Overview
Middle East respiratory syndrome (MERS) is a viral respiratory illness caused by the Middle East respiratory syndrome coronavirus (MERS-CoV). It can lead to severe respiratory failure and extrapulmonary organ dysfunction, with significant mortality rates 57.Diagnosis
Clinical Presentation: Fever, cough, shortness of breath, and gastrointestinal symptoms 5.
Laboratory Tests: Detection of MERS-CoV RNA via RT-PCR in respiratory samples 5.
Imaging: Chest imaging often shows bilateral infiltrates, consistent with pneumonia 5.
Serology: Antibody testing can confirm past infection but is less useful acutely 5.Management
Supportive Care: Mechanical ventilation for severe respiratory failure, fluid management, and treatment of complications 5.
Antiviral Therapy: No specific antiviral treatment universally recommended; ribavirin and interferon have been used empirically 5.
Immunomodulatory Agents: Use of corticosteroids for severe cases remains controversial and should be individualized 5.
Infection Control: Strict adherence to contact and droplet precautions to prevent nosocomial transmission 6.Special Populations
Pediatrics: Limited data; management focuses on supportive care with close monitoring 5.
Elderly: Higher risk of severe disease and complications; intensive supportive care is crucial 5.
Comorbidities: Patients with underlying conditions like diabetes, renal disease, or immunocompromise face increased mortality; tailored supportive care is essential 57.Key Recommendations
Implement Strict Infection Control Measures: To prevent nosocomial transmission and community spread (Evidence: Strong 6).
Provide Aggressive Supportive Care: Including mechanical ventilation for severe respiratory failure (Evidence: Moderate 5).
Monitor and Manage Comorbidities: Closely manage underlying health conditions to mitigate increased mortality risk (Evidence: Moderate 57).
Consider Individualized Use of Immunomodulatory Agents: Such as corticosteroids in severe cases, based on clinical judgment (Evidence: Weak 5).References
1 Kaur M, Bridi L, Kaki D, Albahsahli B, Bencheikh N, Saadi A et al.. Funding for Refugee Health Research From the National Institutes of Health Between 2000 and 2020. JAMA network open 2024. link
2 Liu D, Chen Y. Epitope screening and vaccine molecule design of PRRSV GP3 and GP5 protein based on immunoinformatics. Journal of cellular and molecular medicine 2024. link
3 Barghadouch A, Skovdal M, Norredam M. Do health reception policies in the Nordic region recognize the rights of asylum-seeking and resettled refugee children?. Health policy (Amsterdam, Netherlands) 2019. link
4 Holt GR, McMains KC, Otto RA. Workforce Considerations, Training, and Diseases in the Middle East. Otolaryngologic clinics of North America 2018. link
5 Al-Dorzi HM, Alsolamy S, Arabi YM. Critically ill patients with Middle East respiratory syndrome coronavirus infection. Critical care (London, England) 2016. link
6 Gao J, Song P. China upgrades surveillance and control measures of Middle East respiratory syndrome (MERS). Bioscience trends 2015. link
7 Zhao G, Jiang Y, Qiu H, Gao T, Zeng Y, Guo Y et al.. Multi-Organ Damage in Human Dipeptidyl Peptidase 4 Transgenic Mice Infected with Middle East Respiratory Syndrome-Coronavirus. PloS one 2015. link
8 . Physician service to Afghan refugees. New Jersey medicine : the journal of the Medical Society of New Jersey 1989. link