20-05-2025
MERS Coronavirus Infection Remains A Threat In The Middle East
TOPSHOT - Camels are pictured with a drone during the annual King Abdulaziz Camel Festival in Rumah, ... More some 160 kilometres east of Riyadh, on January 7, 2020. (Photo by Faisal AL-NASSER / AFP) (Photo by FAISAL AL-NASSER/AFP via Getty Images)
President Trump recently completed a whirlwind tour of the Middle Eastern countries of Saudi Arabia, Qatar and the UAE. As part of the welcome fanfare in Qatar his motorcade was escorted by royal camels. I wondered whether the President's entourage was aware that Saudi Arabia experienced a recent outbreak of potentially deadly MERS-CoV, the Middle East respiratory syndrome coronavirus, which is associated with camels. In the outbreak, Saudi Arabia reported nine cases of MERS-CoV infection that occurred between March 1 and April 21, 2025. Among the cases, there were two deaths, and a cluster of six healthcare workers were infected in Riyadh after exposure to a single patient.
RIYADH, SAUDI ARABIA - MAY 13: U.S. President Donald Trump walks with Saudi Crown Prince Mohammed ... More bin Salman during an official state arrival ceremony at the Saudi Royal Court on May 13, 2025, in Riyadh, Saudi Arabia. Trump begins a multi-nation tour of the Gulf region focused on expanding economic ties and reinforcing security cooperation with key U.S. allies. (Photo by)
MERS-CoV is a novel coronavirus, similar to the SARS-CoV2 virus that causes Covid. Like Covid, MERS can cause fatal respiratory failure. The natural host is considered dromedaries, which are single-humped Arabian camels found in the hot desert environment of the Arabian Peninsula, as opposed to Bactrian, or two-humped camels found in Asia. MERS-CoV infection is associated with close contact with dromedary camels. Like Covid, once humans are infected, they can spread the virus to others.
MERS first surfaced in 2012 in Saudi Arabia. Since then, 2,627 cases have been reported in 27 countries, with 946 deaths (36% fatality rate). The majority (84%) of cases have been reported in Saudi Arabia, and cases have been identified only in the Middle East since 2019. A handful have been reported each year since 2021; however, given that MERS is contagious and is lacking countermeasures, it has been listed by the WHO as a priority pathogen of concern with pandemic potential.
The recent Saudi Arabia case cluster illustrates the devastation potential and risk of transmission once MERS-CoV gains access to the healthcare environment. In South Korea a large outbreak in 2015 spread through medical facilities and led to 186 confirmed cases, with 38 deaths (20% death rate). The index case had traveled to the Middle East.
Saudis wear mouth and nose masks as they watch camels at their farm on May 12, 2014 outside Riyadh. ... More Saudi Arabia has urged its citizens and foreign workers to wear masks and gloves when dealing with camels to avoid spreading the Middle East Respiratory Syndrome (MERS) coronavirus as health experts said the animal was the likely source of the disease. AFP PHOTO/FAYEZ NURELDINE (Photo by Fayez Nureldine / AFP) (Photo by FAYEZ NURELDINE/AFP via Getty Images)
As with other severe respiratory viruses, common signs and symptoms of MERS infection include fever, cough, shortness of breath and pneumonia. Some patients may also have gastrointestinal symptoms, such as nausea, vomiting and diarrhea. Although MERS has a high death rate, it presents with a wide range of illness, from asymptomatic to respiratory failure and death. Asymptomatic cases may spread the virus unknowingly and since they may not be identified, the death rate may be an overestimate. Individuals with chronic illnesses, such as diabetes, heart, lung, or kidney disease or cancer are at greater risk of severe illness.
MERS spreads initially to humans by direct or indirect contact with infected dromedaries. Infected humans infected can then transmit it to others through contact or respiratory secretions when they cough or sneeze.
MERS should be considered in anyone who develops severe respiratory symptoms and fever within 14 days of contact with dromedary camels or travel to the Arabian Peninsula, especially if they have visited a healthcare facility. Additional risk could come from close contact with someone who becomes ill after recent travel to the Arabian Peninsula.
There are no specific treatments yet for MERS other than supportive care, and there are no vaccines, although research is being conducted on these. The main thing to do is avoid direct contact with the secretions of camels and avoid ill individuals with potential risk. Infection control measures in hospitals that were utilized to prevent Covid transmission are also beneficial for preventing the spread of MERS, which may have impacted the low numbers of cases since 2021. Royal camels certainly make an exciting welcome display in the Middle East, but you might want to think twice before climbing onto that camel for a ride in the desert.
