Middle East respiratory syndrome coronavirus (MERS-CoV) reminder

As international travel continues to accelerate, travellers are reminded about the risk of Middle East respiratory syndrome coronavirus (MERS-CoV)

MERS-CoV is a respiratory virus that has spread to humans from animals. Although its origins are not fully understood, it is believed to have originated in bats and then spread to camels. Studies show that humans can be infected through direct or indirect contact with infected dromedary camels. MERS-CoV has been found in these camels in several countries in the Middle East, Africa and South Asia. While some cases have been linked to human-to-human spread in healthcare settings and private households, the virus does not pass easily from person to person, unless there is close contact, such as providing unprotected care to an infected patient. Sustained human to human transmission has not been documented [1].

MERS-CoV was first identified in Saudi Arabia in 2012 and most cases are still reported in the Middle East [1, 2]. However, a large outbreak did occur outside this region, in the Republic of Korea in 2015, and cases have been exported from the Middle East to other countries, including the United Kingdom (UK) [3].

MERS-CoV symptoms include fever, cough, and shortness of breath. This can lead to severe pneumonia, causing breathing difficulties. In some cases gastrointestinal symptoms, including diarrhoea also occur. The virus appears to cause more severe illness in older people, those with weakened immune systems and anyone with conditions such as cancer, chronic lung problems, diabetes and kidney disease [1].

Risk of infection with MERS-CoV to UK residents in the UK remains very low. Risk of infection with MERS-CoV to UK residents travelling to the Middle East is very low, but may be higher in those with exposure to specific risk factors within the region, such as camels (or camel products) or the local healthcare system [3].

Country-specific information on MERS-CoV can be found on our Country Information pages and Outbreak Surveillance section.

Advice for travellers

Before travel

Get travel health advice from your GP, practice nurse or a travel clinic, ideally at least four to six weeks before travel. This is particularly important if you have chronic medical condition or take medication that weakens your immune system.

UKHSA provides specific guidance for travellers here: MERS-CoV: advice for people travelling to the Middle East.

During and after travel

All travellers to the Middle East are advised to avoid contact with camels as much as possible:

• Avoid raw camel milk and/or camel products from the Middle East.
• Avoid consumption of any type of raw milk, raw milk products.
• Avoid consumption of any food that may be contaminated with animal secretions unless peeled and cleaned and/or thoroughly cooked.
• Practise good general hygiene measures, such as regular hand washing with soap and water at all times, but especially before and after visiting farms, barns or market areas.
• Follow the advice of local health authorities.
• If you develop fever and cough within 14 days of travel from the Middle East, get medical advice, telling your doctor/health professional exactly where you travelled to. This ensures appropriate clinical assessment, infection control measures and testing can be undertaken.
• If you are very ill with an infectious disease, you are advised not to travel, but to seek health advice immediately [3].

UKHSA provides specific guidance for returning travellers here: MERS-CoV: advice for travellers returning from the Middle East.

Advice for health professionals

Health professionals advising travellers can check our Country Information pages to MERS CoV check risk at specific destinations.

Advice for health professionals on investigating and public health management of suspected MERS CoV cases is available from UKHSA: MERS-CoV: clinical management and guidance.