Middle East Respiratory Syndrome (Mers-CoV – Middle East respiratory syndrome coronavirus infection) or camel flu it is an acute infectious disease caused by a zoonotic virus which can be transmitted from animals (in this case, dromedaries) to people. The origin of the virus is not fully understoodhowever, based on the results of the analysis of the viral genome, it is believed that it originated in bats and later, in a remote era, transmitted to dromedaries.

thing causes

Usually MERS causes a severe acute respiratory disease characterized by fever, cough and difficulty breathing. Pneumonia is common, but not always present. Gastrointestinal symptoms, such as diarrhea, have also been reported. In some cases, infected people were asymptomatic. Mortality is about 35%. Most human cases are infected in healthcare settings, through person-to-person transmission. Scientific research suggests that dromedaries constitute the reservoir of the virus and can infect people. The largest outbreaks have occurred in Saudi Arabia, the United Arab Emirates and the Republic of Korea, but smaller outbreaks of the disease have also been reported in other countries.

How it is transmitted

The infection occurs via the respiratory tract (e.g. coughing, sneezing), however the mechanism by which it spreads is not yet fully understood.

Person-to-person transmission: the virus is not easily transmitted from person to person in the absence of close contact, such as when caring for a MERS patient without applying the correct prevention measures. There have been reports of clusters of cases in healthcare settings where person-to-person transmission has occurred. Currently, confirmed cases of human-to-human transmission involve family members, patients and healthcare personnel.

zoonotic transmission: this route of transmission is not fully understood, however dromedaries represent the main reservoir of the virus and a possible source of human infection. In several countries, viral strains have been isolated from dromedaries identical to those isolated from people.

Symptoms and signs

The clinical form can range from asymptomatic to mild respiratory disturbances or a severe respiratory form that can be fatal. The incubation period is generally 5-6 days but can vary from 2 to 14 days. The majority of confirmed cases of MERS presented with a severe acute respiratory form characterized by

– temperature
– cough
– difficulty breathing.

Pneumonia is a frequent but not always present symptom. Many also experienced gastrointestinal symptoms, such as diarrhea. Severe forms can cause respiratory failure requiring mechanical ventilation and admission to an intensive care unit. They can be deadly. However, there are also asymptomatic and mild flu-like forms.


In elderly people, in people with immune deficiencies and in subjects with chronic pathologies, such as kidney pathologies, tumors, chronic lung diseases and diabetes, the disease can evolve into more serious forms. Mortality is about 35%. In Italy, it has been active since January 2013 a surveillance network of severe acute respiratory infections (SARI) and acute respiratory distress syndromes (ARDS). In addition, the national network is active for the management of severe acute respiratory failure syndrome from influenza virus pneumonia and the possible use of ECMO therapy (extracorporeal oxygenation).


The diagnosis of Mers-CoV is made through laboratory tests (serological and PCR).


There is no treatment specific antiviral for disease caused by Mers-CoV. Treatment should be based on the patient’s symptoms. Supportive care can be very effective.


The general measures to prevent respiratory diseases are of avoid close contactwhenever possible, with anyone show symptoms of the disease (coughing and sneezing)to cover the nose and mouth when sneezing or coughing and to maintain good hand hygiene by washing them with soap and water.

The foods of animal origin properly produced are safe, while it is recommended to avoid consuming raw or undercooked meat and unpasteurized milk. Furthermore, after visiting a farm, a herd of animals (especially dromedaries), a market where there are live animals or their productsIt is recommended to wash your hands thoroughly with soap and water. It is advisable not to touch sick animals.

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