Middle East respiratory syndrome coronavirus (MERS-CoV) reminder

NaTHNaC has reviewed MERS-CoV advice for UK travellers in line with current UK Health Security Agency recommendations and is reminding travellers to be aware of their MERS-CoV risk

MERS-CoV is a respiratory virus that has spread to humans from animals. Humans can be infected by 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. Most MERS-CoV cases have reported exposure to camels or camel products, but there has also been human-to-human spread of MERS CoV in healthcare settings and private households, particularly after close contact, such as providing unprotected care to an infected person. There have been very rare cases where no exposure can be identified [1].

MERS-CoV was first identified in Saudi Arabia in 2012 and most cases are still reported in the Middle East [1, 2]. 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].

NaTHNaC has reviewed MERS-CoV advice for UK travellers in line with current UK Health Security Agency (UKHSA) and World Health Organization (WHO) guidance and recommendations.

Risk of infection with MERS-CoV for UK residents travelling to the Middle East is very low, but may be higher for those in contact with camels (or camel products) or the local healthcare system.

Risk of infection with MERS-CoV to UK residents in the UK remains very low [3].

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

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Advice for travellers

Before you 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 a 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.

While you are away

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 including meat (raw or undercooked) from the Middle East.
• Avoid eating and drinking all types of raw milk and raw milk products.
• Avoid eating any food that may be contaminated with animal secretions unless cleaned and/or thoroughly cooked or is fruit that can be peeled.
• If you must visit farms, barns and market areas where camels are present or go on camel rides, practise good general hygiene measures, including regular hand washing with soap and water at all times.
• If you have diabetes, kidney problems, chronic lung disease or a weakened immune system (immunosuppression) you are at risk of severe MERS-CoV illness and should avoid all areas where camels are found. If you do visit farms, barns or market areas or go on camel rides clean your hands regularly, including before and after attending or touching animals.
• Avoid all contact with sick animals.
• Follow the advice of local health authorities.
• If you are ill with any infectious disease, you are advised not to travel, but stay at your destination and get local health advice immediately [3].

When you return

If you develop fever and cough within 14 days of travel from the Middle East, get urgent medical advice, telling your doctor/health professional exactly where you travelled to. This makes sure you get an appropriate clinical assessment; infection control measures are followed and the right tests are carried out.

UKHSA has 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.