The deadly virus Merce continued to "tour" in South Korea. US authorities will fund the creation of more dangerous viruses

"RG" answered the most common questions on coronavirus

Text: Oleg Kiryanov (Busan)

Recently, many have learned about the new coronavirus MERS (Middle East Respiratory Syndrome), which has already spread to South Korea, starting to spread there actively. It is a matter of concern that those who contract the virus have high mortality rates, and there is still no vaccine for it. At the same time, rumors and conjectures began to circulate that exaggerate the danger from what some of the most impressionable people called it, "the new plague of the 21st century." Rossiyskaya Gazeta decided to clarify the situation by summarizing the answers to the most frequently asked questions about the MERS coronavirus, and at the same time talking about the state of affairs with the spread of the disease today. Separately, it will be told about South Korea, which, in connection with the virus, is attracting a lot of attention, having become the front line in the fight against a new infection.

What is this coronavirus MERS?

MERS is an abbreviation for the English name for the disease - Middle East respiratory syndrome which means "Middle East Respiratory Syndrome". Sometimes the word "coronavirus" - coronavirus is added to the name and abbreviation. Then a longer name appears - MERS-CoV. In the Russian media, you can also often find the Russian-language abbreviated name, which is the translation of MERS-CoV into Russian - MERS-CoV.

MERS belongs to the family of coronaviruses, which includes many other viruses, both the common cold and severe acute respiratory syndrome SARS.

Where did he get the "crown" in the title?

The family of viruses received such a “beautiful” name, since the villi on the virus shell are shaped like a spectacular solar corona.

Where did he come from?

There is controversy over the "original" reservoirs of the new coronavirus. It is possible that a mutation of any of the existing viruses has occurred. But to humans, MERS began to be transmitted from animals, having also overcome the interspecies barrier for unknown reasons. According to some reports, camels were carriers of the virus at the very beginning (which is why MERS is sometimes called “camel flu”), according to other experts, the virus began to be transmitted from bats. Recently, experts from the World Health Organization (WHO) are leaning towards the version of the "camel" origin of the virus.

The first human case of MERS was recorded in the summer of 2012 in Saudi Arabia. This was the start of the spread of infection among people.

How many people fell ill in the world, which countries MERS already affected?

The number of people infected with this virus is gradually increasing, although one cannot speak of an explosive spread. At the moment, the number of infected people is about 1200 people in the world. MERS has affected 25 countries so far: in the Middle East - Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, UAE, Yemen; in Europe - Austria, France, Germany, Greece, Italy, the Netherlands, Turkey, Great Britain; in Asia - China, Philippines, South Korea, in America - the USA.

The undisputed champion in the number of infected is Saudi Arabia - more than 1,000 people. That's where most of the deaths are. In general, the bulk of the cases are in the Middle East region. But recently, quite unexpectedly, South Korea came in second place in terms of the number of infected and deaths - 145 infected and 14 deaths.

How contagious is it and how is it transmitted?

Again, due to lack of study, there is no definitive answer, but MERS is considered to have a limited ability to transmit. That is, it is not so easily transmitted, otherwise there would be much more sick people in the world. So far, there is no evidence that it is transmitted by airborne droplets. Transmission requires close and fairly long contact with an infected person, for example, through a handshake, if a person sneezes and particles of saliva fall on you, etc. The vast majority of the infected appeared in hospitals, where their friends, acquaintances, relatives, doctors, as well as strangers were with the infected for a long time. In any case, as doctors now believe, close and direct contact with the patient is needed for transmission. The virus itself cannot exist outside the body for a long time and dies within a maximum of several days. It is also easily destroyed by conventional disinfectants.

It is often called "deadly" and other frightening epithets. Is he really that dangerous? Who should be the first to fear?

If you look at the "naked statistics" of mortality, then the numbers are really very serious. There is no vaccine yet for this type of coronavirus. In the whole world, the mortality rate from MERS is at the level of 39%. But here the following should be taken into account: a very large number of the dead are people of advanced age (over 60, and more often over 70 years), whose body was weakened by a large number of other diseases. MERS, on the other hand, has become, in fact, the “last” blow for those when people could have been brought to death by an ordinary serious cold. For example, in the same South Korea, the youngest of the dead is 58 years old, but most of the victims were over 70 years old, who had previously had “bouquets” of other diseases: cancer, pneumonia, diabetes, and so on.

