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Deadly COVID Cousin MERS May Be Spreading After World Cup. Here are the Symptoms, Including Breathing Difficulties.

MERS can be deadly—here’s what you need to know. 
FACT CHECKED BY Emilia Paluszek

Government health agencies are warning against the spread of Middle Eastern Respiratory Syndrome (MERS-CoV) as people return to their home countries after visiting Qatar for the World Cup. MERS is a viral respiratory disease, which, like COVID-19, is caused by a coronavirus. "MERS is a rare but severe respiratory illness that may affect travelers to Middle Eastern countries," Australian health authorities warn. "It is spread through close contact with camels carrying the virus or an infected person, or by consuming uncooked camel meat or unpasteurised camel milk. There is currently no vaccine available. Reduce your risk of getting MERS by observing good hygiene practices, avoiding close contacts with camels and avoiding consuming uncooked meat or unpasteurised milk."

MERS was first reported in Saudi Arabia in 2012. According to the World Health Organization, "Approximately 35% of cases reported to WHO have died, but this may be an overestimate of the true mortality rate, as mild cases of MERS may be missed by existing surveillance systems… Approximately 80% of human cases have been reported by Saudi Arabia, largely as a result of direct or indirect contact with infected dromedary camels or infected individuals in health care facilities. Cases identified outside the Middle East are usually individuals who appear to have been infected in the Middle East and then traveled to areas outside the region. To date, a limited number of outbreaks have occurred outside the Middle East."

So how can people protect themselves from MERS? "Unlike influenza or the common cold, MERS-CoV doesn't seem to spread readily among people in communities," says Pritish K. Tosh, MD. "Instead, MERS-CoV has spread mostly among people who are in close contact, such as people living with or providing direct care for an infected person. There's currently no vaccine to prevent MERS-CoV. However, as with any virus, you can reduce your risk of infection by using good health and hygiene practices:

  • Vigorously wash your hands with soap and water for at least 20 seconds.
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw used tissues in the trash immediately, and then wash your hands carefully.
  • Disinfect frequently touched surfaces, such as doorknobs.
  • Avoid touching your face, mouth and nose with unwashed hands.
  • Don't share cups, utensils or other items with sick people."

Here are five symptoms of MERS, according to experts. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Shortness Of Breath

Young woman feeling sick and holding her chest in pain at home.

Trouble breathing is a common early symptom of MERS. "The clinical spectrum of MERS-CoV infection ranges from no symptoms (asymptomatic) or mild respiratory symptoms to severe acute respiratory disease and death. A typical presentation of MERS is fever, cough and shortness of breath," says the WHO.

"MERS is contagious. However, it does not spread quickly, unlike COVID-19, which spread rapidly around the world," says Cleveland Clinic. "MERS transmission requires close contact, such as between family members or in a healthcare setting. Health officials have not observed community-wide spread of MERS. You can also get MERS from camels. In Saudi Arabia and surrounding countries, camels have strains of MERS that match human strains. This suggests active transmission of MERS from camels to people."



The surprised girl holds a thermometer in her hands.

Fever is another common symptom of MERS, experts say. "A person with MERS may have no symptoms, mild cold-like symptoms or a severe life-threatening illness," says Cleveland Clinic. "Typically, people with MERS develop respiratory symptoms that include cough, fever, shortness of breath. If you have respiratory symptoms, your healthcare provider will ask you about your medical history. Let your provider know if you traveled recently or had contact with sick people or camels. Laboratory tests can determine if you have active MERS or a previous MERS infection."

Because MERS is contagious, it's important for people suspected of having it to isolate themselves as soon as possible (as with COVID-19). A 2015 outbreak in South Korea was said to happen because infected people were "doctor shopping". "The accessibility and affordability of health care in Korea encourage 'doctor shopping'; patients frequently consult specialists in several facilities before deciding on a first-choice facility," WHO said at the time. 




A cough—sometimes bloody—is another symptom of MERS. "MERS-CoV ranges from mild to severe. Some people experience no symptoms or symptoms similar to those of a mild upper respiratory infection," says Dr. Tosh. "But many people have fever and cough that progress to pneumonia. Sometimes people experience digestive system signs and symptoms such as abdominal pain, nausea, vomiting and diarrhea. The kidneys and the lining around the heart also can be affected.

"MERS-CoV can lead to respiratory or kidney failure and is sometimes fatal. You're most at risk of serious illness if you're an older adult or if you have a weakened immune system or a chronic disease, such as diabetes or lung disease. Treatment for MERS-CoV focuses on relieving symptoms and includes rest, fluids, pain relievers and, in severe cases, oxygen therapy."




Some people with MERS report gastrointestinal issues, including diarrhea. Because healthcare workers are at high risk of contracting MERS, there has been concern in the past that globe-trotting doctors and nurses could unwittingly spread the virus. "This is how MERS might spread around the world," said infectious disease expert Dr. Amesh Adalja of the Johns Hopkins Center for Health Security.

"There is not much public health authorities or border agents can do," said infectious disease expert Dr. Michael Osterholm. "Sure, they can ask people, 'did you work in a healthcare facility in Saudi Arabia,' but if the answer is yes, then what?" Osterholm believes healthcare workers are best qualified to be aware of the dangers, and "there should be a heightened awareness among them of possible MERS symptoms."



Young vomiting woman near sink in bathroom

Vomiting is another symptom of MERS, doctors say. "As with SARS, extrapulmonary manifestations are common in severe MERS disease," says Robert M. Kliegman, MD. "Gastrointestinal symptoms such as nausea, vomiting, and diarrhea occur in one third of patients, and acute kidney injury has been documented in half of critically ill patients. Encephalitis-like neurologic manifestations have been observed in three cases."

The CDC is careful to keep track of all cases of MERS to prevent any outbreaks. "CDC continues to closely monitor the MERS situation globally. CDC is working with the World Health Organization and other partners to better understand the virus, how it spreads, the source, and risks to the public's health. We recognize the potential for MERS-CoV to spread further and cause more cases in the United States and globally."


How to Stay Safe Out There


Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Ferozan Mast
Ferozan Mast is a science, health and wellness writer with a passion for making science and research-backed information accessible to a general audience. Read more about Ferozan