Middle East Respiratory Syndrome (MERS): Causes, Symptoms, and Treatment

Medically Reviewed by Neha Pathak, MD on December 13, 2022
Written by Alexandra Benisek
5 min read

Middle East respiratory syndrome (MERS) is a severe respiratory illness that happens from a type of coronavirus called MERS-CoV. Experts first saw MERS in Saudi Arabia in 2012. The illness has similar symptoms to COVID-19, but it’s not as contagious.

The World Health Organization (WHO) has recorded 2,519 cases of MERS as of January 2020. While 27 countries have had cases, 80% of the infections are in Saudi Arabia. Researchers believe that 3 or 4 out of every 10 people with MERS have died. But this might not be fully accurate because a lot of mild cases are undiagnosed.

So far, there’ve only been two cases of MERS in the United States. They were both health care workers who had traveled to Saudi Arabia.

MERS may have come from bats and then spread to other animals before it spread to humans. Experts believe that it first spread to camels, who then spread it to people.

The MERS-CoV virus lives in your respiratory tract, like some other infectious diseases. People spread it to others through coughing. You can also get the infection from camels. In Saudi Arabia and nearby countries, camels have the same strain of MERS as humans. This shows that there’s been transmission between camels to people.

While it’s contagious, MERS doesn’t spread as fast as COVID-19. So far, experts haven’t seen any community-wide spread of MERS.

You may have no symptoms with MERS. Or you could notice mild side effects like a cold. Sometimes, people get severe symptoms that could be deadly.

In most cases, you’ll have respiratory, or lung-related, symptoms like:

  • Fever
  • Cough
  • Shortness of breath

Other side effects of MERS not related to your lungs include:

  • Diarrhea
  • Nausea
  • Vomiting 

These symptoms will most likely show up within 2 to 14 days after you’re around the virus.

Anyone can get MERS, but it tends to affect people who live in the Arabian Peninsula or travel to this area. All cases of MERS are linked to living in or traveling to countries in or near the Arabian Peninsula. These include Iran, Iraq, Israel, Saudi Arabia, and Syria.

You’re also at a higher risk for the illness if you:

  • Have been close to a person who’s traveled to the Arabian Peninsula and gotten sick
  • Have been near someone with a confirmed case of MERS
  • Were in direct contact with camels, or ate or drank raw camel meat or milk
  • Are a health care worker and have come in close contact with someone with MERS and didn’t follow all the infection control guidelines

Most people who’ve died from MERS had an existing medical condition that made their immune system weak. In some cases, people didn’t even know they had another condition.

You may be more at risk for severe infection if you have:

  • Cancer
  • Diabetes
  • Chronic lung disease
  • Chronic heart disease
  • Chronic kidney disease

With MERS, you can develop other issues too. Sometimes the infection gets worse and leads to pneumonia, respiratory (breathing) failure, or kidney failure. If you have breathing issues, you might need to use a mechanical ventilator.

You’re more likely to develop a severe case of MERS if you have other health conditions that affect your immune system.

If you think you have MERS, your doctor will ask you about your medical history. Make sure to tell your medical team if you’ve traveled recently or if you’ve been around any sick people or camels.

After they ask some questions about your symptoms, your doctor will do some lab tests to see if you have an active MERS infection or one from the past.

They might order multiple tests. These might include:

A lower respiratory tract sample. Your doctor will take some fluid from your lungs. You’ll cough up sputum, or phlegm, into a container. Your doctor could also put a thin,  flexible tube down your throat and into your lungs. This tube will collect a sample as well.

An upper respiratory tract sample. Your medical team will swab the inside part of your nose or upper throat.

A serum sample. The liquid part of your blood is called serum. Your doctor will get a blood sample and spin it really fast in a centrifuge. This separates the serum from your red and white blood cells and platelets.

But not all laboratories are able to do MERS-CoV tests. If this is the case, your doctor might send your sample to a state health department. They can also send them to the CDC.

There aren’t any approved treatments for MERS. There’s also no vaccine for it. Your doctor will instead treat and manage your symptoms.

If your symptoms aren’t intense, you can stay at home and use medications to feel better. They’ll help treat your pain and fever.

But if you have a more severe MERS case, you might need to go to the hospital. During your time at the hospital, you may need IV (intravenous) fluids, mechanical ventilation, or supplemental (extra) oxygen.

MERS is a rare disease not easily transmitted from person to person. You’re not likely to get it unless you travel to the Arabian Peninsula or come into close contact with someone who has recently traveled there and has symptoms. If you do plan to travel to the Arabian Peninsula: 

To keep yourself safe from MERS, you can follow tips that are similar to those for preventing other respiratory infections:

  • Don’t touch your eyes, mouth, or nose.
  • Don’t get too close to people who are sick.
  • Cover your nose and mouth with a tissue when you sneeze and cough.
  • Wash your hands frequently.
  • Disinfect and clean surfaces often.

If you work or interact with camels, you’ll want to follow special guidelines to avoid MERS:

  • Always wash your hands after you’ve touched a camel.
  • Stay away from sick camels.
  • Don’t go near camels if you have a chronic health condition or if you have a weak immune system.
  • Never drink unpasteurized camel milk or eat uncooked camel meat.

If you do get MERS, you have a high risk of developing severe disease, especially if you have existing health conditions.

If you think you have MERS, it’s important to:

  • Stay at home.
  • Wash your hands often.
  • Keep yourself separate from others while at home (stay in a different room and use a different bathroom).
  • If you must be in the same room as someone else, use a face mask.
  • Cover your nose and mouth with a tissue when you sneeze or cough. Wash your hands right away afterward.
  • If you have to go to the doctor, let your doctor know beforehand about your possible infection.
  • If you start to feel sick, call your doctor as soon as possible.

If you think that you have MERS, call your doctor immediately. They can offer testing and guidance for managing it so you don’t spread it to those around you.