Middle East respiratory syndrome (MERS)

Last reviewed: 3 Sep 2022
Last updated: 08 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • residence in, or travel to, the Middle East (or country where there is an active outbreak) in previous 14 days
  • age >14 years
  • fever
  • cough
  • dyspnoea
More key diagnostic factors

Other diagnostic factors

  • haemoptysis
  • diarrhoea
  • abdominal pain
  • nausea/vomiting
  • chills/rigors
  • myalgia
  • arthralgia
  • malaise
  • headache
  • sore throat
  • rhinorrhoea
  • tachypnoea
  • tachycardia
  • cyanosis
  • chest pain
  • crackles/rales on auscultation
Other diagnostic factors

Risk factors

  • residence in, or travel to, the Middle East (or country where there is an active outbreak) in previous 14 days
  • close contact with infected individuals
  • exposure to infected dromedary camels
More risk factors

Diagnostic investigations

1st investigations to order

  • FBC
  • comprehensive metabolic panel
  • pulse oximetry
  • blood cultures
  • real-time reverse transcription polymerase chain reaction (RT-PCR)
  • RT-PCR sequencing assay
  • chest x-ray
More 1st investigations to order

Investigations to consider

  • serology
  • CT chest
More investigations to consider

Treatment algorithm

INITIAL

suspected MERS

ACUTE

confirmed MERS: post initial stabilisation and isolation measures

Contributors

Authors

Sarah Shalhoub, MD

Infectious Diseases Consultant

London Health Sciences Center

Western University

London

Canada

Disclosures

SS is the author of several references cited in this topic.

Ali S. Omrani, MBBCh, MSc, FRCP, FRCPath

Senior Consultant, Infectious Diseases

Communicable Diseases Center

Hamad Medical Corporation

Doha

Qatar

Disclosures

ASO is the author of several references cited in this topic.

Peer reviewers

Ioannis P. Kioumis, MD, PhD

Associate Professor of Pulmonary Medicine and Infectious Diseases

Aristotle University of Thessaloniki

Respiratory Medicine Clinic

General Hospital G. Papanikolaou

Thessaloniki

Greece

Disclosures

IPK declares that he has no competing interests.

William A. Petri, Jr, MD, PhD, FACP

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

  • Middle East respiratory syndrome (MERS) images
  • Differentials

    • Coronavirus disease 2019 (COVID-19)
    • Severe acute respiratory syndrome (SARS)
    • Common cold
    More Differentials
  • Guidelines

    • CDC health information for international travel (Yellow Book): Middle East respiratory syndrome (MERS)
    • Interim infection prevention and control recommendations for hospitalized patients with Middle East respiratory syndrome coronavirus (MERS-CoV)
    More Guidelines
  • Calculators

    CURB-65 pneumonia severity score

    More Calculators
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