Although the origins and essence of the coronavirus are not yet completely clear, doctors believe that the main risk group is older people with a weakened immune system, with serious health problems (diabetes, cancer, etc.). There is also evidence that those with serious respiratory diseases are especially vulnerable. MERS often leads to breathing difficulties, which, coupled with previous problems, can lead to death in some people. In general, the main risk group is the elderly with serious illnesses.

If there is no vaccine, will everyone eventually die? Are there people to whom the virus is not transmitted?

It is worth recognizing that many media have tried and caught up with fear, significantly exaggerating the danger. Many people eventually recover, the body simply overcomes the disease itself. In Korea, 10 people have already been discharged, who, having been ill, recovered and are now living the same life again. Due to the lack of a vaccine, the main task of doctors now is to help the body overcome itself, to support it at key moments. As a result, we repeat, the body of people with normal immunity copes on its own. There is also data that allows us to say that often the virus simply does not "stick" to healthy people. Most likely, the immune system works here, which repels the virus. So, one should not inflate fears, this is by no means a terrible infection that came from another planet and which can “mow down” all of humanity. Many compare MERS to the general symptoms and course of the illness with the flu, albeit quite severe.

There is one feature that, perhaps, will allow parents to calm down at least a little. For reasons not yet understood, MERS is rarely transmitted to children. According to statistics in the world of all cases, only 3% were children under the age of 14 years. This is significantly less than in other age groups. In the same South Korea, no one fell ill under the age of 14, the youngest of the infected is 16 years old, and, as doctors say, a teenager is much easier than others to carry the infection. In general, the virus is much more easily transmitted to children than to adults.

What are the symptoms?

Very similar to the common cold: fever, fever, coughing, sneezing, often shortness of breath, sometimes diarrhea, general malaise. Note that the symptoms do not appear immediately. The incubation period is from seven to 14 days, which is why quarantine measures are important. A person may not feel anything, but carry a virus in himself, which has just begun its development.

How to understand what I have: MERS Or the common cold?

You yourself cannot determine this, for this it is necessary to conduct rather complex clinical analyzes, and sometimes a whole series. In any case, we advise you not to panic and not be overly nervous if the temperature suddenly rises and you start to cough. It is much more likely that this is a common cold or a banal flu, which, by the way, no one has canceled, but which everyone “forgot” about amid the discussion of MERS. The new coronavirus is rather exotic, and it does not spread so easily. In any case, with signs of a severe cold, just go to the doctor and talk about the symptoms. True, if the day before you have visited countries where a fairly wide spread of MERS has been noted (especially Saudi Arabia, as well as other countries in the Middle East, South Korea), then you will need to immediately tell the doctor about this.

How to protect yourself from possible infection with coronavirus in countries where it is common?

Just like regular flu. I wash my hands more often, if possible we avoid visiting crowded places, it is also better not to go to hospitals, as they are the main breeding grounds for infection. You can also wear a mask. If you suddenly want to sneeze, but there is no mask, then we sneeze, hiding behind our sleeves. Contact with patients should be avoided.

Doctors also categorically advise not to touch animals infected with MERS, not to consume camel meat and camel milk that have not undergone sufficient heat treatment. Although such recommendations among the Russians are more likely to cause a smile. This is more relevant for those who are in the countries of the Middle East.

However, just in case, the Koreans also checked their camels in zoos. It turned out that in Korea, all camels are virus-free. But here it is rather logical: “Korean” camels were either born in Korea or brought from Australia, and not from the Middle East, as it happened for the zoos of the Land of Morning Calm.

Are there any foods that will help the body keep the virus out?

