Makindo Medical Notes

🦠 Middle East Respiratory Syndrome (MERS-CoV): Fever may be absent in infants, elderly, immunosuppressed, or those on antipyretics → maintain suspicion in at-risk cases.

ℹ️ About

• Viral respiratory illness caused by MERS coronavirus (MERS-CoV).
• First identified in Saudi Arabia (2012), later reported in the Middle East, Asia, Europe, USA.
• 🐪 Camels = natural reservoir; human-to-human spread in healthcare settings.

🧬 Aetiology

• Novel coronavirus strain causing severe lower respiratory disease.
• Incubation: 2–14 days (median ~5–6).
• Transmission: droplets, direct contact, contaminated surfaces.

🤒 Clinical Features

• Respiratory: Fever, cough, dyspnoea → pneumonia, ARDS.
• GI: Diarrhoea, nausea, vomiting, abdominal pain.
• Severe illness: ARDS, septic shock, multi-organ failure; worse with diabetes, CKD, immunosuppression.
• Atypical: Afebrile presentation in high-risk groups.

🧪 Investigations

• 🩸 Bloods: U&E (AKI risk), LFTs, FBC.
• 💨 ABG: Assess hypoxaemia/respiratory failure.
• 🧫 PCR: Nasopharyngeal, sputum, or BAL = diagnostic gold standard.
• 🩻 CXR/CT: Bilateral pneumonia, ARDS, ground-glass opacities.

🛡️ Prevention

• 🚫 Avoid raw camel milk/urine & undercooked camel meat.
• 🏥 Strict infection control: standard + contact + airborne precautions.
• 😷 PPE: N95 mask, gown, gloves, eye protection for healthcare workers.
• 🚪 Isolation: suspected/confirmed patients in negative-pressure rooms if available.

💊 Management

• Supportive: ABCs, O₂, IV fluids, vasopressors if shock.
• Advanced: ITU/HDU for mechanical ventilation, renal replacement if needed.
• No licensed antivirals; investigational drugs under study.
• 🧴 Infection control = critical to prevent outbreaks (PPE, hand hygiene, surface disinfection).
• 🏠 Mild disease: home isolation until recovery.

📚 References

• WHO – MERS-CoV
• CDC – MERS-CoV
• MERS-CoV Review – NCBI