Middle East Respiratory Syndrome

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KEY POINTS

• Middle East Respiratory Syndrome (MERS) is an infection caused by a specific virus.
• Treatment may include medicines, oxygen, fluids to treat or prevent fluid loss, and staying in a separate hospital room away from other people.
• To help prevent MERS, your child should avoid contact with people who are ill. Teach your child to wash hands often and especially after using the restroom, coughing, sneezing, nose blowing, and before eating or touching his or her eyes.

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What is Middle East Respiratory Syndrome (MERS)?

Middle East Respiratory Syndrome (MERS) is an infection caused by 1 type of coronavirus called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). It was first reported in Saudi Arabia in 2012. People in the US have a low risk of MERS.

Other types of coronaviruses are some of many viruses that cause the common cold.

What is the cause?

When your child has MERS, the virus is in the mucus and saliva. We believe it spreads to others when your child coughs or sneezes. However, your child must be in close contact for more than a short time before your child gets the virus, and so far, there has been limited spread from one person to another. Your child is not likely to get MERS from walking by a person or sitting across from someone in a waiting room or office for a brief time.

Animals, such as camels, may spread the virus to humans. Your child is at higher risk for MERS if your child has recently traveled to countries in the Middle East, or if your child has been exposed to someone who traveled there in the past 2 weeks. It’s also possible your child may get MERS if your child has frequent contact with something with the MERS virus on it (like cups, doorknobs, and hands) and then touches his or her mouth, nose, or eyes.

What are the symptoms?

Some people with the virus do not have symptoms. Symptoms normally begin within 5 to 14 days of exposure, and may be mild to serious. Most people with MERS have symptoms such as:

• Fever and chills
• Cough without mucus
• Shortness of breath
• Muscle aches
• Headache

Symptoms may include mild respiratory symptoms, such as sore throat, runny nose, and cough with mucus. Your child might also have nausea, vomiting, and diarrhea. Symptoms can quickly get worse, and serious symptoms need treatment right away.

MERS may cause pneumonia or death, and children with long-term medical conditions are at higher risk.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms, medical history, and recent travels, and examine your child. Tests may include special tests to look for the virus.

Tests may be done to look for other causes of the symptoms that might cause complications, such as:

• Blood and urine tests
• Sputum culture, which is a test of a sample of mucus coughed up from deep in your child’s lungs
• Throat culture, which is a test of fluid from the back of your child’s throat
• Chest X-ray

How is it treated?

There is no specific treatment for the MERS virus. The goals of care are to prevent others from getting the virus and to treat any complications your child may have.

If your child has MERS, your child should be in isolation. This means that special precautions must be taken:

• Your child should be separated from other people. If your child is in the hospital, your child will be in a private room, and people who enter the room will wear masks. If your child is at home, your child should stay in a different room from other people and use a separate bathroom. Your child should not go to work, school, or public areas, and should not use public transportation. Your child should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people. After using these items, they must be washed thoroughly with soap and warm water.
• Call ahead before visiting your healthcare provide and tell him or her that your child may have MERS infection.
• Your child should wear a facemask when in the same room with other people and when your child visits a healthcare provider.

Treatment depends on your child’s symptoms. If your child is very ill, your child needs to be in the hospital. Treatment may include:

• Giving your child oxygen to breathe. You child may need to have a tube in the throat and a machine to help with breathing and to make sure your child is getting enough oxygen
• Giving your child IV fluids and medicines to treat symptoms

How can I take care of my child?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent the spread of MERS?

If your child has MERS, to help prevent the spread of the virus:

• Keep your child at home and limit contact with others. Your child should avoid close contact with others for long periods of time, including kissing and hugging.
• Teach your child to cover his or her mouth and nose with a new tissue when coughing or sneezing. Throw the tissue in a separate trash container. You or the person emptying the container should not touch the trash and should wash hands thoroughly after touching the container.
• Your child should clean hands often with soap and water or an alcohol-based hand cleaner, especially after using tissues or coughing or sneezing.
• Your child should not share silverware, dishes, clothing, towels, or bedding. Wash these items with hot water and soap before others use them.
• Use a household disinfectant often to clean surfaces that your child has touched or used, including toys, door knobs, toilets, and sinks.

There is no vaccine to protect against the virus.

If your child doesn’t have MERS, to reduce the risk of getting MERS:

• Make sure your child washes hands often and especially after using the restroom, coughing, sneezing, or nose blowing. Your child should also wash hands before eating or touching his or her eyes.
• Your child should stay at least 6 feet away from people who are sick, if possible.
• Your child should avoid touching his or her eyes, nose, or mouth when out in public.
• Take care of your child’s health. Make sure your child gets at least 7 to 9 hours of sleep each night and eats a healthy diet. Help your child learn ways to manage stress. Teach your child to avoid alcohol, caffeine, nicotine, and drugs. Encourage your child to stay physically active as advised by your provider.

You can get more information from:

• World Health Organization
  http://www.who.int/emergencies/mers-cov/en/
• The Centers for Disease Control and Prevention
  888-232-3228
  https://www.cdc.gov/