Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Middle East Respiratory Syndrome (MERS) is a viral respiratory disease caused by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The virus was first reported by the WHO on 22 September 2012. Till date, MERS-CoV infection has been reported in at least 27 countries with majority of cases reported in the Middle East region. MOH has been closely monitoring the global MERS situation since the disease emerged in 2012. To date, there has been no reported case of MERS in Singapore but the possibility of an imported case here cannot be ruled out given today’s globalised travel patterns. The risk of outbreak in our community remains low as there has been no evidence of sustained community spread and transmission of the virus from person to person had occurred mainly in healthcare settings.

MERS-CoV is present in infected dromedary camels, and can be transmitted to humans through contact with infected animals or contaminated animal products. MERS-CoV may also spread through close contact with infected persons.

MERS-CoV infection may cause the following symptoms:

• Fever
• Cough
• Shortness of breath

MERS-CoV infection may result in severe illness and complications such as pneumonia, and death occurs in about a third of infected persons.

There is no commercially available vaccine or curative treatment for MERS. Patients with MERS are managed with symptomatic treatment and supportive care.

To reduce risk of exposure to MERS-CoV, we advise travellers to affected areas to maintain their vigilance and adopt the following health precautions:

• Observe good personal hygiene at all times.
• Practise frequent hand washing (e.g. before handling food or eating, after going to toilet, or when hands are soiled).
• Adopt good food safety and hygiene practices and avoid consuming raw and unpasteurised milk, undercooked meats, or food prepared under unsanitary conditions, and properly washing fruits and vegetables before eating them.
• Avoid close contact with persons who are unwell, such as those suffering from respiratory infections.
• Avoid contact with camels and other animals, including not visiting camel farms. If contact has been made, thoroughly wash hands with soap.
• Avoid visiting healthcare institutions in the Middle East unless it is necessary to do so as part of accessing medical care.
• Wear a surgical mask in crowded places.
• Ensure that the required and/or recommended vaccinations (e.g. COVID-19, meningococcal and influenza vaccination) are up-to-date.

Returning travellers from a MERS-CoV affected area should monitor their health closely for two weeks. They should wear a surgical mask and seek medical attention promptly if they become unwell with fever and cough and/or breathlessness and inform the doctor of their relevant travel history. Truthful declaration of travel history is important. Persons suspected to have MERS-CoV infections may be isolated for observation and further investigations.