MERS

Coronaviruses have been known to cause human infection since the 1960s. In September 2012, a novel corona virus was isolated from a patient in Saudi Arabia presenting with acute respiratory distress and acute kidney injury. Soon after, similar clinical syndromes were described in additional patients in Saudi Arabia. Analysis revealed the disease syndromes to be due to a novel virus closely linked to the Middle East duly named the Middle East Respiratory Coronavirus (MERS-CoV). Since its initial discovery initially in 2012 a total of 1806 cases have been reported from 27 countries, with a case fatality rate of 36%. Zoonotic transmission is of significant importance and evidence is growing implicating the dromedary camel as the animal host. The clinical picture of MERS-CoV includes asymptomatic infections, mild or moderately symptomatic cases and fatal disease. Transmissions of MERS-CoV within healthcare settings are facilitated by overcrowding, poor compliance with basic infection control measures, unrecognized infections, the superspreaders phenomenon and poor triage systems. The actual contributing factors to the spread of MERS-CoV are yet to be systematically studied, but data to date suggest viral, host and environmental factors play a major role. Supportive care has been the mainstay of management for patients with MERS-CoV infection. To prevent spread of MERS-CoV within health-care settings, it is important to eliminate practice variation by adopting a respiratory screening program and to practice the best available infection control measures. Risk assessment and training of all HCWs on recognizing, isolating, and cohorting possible cases are of great importance to further decrease transmissions within the health-care facilities.