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ADVANCE Perspective: Respiratory Views

MERS: The Next Pandemic?

Published June 11, 2015 5:27 PM by ADVANCE for Respiratory Care & Sleep Medicine

By Bruce Merchant, MD

Science tells us that new viral mutations are occurring all the time. Many of these mutations are effectively neutral and are of little importance but, every now and again, a mutation will occur in a virus which gives it a major biological advantage.

For a virus, that’s the ability to infect a host and to go on successfully doing so in one host after another. One such recent viral mutation that affects humans is a strain of corona virus called MERS CoV.  The disease that this virus causes is simply called Middle East Respiratory Syndrome (MERS) and it first showed up in humans just three years ago.

MERS is a viral disease that, once it really takes hold in a person’s lungs, is almost as  deadly as Ebola. As with Ebola, there is no vaccine and no known cure, so for us humans the most meaningful strategy to escape this scary troublemaker is avoidance. Although MERS CoV and Ebola are very different viruses, within a couple of weeks, MERS, like Ebola, can lead to pneumonia, diarrhea, kidney shut-down and even death. MERS CoV also is a completely different virus from the one which caused the Severe Acute Respiratory Syndrome (SARS) outbreak a few years ago.

SEE ALSO: Ebola, H1N1 and SARS

MERS first surfaced in Jordan in 2012 and, over the past three years, it has caused lethal cases in most Middle Eastern Countries. It can be communicated by a cough or a sneeze and, of course, by even closer human contact, like kissing). So if you are planning a trip to Saudi Arabia, Dubai, Egypt, Kuwait, Yemen, Oman, Iraq, Jordan or Iran, or other lesser countries within that region, you should first ask yourself: Is this trip really necessary? And if your answer is definitely, YES! Then there are some special precautions that you should take. These include:

  • See your primary health care professional and get all your regular “shots” up to date. (None of these will affect MERS directly, but they may help you avoid other infections that could weaken you and make you more susceptible to MERS).
  • Carry (and use) alcohol wipes wherever you go.
  • Your Mom told you not to “pick your nose.” She was right! That goes also for rubbing your eyes and putting your fingers in your mouth.
  • Wash your hands several times a day (with an alcohol wipe follow-up).
  • Carry a few surgical masks with you. I recommend wearing one - after being seated - when on any air flight in the region. Airplane flights are probably the most hazardous locations you will find yourself in. People, some coughing and sneezing, are generally really packed in, and the air is commonly re-circulated without adequate filtration. 
  • If you’re traveling, please be aware of the Airline’s health guidelines which can change from day to day and from destination to destination
  • Don’t get into a spitting match with a camel!

That last rule deserves some explanation. There is strong evidence that MERS CoV  is carried quite often by camels. In camels it doesn’t cause any serious illness. It does seem likely that camels probably represent the host reservoir from which the MERS CoV that infects humans has arisen. There isn’t very good evidence yet for the direct transmission of MERS from camels to humans. But there is plenty of evidence for human to human transmission. Even so, with regard to camels it will probably be best to keep out of spitting distance.

Very recently, there have been 95 confirmed cases of MERS (including 25 deaths) in South Korea initially transmitted by an elderly man who had recently traveled to the Middle East. This has caused authorities there to close over a thousand schools. There has been one instance of an infected person from South Korea travelling on to China where the traveler was promptly detected and isolated. Given these recent developments, the above rules should apply for any trip to South Korea, and, for that matter, to China and possibly to other countries in Southeast Asia.

Gene mutations are real and can be scary as well as life-threatening but, please remember, taking precautions and being aware of viral mutations and where they are in the world is essential to our global health.

Dr. Bruce Merchant is a research physician in the immunology and pathology of human tumors and infectious diseases. He also holds a doctorate in Immunopathology from the University of Chicago. He is also involved with two separate clinical studies, one that involves the use of convalescent immune plasma (from Ebola survivors) and another employing a number of new pharmaceuticals, which are to be critically tested in Ebola patients in West Africa. He is the author of the new book, Moonkind: Survivors of Ebola. Learn more about Dr. Merchant at

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