[Middle East Respiratory Syndrome (MERS)].

Iinuma, Yoshitsugu

Middle East respiratory syndrome (MERS) is an emerging infectious disease of growing global importance, which has caused severe acute respiratory disease in more than 1,700 people, resulting in almost 600 deaths. MERS is caused by a novel betacoronavirus (MERS-CoV). All cases of MERS have been linked through travel to or residence in countries in or near the Arabian Peninsula. Dromedary camels are considered natu- ral reservoirs for MERS-CoV. MERS-CoV is mainly transmitted from infected dromedary camels to human beings, and it is transmitted among human beings by droplets, contact, and perhaps airborne spread. Both community-acquired and hospital-acquired cases have been reported with little human-to-human transmis- sion reported in the community. The largest known outbreak of MERS outside the Arabian Peninsula oc- curred in the Republic of Korea in 2015, with 186 cases. The outbreak was associated with a traveler re- turning from the Arabian Peninsula. Clinical features of MERS range from asymptomatic or mild disease to acute respiratory distress syndrome and multi-organ failure resulting in death, especially in individuals with underlying comorbidities. MERS is suspected in the presence of febrile acute respiratory illness and close contact with MERS-CoV, and can be confirmed by the detection of viral nucleic acid through RT-PCR or se- rology. No specific drug treatment exists for MERS; however, the neutralizing antibodies, ribavirin and interferon have been shown to be potentially useful anti-MERS-CoV drugs. Rigorous infection prevention and control measures with droplet and contact precautions are crucial to prevent the spread in health-care facilities. [Review].