There are no definitive recommendations for this either. In general, you should eat something that will help strengthen immunity in general, that is, what is advised to eat and drink when there is a flu epidemic in the country. Recently, by the way, in the South Korean media came across a list of 10 products that should "help repel MERS." Familiar doctors, having looked through the list, shrugged their shoulders and said: “It definitely won’t get worse, and we’ll find out how effective it really is later.” But since “it won’t get worse”, then just in case, this list. But it is worth remembering that this is not a guarantee from MERS, but rather a small help for immunity at best. These foods are: garlic, broccoli, animal protein, yogurt, oysters and fish oil, mushrooms, black tea, barley, sweet potatoes, cactus.

How did the coronavirus get from the Middle East to South Korea, far from that region?

It was brought in in the second half of May 2015 by an elderly Korean who has his own farm in Saudi Arabia. He traveled to several countries in the region, including Saudi Arabia, Kuwait, Bahrain and Qatar. Most likely somewhere there and “picked up” MERS. Then he came to a Korean clinic complaining of a cold, and the disease began to spread throughout the country, and quite quickly, when compared with the pace in other countries.

What is the situation with MERS in South Korea?

As of June 14, 2015, a total of 145 cases of infection with the virus have been recorded. Of these, 14 people died (9.7%), 10 fully recovered and were discharged. That is, there are currently 121 confirmed patients in the country (minus those who have died and recovered), 16 of whom are assessed as “unstable.” More than four thousand people are in quarantine, but most of them are quarantined at home. At the same time, more than 1,900 people have already been released from the quarantine regime. In the country, more than 10% of kindergartens, schools and universities went on forced vacations. The main foci of the spread of the disease are several clinics in Seoul and the province of Gyeonggi. In other regions, there are only a few confirmed infected.

Why did the coronavirus spread so quickly in a country like South Korea, which is famous for high technology and has modern medicine and healthcare?

We emphasize right away that in many respects the excitement around the disease is inflated. There are 50 million people in the country, and 145 people are sick. This is not an epidemic, people now get sick more often with a common cold, but they talk about it much less, having quickly learned the recently unfamiliar abbreviation MERS.

But indeed, in comparison with other countries, in Korea, the spread is faster. This was influenced by a number of different factors. The country has a very high population density. 50 million people live on the territory of 500 by 300 km. Transport is very well developed, the economy is active, people are used to moving around the country a lot, many large-scale events are constantly held in the country, and therefore all this unwittingly contributes to the spread of infection.

There is also an opinion that the climate of Korea somehow “suited” for the new coronavirus.

However, WHO experts have a colder and more professional point of view on this matter. The other day, WHO Assistant Director General for Health Security Keiji Fukuda voiced the following reasons. Firstly, local doctors and the healthcare system were not prepared to “receive” the new coronavirus. At best, they only heard about him remotely and did not expect him to make his way from the Middle East to the country. And therefore, at first, they did not take the measures necessary for quarantine of the sick and disinfection, which provoked an outbreak.

Secondly, the features of the Korean healthcare system. A common approach in the Korean healthcare system is vulnerable from an epidemiological point of view: patients arrange the so-called "medical shopping" when, in search of better conditions, the same treatment is carried out in different clinics, spreading the disease. In addition, patients in Korea are constantly visited by a large number of relatives and friends, the patients themselves go where and when they want, no one limits them. Reception areas are overcrowded, no one is isolated. Thirdly, the ineffective actions of the authorities at the initial stage. They did not disclose the situation about the foci of infection, which did not allow it to be localized quickly. As a result, people continued to visit infected clinics, where, moreover, anti-epidemiological measures had not yet been taken. Fourth, the indecisive actions of the authorities to control the sick and potential infected. Many of those infected continued to live normal lives, not following the recommendations to remain in home quarantine. Fifth, there is a shortage in Korea of ​​qualified epidemiologists, equipment, experience, and research centers in this area. The combination of these very different factors has led to the fact that South Korea is now second only to Saudi Arabia in the world in terms of the number of infected people.

What is the general atmosphere in South Korea? How do people react to it?

