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Middle East respiratory syndrome (MERS)

Last reviewed: 23 Sep 2025
Last updated: 07 Jan 2025

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
  • dyspnea
Full details

Other diagnostic factors

  • hemoptysis
  • diarrhea
  • abdominal pain
  • nausea/vomiting
  • chills/rigors
  • myalgia
  • arthralgia
  • malaise
  • headache
  • sore throat
  • rhinorrhea
  • tachypnea
  • tachycardia
  • cyanosis
  • chest pain
  • crackles/rales on auscultation
Full details

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
Full details

Diagnostic tests

1st tests to order

  • CBC
  • comprehensive metabolic panel
  • pulse oximetry
  • blood cultures
  • real-time reverse transcription polymerase chain reaction (RT-PCR)
  • RT-PCR sequencing assay
  • chest x-ray
Full details

Tests to consider

  • serology
  • CT chest
Full details

Treatment algorithm

INITIAL

suspected MERS

ACUTE

confirmed MERS: post initial stabilization 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

利益声明

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

利益声明

WAP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013 Sep;13(9):752-61.全文  摘要

Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis. 2014;29:301-6.全文  摘要

Alraddadi BM, Watson JT, Almarashi A, et al. Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans, Saudi Arabia, 2014. Emerg Infect Dis. 2016;22:49-55.全文  摘要

World Health Organization. Clinical management of severe acute respiratory infection when Middle East respiratory syndrome coronavirus (MERS-CoV) infection is suspected. Interim guidance. Jan 2019 [internet publication].全文

Cevik M, Tate M, Lloyd O, et al. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe. 2021 Jan;2(1):e13-e22.全文  摘要

Arabi YM, Balkhy HH, Hayden FG, et al. Middle East respiratory syndrome. N Engl J Med. 2017 Feb 9;376(6):584-94.全文  摘要

Arabi YM, Asiri AY, Assiri AM, et al. Interferon beta-1b and lopinavir-ritonavir for Middle East respiratory syndrome. N Engl J Med. 2020 Oct 22;383(17):1645-56.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Middle East respiratory syndrome (MERS) images
  • 鉴别诊断

    • Coronavirus disease 2019 (COVID-19)
    • Severe acute respiratory syndrome (SARS)
    • Common cold
    更多 鉴别诊断
  • 指南

    • Laboratory testing for MERS
    • Prevention and control for hospitalized MERS patients
    更多 指南
  • 医学计算器

    CURB-65 pneumonia severity score

    更多 医学计算器
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