper personal protection tools (gown, gloves, N95 masks, google or facial protector); when a person stayed in the same sickroom, medical office and treatment room (family and medical staffs); or when a person came in direct contact with the secretion of the patient.
 

What should I do if I am a presumed MERS patient?

Isolate yourself and contact public clinic to inform your symptoms. Follow their guidelines.

 

Is there a vaccine?

As of now, there is no vaccine.

 

How does Incheon test MERS?

After the suspected MERS patients report themselves to the relevant public clinics, they will be transferred to the designated hospitals where the medical staffs pick the sample – e.g. sputum, BAL fluid, lung structure.

• The sample picked will be packaged in three layered container and will be sent to the Research Institute of Public Health where the virus genetic test will be conducted. The institute uses Real-time PCR to examine the upE and ORF1a gene, which is the specific gene found in MERS-coV.
 

Is it similar to SARS virus?

No, the coronavirus in MERS is not same as the virus in SARS, which occurred in 2003. However, MERS-coV has many similarities with the coronavirus found its bats like the ones in SARS.

• According to the world’s renowned journal, “The Lancet”, MERS virus and SARS virus display symptoms after the latent period of two to 14 days, and they have similar symptoms. Both the MERS and SARS patients suffer from over 38 ˚C fever.
• 20% of the patients suffer from diarrhea, nausea and vomiting.
• There are some difference as well; 72% of MERS patients suffer from short in breathing while only 40% of SARS patients display such symptom.
• 17% of MERS patients have hemoptysis (emission of coughing phlegm with blood), while only 1% of SARS patients have such symptom.
• While 11% of MERS patients have headache, over half of the SARS patients suffer from the symptom.
• The age range of both the MERS and SARS patients are wide from one year to 90 years old; however, 90% of the patients are adults.
• In terms of gender ratio, male patients occupied 64.5% for MERS, which is two-fold more than female patients. In the meantime, 43% of SARS patients was men, while female patients was 57%.
• Unlike SARS which spreads in winter, MERS spreads mainly in April and May.
• The lethality of MERS is higher than SARS by four fold; MERS’ lethality is 40% while that of SARS is 9.6%.
• However, one should guard against having excessive fear about MERS because MERS has relatively low infectivity compared to SARS.