There is a very wide coverage of this topic in the media. On the one hand, this is understandable, on the other hand, it provokes nervousness. There are fewer people on the streets, people wearing masks are much more likely to be seen, reminders of MERS and measures to prevent infection are everywhere. Many planned mass events are canceled or postponed: festivals, symposiums, concerts, etc. But in general, life goes on. The country has by no means died out, there are still enough people, everything works as before, and far from all mass events have been canceled. In general, much is exaggerated in the foreign media. There is a certain impact of the coronavirus outbreak, but it should not be exaggerated, the country continues to live.

Are there any peculiarities in the situation with MERS in Korea, which surprise experts or allow us to say that the virus has become stronger?

WHO experts, after analyzing the “Korean” modification of the coronavirus, confirmed that it did not mutate and is practically the same as in the Middle East. That is, he is already more or less familiar and so far there are fewer surprises from him. Of the features - increased (compared to other countries) the rate of spread, but at the same time significantly lower than in the whole world, the mortality rate. If in the world, on average, 39% of those infected die from MERS, then in Korea the figure fluctuates around 10%. At the same time, all deaths were recorded exclusively in the elderly, who had previously had serious health problems.

The presence of “superspreaders”, that is, individuals from whom the disease was transmitted to a significant number of other people, is also noted. What is the reason for the appearance of such “super-spreaders” (there are now three or four of them) - the doctors cannot yet answer.

Further prospects for the development of the situation? When will this epidemic end?

We emphasize once again that this cannot be called an epidemic. There is much more hype, and the scale of distribution, as statistics show, is still very modest. But, as experts admit, in any case, new patients will continue to appear. The virus will not disappear overnight. Most likely, the rate of distribution will decrease. The authorities took into account the omissions at the first stage, began to act more decisively, international experts also provided their assistance, and the level of development of medicine in Korea is very high. It can be expected that the virus will gradually disappear, but it will take more time.

Another question is that mutations of the coronavirus cannot be ruled out, including in the direction of a higher degree of spread among people. But so far there is no evidence to support this. Doctors are constantly monitoring the situation, active work is underway to create a vaccine, but so far they have not yielded results.

I was going to go on vacation to see South Korea, but now I'm thinking. Do you think I should cancel my tickets and cancel my trip?

The concern is understandable. More than 100,000 foreign tourists, mostly from China, Hong Kong, Taiwan and Japan, have already canceled tours to Korea, according to recently released data from the Korea Tourism Organization. Rostourism also recommended to refrain from visiting South Korea without special need. On the other hand, WHO stressed that it does not yet consider it necessary to impose travel restrictions. Therefore, everyone must make their own decisions. In our subjective opinion, if you are an elderly person with serious illnesses, then it is probably better not to risk it. And the rest should just wash their hands more often, maybe wear a mask, avoid contact with the sick, not really get involved in being in crowded places, and then, perhaps, you can be calm in Korea too. But in general, given the above, it is worth weighing everything for yourself, although South Korea as a whole continues to live its normal life.

Image copyright SPL Image caption The first death from the MERS virus was reported in Saudi Arabia in June 2012.

The spread of the Middle East respiratory syndrome (MERS) virus has led to new casualties in South Korea.

According to the World Health Organization (WHO), the new coronavirus is transmitted between people through close contact.

This is the largest outbreak of the disease outside the Middle East.

What do we know about the new virus, which in many ways resembles the already known SARS virus?

New coronavirus

It belongs to the family of coronaviruses, which includes many other viruses, including those that cause the common cold and severe acute respiratory syndrome - SARS.

The first cases of the new virus were reported in Saudi Arabia in June 2012.

Image copyright Reuters Image caption The MERS virus is easily destroyed by common hygiene products.

At least 449 people have died from it so far, according to the WHO.

Bat populations are the natural reservoir of the virus. A number of studies have identified the presence of antibodies to MERS-CoV in camels.

By the summer of 2015, cases of the disease were recorded in 23 countries, including Saudi Arabia, Yemen, the United Arab Emirates, France, Germany, Italy, Greece, Tunisia, Egypt, Malaysia, South Korea and others.

As of June 1, 2015, there were 1,154 confirmed cases and at least 431 deaths (39%) associated with coronavirus infection. In South Korea, as of June 9, 2015, there were about 100 infected, as of the morning of June 10, nine died.

