Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

In September 2012, the World Health Organization (WHO) announced the discovery of a novel coronavirus. This virus has been named the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV is a serious respiratory disease with common symptoms in patients that include fever, cough, shortness of breath, and breathing difficulties. Most patients have had pneumonia. Some patients present with gastrointestinal illness prior to the onset of respiratory symptoms. About half of people infected with MERS-CoV have died. The virus has been shown to spread between people who are in close contact. It can also spread from infected patients to health care personnel. No travel warnings or restrictions have been issued related to MERS-CoV. The U.S. Centers for Disease Control and Prevention (CDC) is recommending surveillance and testing for individuals who have unexplained severe respiratory illness and a history of travel to countries in the Arabian Peninsula or neighboring countries. These countries include: Bahrain, Iran, Iraq, Israel, the West Bank and Gaza, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, the United Arab Emirates (UAE) and Yemen.

Since May 2015, the Republic of Korea has been investigating an outbreak of MERS-CoV. It is the largest known outbreak of MERS-CoV outside the Arabian Peninsula. CDC has expanded surveillance and testing for people who have unexplained severe respiratory illness after being in a health care facility (as a patient, worker or visitor) in the Republic of Korea.

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Additional Info Group

General Information

For Health Professionals

Interim Local Health Departments MERS-CoV investigation short form (PDF, 376 KB)

Testing for novel coronavirus

Currently, PCR testing of specimens for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is available in Wisconsin only at the Wisconsin State Laboratory of Hygiene (WSLH) and at the CDC. Currently available diagnostic tests for seasonal coronaviruses are not suitable for detecting MERS CoV.

To increase the likelihood of detecting MERS-CoV, CDC recommends collection of specimens from different sites--for example, a nasopharyngeal swab and a lower respiratory tract specimen such as (induced) sputum, bronchoalveolar lavage, bronchial wash, or tracheal aspirate. Lower respiratory tract specimens should be a priority for collection and polymerase chain reaction (PCR) testing. The Wisconsin Division of Public Health will approve test requests to be performed at the WSLH if a patient meets the criteria described below.

Case Definition
Clinical Features	AND	Epidemiologic Risk
Severe Illness Fever and pneumonia or acute respiratory distress syndrome (based on clinical or radiological evidence)	and	A history of travel from countries in or near the Arabian Peninsula¹ within 14 days before symptom onset, or close contact² with a symptomatic traveler, who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula.¹ – or – A history of being in a health care facility (as a patient, worker, or visitor) in the Republic of Korea within 14 days before symptom onset. (New Guidance) – or – A member of a cluster of patients with severe acute respiratory illness (e.g., fever and pneumonia requiring hospitalization) of unknown etiology, in which MERS-CoV is being evaluated, in consultation with state and local health departments in the US.
Milder illness Fever and symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath)	and	A history of being in a health care facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula,¹ in which recent health care-associated cases of MERS have been identified. – or – Close contact² with a confirmed MERS case while the case was ill.

¹ Countries considered in the Arabian Peninsula and neighboring include: Bahrain; Iraq; Iran; Israel, the West Bank, and Gaza; Jordan; Kuwait; Lebanon; Oman; Qatar; Saudi Arabia; Syria; the United Arab Emirates (UAE); and Yemen.

² Close contact is defined as: a) being within approximately 6 feet (2 meters) or within the room or care area for a prolonged period of time (e.g., healthcare personnel, household members) while not wearing recommended personal protective equipment (i.e., gowns, gloves, respirator, eye protection; or b) having direct contact with infectious secretions (e.g., being coughed on) while not wearing recommended personal protective equipment (i.e., gowns, gloves, respirator, eye protection).

Last Revised: December 18, 2015