Middle East respiratory syndrome coronavirus
Background
- Abbreviation: MERS or MERS CoV
- New coronavirus was first described in September 2012, when it was reported to have caused fatal acute lower respiratory illness in a man in Saudi Arabia.
- First US case reported in Indiana on May 1, 2014
Clinical Features
Differential Diagnosis
Causes of Pneumonia
Bacteria
Viral
- Common
- Influenza
- Respiratory syncytial virus
- Parainfluenza
- Rarer
- Adenovirus
- Metapneumovirus
- Severe acute respiratory syndrome (SARS)
- Middle east respiratory syndrome coronavirus (MERS)
- 2019-nCoV (COVID-19)
- Cause other diseases, but sometimes cause pneumonia
Fungal
- Histoplasmosis
- Coccidioidomycosis
- Blastomycosis
- Pneumocystis jirovecii pneumonia (PCP)
- Sporotrichosis
- Cryptococcosis
- Aspergillosis
- Candidiasis
Parasitic
Evaluation
CDC Case Definition[1]
A patient with (needs all three):
- Fever AND
- Pneumonia or ARDS (based on clinical or radiological evidence) AND
- One of the below:
- history of travel from countries in or near the Arabian Peninsula^ within 14 days before symptom onset; OR
- close contact^^ with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula^; OR
- is a member of a cluster of patients with severe acute respiratory illness (e.g. fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments.
^Countries considered in or near the Arabian Peninsula: Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Palestinian territories, Qatar, Saudi Arabia, Syria, the United Arab Emirates (UAE), and Yemen.
^^Close contact is defined as
- any person who provided care for the patient, including a healthcare worker or family member, or had similarly close physical contact; or
- any person who stayed at the same place (e.g. lived with, visited) as the patient while the patient was ill.
Management
Immediately contact the Acute Communicable Disease Control Program (ACDC) at 213-240-7941, ask for the Administrator on Duty (AOD), if a patient meets criteria