How the virus works

Coronaviruses cause respiratory inflammation in humans and animals. Symptoms include fever, cough, and difficulty breathing.

Infection can lead to pneumonia and renal coma. Most of those infected by now are elderly men, often weakened by other diseases.

Experts point out that little is yet known about why this coronavirus is spreading in this way. It is also unclear how often people can become infected with milder forms of the disease.

How does it spread

This remains unclear. It is possible that the virus is spread by droplets when an infected person coughs and sneezes.

Image copyright BBC World Service Image caption While the MERS virus is not considered highly contagious

The fact that the virus is transmitted between people in close contact indicates that it has a limited ability to spread from person to person.

So far, most cases of MERS virus infection have been the result of human-to-human transmission in hospital settings, according to the WHO.

How infection occurs remains unclear.

How dangerous is the MERS virus?

Epidemiologists believe that this virus is not highly contagious. If this were the case, then there would be much more cases of infection.

Coronaviruses are usually very unstable to external influences. Outside the body, they can only survive for 24 hours and are easily destroyed by common disinfectants.

British doctors emphasize that the risk of infection for the general population remains extremely low.

However, on a global scale, there is the potential for a new virus to spread and mutate. At the same time, there is no indication yet that the MERS virus can cause a pandemic.

Doctors have not yet developed effective treatment measures for the sick, and patients with acute symptoms need intensive care to maintain respiratory function. There is no vaccine against the virus.

How to protect yourself from infection

It remains unclear how this virus is transmitted. However, general hygiene measures can prevent its spread - isolating sick people, washing hands frequently, wearing hygienic masks.

How the virus originated

Epidemiologists do not yet know exactly where the new virus originated. Perhaps it was the result of a mutation of an already existing virus.

Another possibility is that the virus was spread among animals and suddenly developed the ability to jump to humans.

Will there be travel restrictions?

So far, WHO believes that there is no need to introduce any restrictions. In case of further spread of the disease and clarification of the mechanisms of its spread, WHO recommendations may be revised.

What other viruses is MERS associated with?

Image copyright BBC World Service Image caption The SARS virus has infected over 8,000 people, mostly in China and Southeast Asia.

Coronaviruses are widespread. Their name comes from the crown-like protrusions on the surface of the viral body.

They were first discovered in the mid-1960s.

Most coronaviruses usually infect only one animal species or a small number of closely related species.

The SARS virus had a wider effect - it infected people and animals, including monkeys, cats, dogs and rodents.

In addition, the SARS virus spread easily among humans, which is not the case for the MERS virus.

What are the consequences of the spread of the SARS virus

The SARS virus has infected more than 8,000 people, mostly in China and Southeast Asia, in an epidemic that began in early 2003. It then spread to 23 countries in the Americas, Europe, and Asia, after which the epidemic ended.

According to the WHO, 774 people have died from this infection. Since 2004, there have been no new cases of infection with this virus in the world.

The modern world is shaking from numerous diseases of people with all kinds of diseases or infections of viruses, the cases of detection of one or another virus, for example, the MERS virus, have become so frequent today. In order to protect yourself as much as possible from infection with such a dangerous virus, you need to know its nature, causes, incubation periods, methods of infection, what symptoms it shows and how it is treated, as well as integral methods for preventing this new infectious disease.

Where did the virus come from, how aggressively manifests itself

The name of the MERS virus is an abbreviation of the English words - Middle East respiratory syndrome, which have a translation - "Middle East respiratory syndrome coronavirus". This is its official name, as a strain of infectious microorganisms of the group of coronaviruses, abbreviated as MERS-CoV. You can sometimes see this name with an "n" - MERS-nCoV - which indicates that the strain is a fairly new discovery and new formation. It is believed that the virus first passed to humans from infected camels, who, in turn, were infected by bats.

In general, coronaviruses were discovered back in 1960. This name - coronavirus - arose from the fact that the virus had some villi on its shell, which together formed a kind of solar corona, which we can usually observe during a solar eclipse. This species has several strains, the most dangerous of which is Mers nCoV (even the very first research experiments in the laboratory showed that out of 64 cases, 38 were fatal). In general, coronaviruses affect different organs of a person or animal, but all their strains are classified as respiratory infectious diseases.

