There is ongoing concern about the outbreak of Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which was first reported by the World Health Organization (WHO) in September 2012. Cases of MERS-CoV have been reported in several countries of the Middle East, including Saudi Arabia, Jordan, Qatar, Kuwait, Oman, the United Arab Emirates, Yemen and Lebanon.
Other countries outside the Middle East have also reported imported cases from returned travellers. All cases have either lived in or travelled to the Middle East, or had close contact with travellers returning from these areas. Singapore has screening arrangements in place at Changi Airport for travellers arriving from MERS-CoV affected countries in the Middle East. There have been no cases in Australia to date.
What are the symptoms and who is at risk?
MERS-CoV can cause a rapid onset of severe respiratory illness with a fatality rate of around 30%. There is no vaccine for MERS-CoV. Symptoms include fever, cough, shortness of breath and breathing difficulties. Some patients have reported a variety of other symptoms, including muscle pain, diarrhoea, vomiting and nausea. Some patients have mild symptoms or are asymptomatic. Severe cases have most frequently occurred in people with underlying conditions that may have made them more susceptible to infection (including diabetes, kidney disease, hypertension, asthma and lung diseases, cancer, cardiovascular disease).
Reducing the risk of exposure
Dromedary camels are suspected to be the source of infection for sporadic cases, but the exact routes of direct or indirect exposure remain unknown. Person-to-person transmission has been documented, particularly in healthcare settings.
The WHO advises that people at potentially higher risk of severe disease due to MERS-CoV should take appropriate precautions when visiting farms, barn areas or market environments where camels are present in MERS-affected countries. Appropriate precautions might include avoiding contact with camels, good hand hygiene, and avoiding drinking raw milk or eating food that may be contaminated with animal secretions or products unless they are properly washed, peeled or cooked.
All travellers should adhere to general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices when visiting a farm or barn in MER-CoV affected countries.
Seek immediate medical attention if you feel unwell with symptoms similar to MERS-CoV infection while travelling or on your return to Australia. Be sure to tell your healthcare provider that you have travelled to a region where MERS-CoV is known to occur. Avoid close contact with people who are ill with these symptoms.
Many confirmed cases have occurred in healthcare workers. The particular conditions or procedures that lead to transmission in hospital are not well known. However, lapses in infection control are known to be important in increasing the risk of infection in healthcare workers. Therefore, the WHO emphasises the importance of infection control strategies and practices in healthcare in affected countries, not only when caring for suspected MERS-CoV patients but also when caring for patients in all circumstances. See the Australian Department of Health website for information about infection control measures for healthcare workers.
For more information about MERS-CoV, see the following websites: