This document provides information about Middle East Respiratory Syndrome Coronavirus (MERS-CoV). It discusses that MERS-CoV was first reported in 2012 in Saudi Arabia and is caused by a novel coronavirus. Common symptoms include fever, cough, and shortness of breath. While most cases have occurred in Saudi Arabia, some patients were infected after travel to the Middle East. The virus likely jumps between animals like bats and camels to humans. Recommendations are provided to prevent spread, including handwashing, avoiding contact with sick individuals, and seeking medical care for fever or respiratory symptoms within 14 days of travel to the Middle East.

1.  Sawsan Mustafa Abdalla
 Associate Professor
 Community Medicine
 Faculty of Medicine

2. In temperate climates coronavirus respiratory
infections occur
primarily in the winter
although smaller peaks are sometimes seen in the
fall or spring
and infections can occur at any time of the year

3. and HCoV appear to predominate unpredictably in
certain years and in certain parts of the world.
Because of the varying sensitivity of different
diagnostic assays, as well as the unpredictable
prevalence of the various strains from year to year, it
is difficult to say which, if any, of the strains is the
most common.

4. Coronaviruses are important human and animal pathogens.
 cause of up to one-third of community-acquired upper
respiratory tract infections in both children and adults.
certain coronaviruses cause diarrhea in infants and children
Cause central nervous diseases (has been suggested but not proven).

5.  medium-sized
 Enveloped
 positive-stranded RNA viruses
 whose name derives from their characteristic crown-
like appearance in electron micrographs
 These viruses have the largest known viral RNA
genomes, with a length of 27 to 32 kb.

7. Replication of viral RNA occurs in the host
cytoplasm
in which RNA polymerase binds to a leader
sequence and
then detaches and reattaches at multiple locations,
allowing for the
production of a nested set of mRNA molecules with
common 3’ ends

8.  Coronaviruses are named so for the crown-like
spikes on their surface.
 They are common viruses that most people get in
their lifetime. These
 viruses usually cause mild to moderate upper-
respiratory tract illnesses.

9. It was first reported on 24th September 2012 by
Egyptian virologist Dr. Ali Mohamed Zaki in Jeddah,
Saudi Arabia
This virus is different from any other coronavirus
previously found in people.

10.  It is also different from the coronavirus that
caused SARS (Severe Acute Respiratory
Syndrome) in 2003.
 Until 23 May2013, MERS-CoV had frequently
been referred to as a SARS-like virus,[8]

11. novel coronavirus that emerged in Saudi Arabia two
years ago,
Recently 244 people were infected in the kingdom,
of whom 76 have died.
( Health Ministry)

12. In an outbreak of MERS-CoV in Saudi Arabia that
resulted in laboratory-confirmed MERS-CoV in 23
individuals,
the median incubation period was 5.2 days
secondary case that occurred in a patient in France
the incubation period was estimated at 9 to 12 days

13. Most patients with MERS-CoV :
severely ill with pneumonia and acute respiratory
distress syndrome
acute kidney injury.
Many patients have required mechanical ventilation
and extracorporeal membrane oxygenation.

14. gastrointestinal symptoms:
anorexia
nausea
vomiting
abdominal pain
diarrhea)
pericarditis
disseminated intravascular coagulation

15.  Fever (>38°C) – 46 patients (98 percent)
 Fever with chills or rigors – 41 patients (87
percent)
 Cough – 39 patients (83 percent)
 Shortness of breath – 34 patients (72 percent)
 Hemoptysis – 8 patients (17 percent)

16.  Sore throat – 10 patients (21 percent)
 Myalgias – 15 patients (32 percent)
 Diarrhea – 12 patients (26 percent)
 Vomiting – 10 patients (21 percent)
 Abdominal pain – 8 patients (17 percent)
 Abnormal chest x-ray – 47 patients (100 percent)

17. Air: by droplets from coughing, sneezing ,ect.
Come in contact with ill patients

18. It is not certain whether the infections are result
of asingle zoonotic event with subsequent human-to-
human transmission
or if the multiple geographic sites of infection
represent multiple zoonotic events from a common
unknown source.

19. The virus MERS-CoV belongs to the
genus Betacoronavirus some researchers believe
the virus is related to one found in the tomb bat.
An Epidemiologist Ian Lipkin of Columbia University
in New York city claims
the virus isolated from the bat was a 100% match to
the virus found in humans.

20. On April 17, 2014 a Saudi expert on the virus
announced a link between the virus and camels,
stating that a virus sample from a camel was a 100%
match to that found in a Saudi patient.[

21. As noted above, it is likely that animals serve
as intermediate hosts for MERS-CoV. In 2013,
MERS-CoV sequences were detected by
reverse-transcriptase polymerase chain
reaction (RT-PCR) in samples from a juvenile camel
belonging to a patient with MERS-CoV in Jeddah, Saudi
Arabia

22. Taking these everyday actions can help prevent the
spread of germs and protect against colds, flu, and
other illnesses:

23.  Wash your hands often with soap and water. If
soap and water are not available, use an alcohol-
based hand sanitizer.
 Avoid touching your eyes, nose, and mouth.
Germs spread this way.
 Avoid close contact with sick people.

24. If Traveling:
Be sure you are up-to-date with all of your shots,
and if possible, see your healthcare provider at least
4–6 weeks before travel to get any additional shots.

25. If you are sick:
Cover your mouth with a tissue when you cough or
sneeze, and throw the tissue in the trash.
Avoid contact with other people to keep from infecting
them.

26. Visit a health care provider if you develop:
fever
lower respiratory illness
cough
shortness of breath
within 14 days after traveling from countries in or
near the Arabian Peninsula*.

27. Health care providers should be alert to
patients who develop:
Severe acute lower respiratory illness (e.g.,
requiring hospitalization) within
14 days after traveling from countries in the
Arabian Peninsula* or

28. Consider other more common causes of respiratory
illness, such as influenza.
Evaluate patients using CDC’s case definitions and
guidance.
Immediately report patients with unexplained
respiratory illness and who meet CDC’s criteria for
“patient under investigation (PUI)” to local health
department.

29. Saudi Arabia recommends that the following groups
should postpone their plans for Hajj and Umrah this
year:
People over 65 years old
Children under 12 years old
Pregnant women

30. People with chronic diseases (such as heart
disease, kidney disease, diabetes, or respiratory
disease)
People with weakened immune systems
People with cancer or terminal illnesses

31. Countries considered in the Arabian Peninsula and
neighboring include:
Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon,
Oman, Palestinian
territories, Qatar, Saudi Arabia, Syria, the United
Arab Emirates (UAE),
and Yemen.

33. THANKS