This type of virus was first detected in 2012 in Saudi Arabia. Further, its spread to eight countries was traced: Jordan, Qatar, Germany, Great Britain, France, UAE, Italy and Tunisia. Now, here, today we hear that outbreaks of this disease are already being recorded throughout South Korea. Such a rate of spread, development and adaptation of a dangerous infection is now of extreme concern to the World Health Organization (WHO), which already considers this disease to be serious and requiring immediate intervention by the world community in measures to eliminate it.

What is the morbidity, mortality

Today, this virus has not yet been fully studied, so they continue to monitor it and record outbreaks. Modern South Korea in May 2015 began to suffer from the Mers virus that suddenly swept over its population. If you track the news feed of any media that tracks this phenomenon, you can find the intensity of the attack on people by this dangerous infection. Thus, the following data are observed and recorded:

• 05/20/15 - the first case was found in a man who returned from a business trip in the Middle East, the next day two more people were found infected with this infection;
• 02.06.15 - two patients died, and 682 people who had contact with the infected were quarantined;
• 06/03/15 – they find the virus in 5 more people with whom other people could also come into contact, because of which about 200 schools had to be closed in Korea;
• 09.06.15 – the virus was found in 95 people, seven of whom have already died;
• 06/13/15 - the disease is already found in the country, outside the hospitals, in one of the ambulance drivers, it also turned out that 138 people are infected and 14 have already died from the virus;
• 06/16/15 - the first German died from the virus with which he was infected in the United Arab Emirates;
• 06/22/15 – 27 people died from the virus, and 50 were discharged with full recovery from clinics and hospitals.

Virologists and doctors are looking for the most effective means of not only fighting the virus, but also ways to prevent the risks of this disease. To date, only a vaccine against the Mers virus is being developed.

Virus Symptoms

At the very beginning, a person infected with the Mers virus may think that he has a common cold, his initial symptoms are so typical. Once the infection enters the body, it takes 5-6 days, sometimes it drags on up to 12 days of its incubation period, and in total, the disease is initially accompanied by the following symptoms:

• runny nose like a cold, only very strong in intensity;
• a pronounced pain in the throat;
• elevated temperature;
• fever;
• dyspnea.

Then they may appear:

• cough to hoarseness;
• swollen lymph nodes;
• pain behind the sternum, in the chest;
• labored breathing.

People with the following illnesses are most affected by this virus:

• diabetes;
• heart and kidney failure;
• any chronic lung disease;
• weakened immunity.

Treatment for this infection

If a person or animal is not treated for this disease, then it can easily turn into acute pneumonia, which then leads to an inevitable death. However, today they have not yet found ways to treat it, because only now they continue to develop drugs that can defeat the new virus. There were attempts to infuse patients with blood plasma of those people whose immunity miraculously overcame the infection, and they recovered. But such an effectiveness of such a practice has not yet been proven, and everything is on an experimental track.

Prevention of the incidence of the virus

However, if the methods of treatment are still in the process of development, then preventive measures can be implemented right now, because here scientists have already proved that the old methods of simple hygiene, as well as precaution, are the truest friends of your health. So, in order not to get sick with the Mers virus, you should pay attention to the following preventive methods:

• Wash your hands frequently with soap.
• If possible, avoid rubbing your eyes and avoid contact with your nose and mouth.
• Avoid contact with animals.
• Don't eat undercooked meat.
• Don't drink camel milk.
• Avoid contact with infected people.
• Try not to be around large crowds of people.
• Try to cover yourself when you sneeze or when someone is sneezing next to you.
• Use protective gauze and other masks.
• Stop traveling to the Middle East and South Korea.

Middle East respiratory syndrome coronavirus ( Middle East respiratory syndrome coronavirus – MERS-CoV), formerly known as the novel coronavirus (nCoV), causes a viral respiratory illness first reported in Saudi Arabia in 2012. The source of MERS is currently unknown, although it is likely that the virus originated from an animal.

