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Is MERS (not to be confused with MRSA) the next virus that will encircle the globe killing tens of millions of people? At this point, it appears that MERS is not yet an epidemic and is not quickly on the way to becoming one, but the virus bears watching.

The latest scare in international health is Middle East Respiratory Syndrome, also known as MERS, which is caused by the Middle East Respiratory Syndrome Coronavirus, also known as MERS-CoV. Not in any way related to Methicillin-Resistant Staphylococcus Aureus, or MRSA, which is caused by staph bacteria, not a virus, MERS has been followed by public health officials around the world since 2013 and in the Western press since 2014, when the first cases were reported in the United States.

What Is MERS?

MERS is a coronavirus, a relatively large virus inside a protective capsule. Other coronaviruses cause many cases of the common cold, and when they get into the lungs, they can weaken the immune system so that there is increased susceptibility to bacterial pneumonia. The virus does not come out of its protective protein coating until it is inside a target cell, where it attaches to the protein-making ribosomes to code them to make copies of itself. In 2002, a coronavirus known as SARS emerged in eastern Asia, and in 2012, the coronavirus MERS was first detected in Saudi Arabia.

As of May 2, 2014, MERS infections have been confirmed in 401 people in 12 countries.

Every infection occurred in Saudi Arabia, although some of the infected people have traveled outside the Kingdom. Not everyone who is infected with the virus develops symptoms, but most infectees eventually show fever, cough, and shortness of breath. About 25% of people who are infected with the virus show no symptoms at all, but about 30% die.

How Is MERS Transmitted?

In 2012, when MERS was known as "Novel coronavirus," the World Health Organization issued a world-wide alert to public health agencies and immigration officials to be on the alert for new cases.

The virus was quickly found, however, not to spread easily from person to person.

At first, all cases were linked to contact with camels infected with the virus; however, by May 2014, 75% of all cases occurred in people who had close personal contact with someone else who was infected by the virus.

The MERS virus is believed to have an incubation period of 2 to 14 days. People who are infected with the virus do not infect other people until they develop their own symptoms. While there have been approximately 100 camel-to-human transmissions of the disease and approximately 300 secondary infections with the disease (from a person infected by a camel to another person), there have been only 2 confirmed cases in which someone who caught MERS from someone who caught the virus from a camel passed it on to another person. The first case in the US involved a healthcare worker returning to the US after doing nursing in Saudi Arabia.

What Is the Treatment for MERS?

Currently there are no treatments for MERS itself. There are only supportive treatments to relieve cough, fever, and low oxygen levels. There are no known effective antiviral medications for the disease, and there is no vaccine. Diagnostic tools, however, have been developed for confirmation of the infection--allowing for other treatments if MERS is not the actual cause of symptoms.

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