VERIFY Fact Sheet: Middle East respiratory syndrome (MERS)

The 2022 FIFA World Cup kicked off in Qatar on Nov. 20, 2022. Over 2.45 million spectators attended the first 48 matches of the tournament, according to FIFA.

Since the start of the tournament, health officials in Australia are warning World Cup attendees heading home from the Middle Eastern country to be aware of a respiratory illness that is commonly found in countries in the region known as Middle East respiratory syndrome (MERS).

Recent online searches show many people are wondering what MERS is, how it spreads and if any vaccines are available to protect against it.

VERIFY is answering some of the most common questions about MERS.

THE SOURCES

• World Health Organization (WHO)
• U.S. Centers for Disease Control and Prevention (CDC)
• European Centre for Disease Prevention and Control
• UK National Health Service
• UK Health Security Agency
• Australian Government Department of Health
• Qatar Ministry of Public Health
• Johns Hopkins Medicine

FAST FACTS

• As of Dec. 15, there have been no MERS cases reported in connection to the World Cup in Qatar. Cases in the U.S. are extremely rare.
• Middle East respiratory syndrome (MERS) is a viral respiratory illness caused by the Middle East respiratory syndrome coronavirus (MERS-CoV).
• MERS is typically spread between animals and people. There is evidence that camels in the Middle East are the main source of the virus. Human-to-human transmission is also possible.
• Some of the most common MERS symptoms include fever, chills, coughing, sore throat, runny nose, trouble breathing and diarrhea.
• Currently, there are no vaccines available to protect against MERS. However, some are in development.

WHAT WE FOUND

What is Middle East respiratory syndrome (MERS)? 

Middle East respiratory syndrome (MERS) is a respiratory illness that is caused by a coronavirus called the Middle East respiratory syndrome coronavirus (MERS-CoV). It was first identified in Saudi Arabia in 2012.

The origins of the virus are not fully understood at this time, according to the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). However, it is believed that MERS-CoV “may have originated in bats and later transmitted to camels at some point in the distant past,” the WHO says.

Since 2012, MERS has been reported in 27 countries, including the United States. All cases of MERS have been linked through travel to, or residence in, countries in and near the Middle East.

Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to severe acute respiratory syndrome (SARS), MERS-CoV and COVID-19, according to the WHO.

Three years after the identification of MERS, the WHO issued updated guidance for naming infectious diseases, requesting that viruses not be named after the region of origin to prevent harmful stigmas. This guidance doesn’t apply to previously established names, like MERS.

Have there been any recent MERS cases reported?

As of Dec. 15, there have been no MERS cases reported in connection to the World Cup in Qatar.

Since the MERS virus was first identified in 2012, there have been a total of 2,601 cases with 935 associated deaths reported from 27 countries, according to WHO data. The majority of these cases have been reported in Saudi Arabia.

VERIFY found that there have been six confirmed cases of MERS in 2022, according to the European Centre for Disease Control and Prevention, the European Union’s public health agency. Three of those cases were reported in Saudi Arabia, two in Qatar and one in Oman, including one death. The public health agency says in all but one of the reported cases, the infected person had contact with camels.

In the United States, only two patients have ever tested positive for MERS-CoV infection. Both of these cases were reported in May 2014, according to the CDC. Both cases were among healthcare workers from Indiana and Florida who lived and worked in Saudi Arabia at the time, where scientists believe they were infected with the virus. The CDC says both workers were hospitalized in the U.S. and later discharged after fully recovering.

“MERS represents a very low risk to the general public in this country,” the CDC says on its website.

The CDC does not recommend people change travel plans because of MERS at this time.

How does MERS spread?

MERS-CoV is a zoonotic virus typically transferred to humans from infected dromedary camels in the Middle East, Africa and South Asia, according to the WHO.

Human-to-human transmission is also possible but is mostly limited to those who have been in prolonged direct contact with an infected person, particularly in a household or in a healthcare setting.

The virus is thought to spread from an infected person’s respiratory secretions, such as through coughing. But the CDC says “the precise ways the virus spreads are not currently well understood.”

“The MERS virus does not pass easily between people unless there is close unprotected contact, such as the provision of clinical care to an infected patient without strict hygiene measures,” the WHO says on its website.

What are MERS symptoms?

MERS-CoV infections can range from showing no symptoms at all to mild respiratory symptoms to severe disease and death, the WHO and the CDC both say.

According to Johns Hopkins Medicine, symptoms of MERS typically start about five days after being exposed to the virus, and can also happen up to 14 days later.

Some of the most common symptoms of MERS include:

• Fever
• Cough
• Shortness of breath
• Chills
• Sore throat
• Runny nose
• Muscle aches
• Nausea and vomiting 
• Diarrhea

The MERS virus appears to cause more severe disease in people with weakened immune systems, older people and people with certain diseases, such as diabetes, cancer and chronic lung disease, chronic kidney disease and chronic heart disease, according to the WHO and the CDC.

The mortality rate for people with the MERS virus is approximately 36% – but the WHO says this may be an overestimate of the true mortality rate because “mild cases of MERS-CoV may be missed by existing surveillance systems, with case fatality rates counted only amongst the laboratory-confirmed cases.”

Is there a MERS treatment or vaccine?

There is currently no specific antiviral treatment or vaccine to protect people against MERS. However, scientists are working to develop one, according to the CDC.

You can reduce your risk of getting MERS and other respiratory illnesses by:

• Washing your hands often with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer.
• Covering your nose and mouth with a tissue when you cough or sneeze. 
• Avoiding touching your eyes, nose, and mouth with unwashed hands.
• Avoiding personal contact, such as kissing, or sharing cups or eating utensils, with sick people.
• Cleaning and disinfecting frequently touched surfaces and objects, such as doorknobs.
• Avoiding contact with camels.
• Avoiding drinking raw (unpasteurized) camel milk.
• Avoiding eating undercooked camel meat.

If you have had close contact with someone who has been diagnosed with MERS, you should contact your healthcare provider and monitor any symptoms that may develop for at least 14 days.