The MERS virus is currently spreading in South Korea. This, combined with the fact that the coronavirus can often mutate, is leading to increased fears that it could lead to an epidemic.
MERS-CoV is different from other viruses and there is currently no vaccine for it.

Most confirmed cases of MERS-CoV presented with symptoms of severe acute respiratory illness. Approximately 36% of patients with documented MERS died.

• MERS-CoV was first reported in Saudi Arabia in 2012.
• MERS-CoV belongs to the coronavirus family.
• All cases were tied to countries in the Arabian Peninsula or neighboring countries.
• Cases of MERS-CoV have also been reported in other countries, have been associated with travel, and originally developed in the Middle East.
• Mammals are thought to play a role in virus transmission (bats and camels remain candidates)
• In addition to humans, MERS-CoV strains have been found in camels in Qatar, Egypt, and Saudi Arabia, and in mice in Saudi Arabia.
• Doctors describe MERS-CoV as a flu-like illness with signs and symptoms of pneumonia.
• Patients with MERS-CoV generally develop severe acute respiratory illness. Some patients had a non-severe respiratory illness, while others had no symptoms.
• There is no specific treatment for patients with MERS-CoV
• Of the confirmed cases of MERS-CoV, 36% were fatal.

What is MERS-CoV?

MERS-CoV belongs to the coronavirus family. Human coronaviruses were first classified in the mid-1960s. Subgroups of coronaviruses are designated as alpha, beta, gamma and delta. There are currently six coronaviruses that can infect humans:

Alpha coronavirusy:

• Human coronavirus 229E
• Human coronavirus NL63

Beta coronaviruses:

• Human coronavirus OC43
• Human coronavirus HKU1
• SARS-CoV
• Middle East respiratory syndrome coronavirus (MERS-CoV).

MERS-CoV belongs to the coronavirus family. Human coronaviruses were first classified in the mid-1960s. MERS-CoV was first reported in 2012 in Saudi Arabia.

Coronaviruses usually infect one species or species that are closely related. However, SARS-CoV infects humans and animals, including monkeys, Himalayan palm civet, raccoon dogs, cats, dogs, and rodents.

The common cold is a syndrome associated with viruses (more than 100 individual viruses, including the human coronavirus).

MERS-CoV is a species in the beta coronavirus genus that currently includes tylo nycteris bat coronavirus HKU4 and pipistrellus bat coronavirus HKU5. Although it is in the same subgroup, MERS-CoV is distinct from the coronavirus that caused severe acute respiratory virus (SARS) in 2003. One parallel between MERS-CoV and SARS is that they are both similar to coronaviruses found in bats.

MERS-CoV in bats MERS-CoV is a species in the beta coronavirus genus that currently includes tylo nycteris bat coronavirus HKU4 and pipistrellus bat coronavirus HKU5.

MERS-CoV is very similar to as yet unclassified insectivorous European and African bat viruses of the Vespertilionidae and Nycteridae families.

All cases were associated with or neighboring countries in the Arabian Peninsula, including:

• Bahrain
• Israel
• Jordan
• Kuwait
• Lebanon
• Palestine
• Qatar
• Saudi Arabia
• Syria
• West Bank
• Yemen.

Cases of MERS-CoV have also been reported in other countries, have been associated with travel, and originally developed in the Middle East. The countries that have reported the disease are:

Near East:

• Egypt
• Jordan
• Kuwait
• Lebanon
• Qatar
• Saudi Arabia (KSA)
• United Arab Emirates (UAE)
• Yemen.

Europe:

• Austria
• France
• Germany
• Greece
• Italy
• Netherlands
• Turkey
• Great Britain.

Africa:

• Algeria
• Tunisia.

Asia:

• China
• The Republic of Korea
• Malaysia
• Philippines.

North and South America:

What causes MERS-CoV?

The cause of MERS-CoV is not yet fully understood. Although not confirmed, the infection may be initially zoonotic in nature, with limited human-to-human transmission. Mammals are thought to play a role in the transmission of the virus - bats and camels remain highly suspect.

