Middle East Respiratory Syndrome (MERS) is caused by a coronavirus (MERS-CoV). Coronaviruses are a large and diverse family of viruses which include viruses that are known to cause illness in humans (including the common cold and SARS) and animals.
On this page:
- MERS situation
- Symptoms and transmission
- Information for health professionals
- Advice for travellers
- Actions in New Zealand.
Health officials first reported MERS in Saudi Arabia in September 2012.
All known MERS cases worldwide have either:
- lived in or travelled to the Middle East
- been linked to people who acquired the infection in the Middle East
- or can be linked to an initial imported case (usually through healthcare facility transmission)
There have been no cases of sustained spread of MERS in the general community outside health care facilities in either Saudi Arabia or following importation into other countries.
No cases of MERS have been detected in New Zealand.
The Ministry of Health is monitoring the international situation regarding MERS, and will be keeping the health sector and public updated should it change.
New Zealand is well prepared in terms of the detection, testing and management of infectious diseases such as MERS.
MERS is a respiratory condition, the main symptoms of which include fever, cough, muscle pain and breathlessness. Sometimes gastrointestinal symptoms may also be present.
MERS can cause severe respiratory symptoms which can lead to death. Serious illness and death occurs more commonly in the elderly and in patients with underlying chronic medical conditions such as diabetes, heart failure, renal failure, chronic lung disease and those who are immuno-compromised.
MERS has a fatality rate of up to 40%. There is no vaccine and no specific treatment.
The incubation period of infection has not yet been fully determined but is likely to be 2 to 14 days (most commonly 5 days).
MERS does not seem to pass easily between people. The virus is thought to spread through an infected person’s respiratory secretions, such as through coughing, and through touching infected surfaces.
Secondary cases have occurred within hospitals, when patients with MERS have not been properly isolated. There is no evidence of sustained community transmission in any country and only occasional instances of transmission within households.
It is important to note that most people who have had close contact with someone confirmed as having MERS have not been infected or become ill.
This strain of coronavirus that causes MERS was first identified in 2012 in Saudi Arabia. Understanding of the virus and the disease it causes is continuing to evolve.
The virus appears to be circulating throughout the Arabian Peninsula, primarily in Saudi Arabia, where the majority of cases (>85%) have been reported since 2012. The 2015 outbreak in South Korea is the largest outbreak outside of the Middle East.
MERS is a virus that is transmitted from animals to humans. Camels are suspected to be the primary source of infection for humans, but the exact routes of direct or indirect exposure are not fully understood.
For case definitions, and advice about investigation and management of suspected cases, please see the attached document Updated Information for Health Professionals: Middle East Respiratory Syndrome (MERS): 20 August 2015 (Word, 290 KB). For an assessment of risk to New Zealand, and to the international community, please see the attached document Middle East Respiratory Syndrome: Risk assessment: October 2015 (Word, 475 KB).
Any samples for testing should be sent to ESR Clinical Virology Laboratory at the National Centre for Biosecurity and Infectious Diseases (NCBID) Wallaceville for testing. See Procedure for shipping respiratory samples to the clinical virology laboratory at ESR NCBID attached (doc 45 KB).
Information for travellers is available on the New Zealand Safe Travel website. This includes World Health Organization (WHO) advice to practice normal hygiene measures, including frequent hand washing and avoiding close contact with animals (particularly camels) and people who are suffering from acute respiratory infections.
Anyone who becomes unwell within 14 days of returning from the Middle East (or with a history of being in a healthcare facility – as a patient, worker or visitor – in a country with healthcare facility transmission of MERS) should phone their doctor or call Healthline on 0800 611 116. It is important to mention recent travel to the Middle East, and any known contact with someone with MERS.
Countries of the Middle East should be considered as: Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Occupied Palestinian Territories, Qatar, Saudi Arabia, Syria, the United Arab Emirates (UAE), and Yemen. However, not all of these countries have had cases of MERS. The latest information on where cases have been reported would be taken into account when considering someone's travel history and their risk of having MERS. Transiting through an international airport (<24 hours stay, remaining within the airport) is not considered to be risk factor for infection.
In line with advice from the WHO, New Zealand does not intend to introduce any travel restrictions in respect to MERS.
WHO has provided some travel advice on MERS for pilgrimages.
- The Ministry of Health closely monitors the international situation regarding new and emerging infectious diseases, including MERS.
- The Ministry of Health first provided material on MERS to the health sector in 2013. This information is reviewed and updated as the situation changes and aligns with advice provided by WHO. Updated clinical and diagnostic guidance has been provided to DHB emergency management planners for distribution to clinicians, primary care providers and laboratories, and to customs and border control officials, as well as to Public Health Units and Medical Officers of Health. View the guidance for health professionals document (doc, 290 KB).
- MERS was made a notifiable and quarantinable disease in September 2013 under the Health Act 1956 (Schedule 1). As such, any suspected case should immediately be notified to the local Medical Officer of Health, by the attending medical practitioner and the laboratory. Any contacts of a probable or confirmed case should also be reported to the local Medical Officer of Health.
- In line with WHO advice, New Zealand does not intend to introduce any travel restrictions in respect to MERS. Based on the information currently available, the WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
- New Zealand has an influenza pandemic plan which can be activated at short notice, if it was needed. It is a whole-of-government plan with the Ministry of Health as the coordinating agency and provides a framework for any infectious respiratory disease.
- Guidance is also available on being prepared to stay at home with your family during a pandemic.
- A technical advisory group on infectious disease is being set up to provide the Ministry of Health with additional expert advice on diseases such as MERS, as required.