In addition to humans, MERS-CoV strains have been found in:

• camels in Qatar, Egypt and Saudi Arabia
• bats in Saudi Arabia

Antibodies against MERS-CoV have been found in camels in Africa and the Middle East, indicating they were previously infected with MERS-CoV, or a very related virus.

Researchers at three centers in the United States and two in Saudi Arabia performed complete genetic sequencing of MERS-CoV isolates from five camels; the results confirmed their genetic sequence identity to human isolates.

Goats, sheep, cows, buffaloes, pigs and wild birds have been tested for antibodies to MERS-CoV; So far, none of them have been found to have the virus.

There is an opinion that mammals play a role in the transmission of the virus (bats and camels remain under suspicion).

The above results support the hypothesis that camels are the likely source of transmission to humans, while bats may be the ultimate reservoir of the virus. A high infectious dose requires very close contact between an infected camel and a human to infect the latter. It has been suggested that the virus can infect humans through airborne droplets, through milk or camel meat.

The experts note that while a respiratory route of transmission is most likely, papers have emerged that prove that MERS-CoV can survive in raw camel milk slightly longer than in milk from other species, suggesting further study of the alimentary route of transmission.

Signs and symptoms of MERS

The most common signs and symptoms of MERS are:

• increase in body temperature up to 38 0 C and above
• cough
• labored breathing
• chills
• chest pain
• sore throat
• malaise
• headache
• diarrhea
• nausea, vomiting
• runny nose
• kidney failure
• pneumonia.

Doctors describe the illness as a flu-like illness with signs and symptoms of pneumonia. Early reports described symptoms similar to those found in cases of SARS-CoV (severe acute respiratory syndrome). However, SARS infection did not cause kidney failure, unlike MERS-CoV.

Patients with MERS-CoV usually develop severe acute respiratory illness. Some patients had mild respiratory illness, while others had no symptoms.

Who is at risk?

The following groups of people are more susceptible to MERS-CoV infection and complications:

• Patients with chronic conditions such as diabetes, chronic lung disease, and heart disease
• Aged people
• Organ transplant recipients who are taking immunosuppressive drugs
• Other patients with weakened immune systems, such as cancer patients undergoing treatment.

Of all confirmed cases of MERS-CoV, 36% were fatal.

Tests and diagnostics

The polymerase chain reaction is used to detect and diagnose infectious diseases and can confirm positive cases of MERS-CoV using a sample from a patient's respiratory tract.

A blood test can determine if a person has been previously infected by checking for antibodies to MERS-CoV.

Treatment and prevention

According to the CDC (USA) and WHO, there is no specific treatment for patients with MERS-CoV infection.

All doctors can do at this time is supportive medical treatment to help relieve symptoms. Supportive care consists of preventing, controlling, or alleviating complications and side effects, as well as trying to improve the comfort and quality of life of patients. Maintenance therapy does not include treatment or improvement of the disease.

Most confirmed cases of MERS-CoV presented with symptoms of severe acute lung disease; 36% of these patients died.

To reduce the risk of MERS-CoV infection among travelers, guidelines have been developed that include the following information:

• There is an increased risk of illness in those travelers who already have a chronic illness.
• There is an increased risk of illness in those travelers who have the flu or traveler's diarrhea.
• Frequent hand washing with soap and water is recommended.
• Avoid eating undercooked meat or food cooked in unsanitary conditions.
• Make sure fruits and vegetables are washed well before eating.
• If a traveler develops an acute respiratory illness with fever, they should minimize close contact with others, wear a medical mask, sneeze into a sleeve, flexed elbow, or tissue (making sure it is disposed of after use).
• If you develop an acute respiratory illness with fever within 14 days after returning from a trip, you should immediately seek medical help.
• All cases must be reported to the local health authorities that control MERS-CoV.

Although MERS-CoV is contagious, the virus does not appear to be transmitted between people without close contact, such as when caring for a patient without protective precautions. Thus, one should follow the recommendations of the doctor if symptoms of the disease occur.

Since very little is known about the strain of the virus, any advice and recommendations should be considered temporary and subject to change.

Confirmed cases and deaths

As of June 9, 2015, WHO provides the following data on the number of cases of MERS-CoV and the number of deaths from this disease:

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