The MERS-Corona virus ( MERS-CoV ) belongs to the Coronaviridae and was first identified in Saudi Arabia in 2012. The virus can dock onto human lung cells, but is only weakly contagious from person to person. The course of the disease after infection ranges from almost no symptoms to mild cold symptoms to fatal outcome. A safe antiviral therapy does not (yet) exist. The virus has now spread to many other countries without having triggered an epidemic or pandemic.
What is MERS-CoV infection?
MERS-CoV (Middle East respiratory syndrome coronavirus) is an RNA virus of the Coronaviridae family. The corona virus has special protein structures on its surface that are reminiscent of tiny spikes. With the prickly structures, the MERS-CoV can dock to human lung cells. Infection occurs when the virus manages to enter the lung cell. For icb – intracerebral hemorrhage, please visit ablogtophone.com.
By comparing the viral genome with the nucleotide sequences of known corona viruses, it turned out that the MERS-CoV must be counted among the genus of beta corona viruses and that their genome was not yet known and classified. The virus was first identified in Saudi Arabia in 2012. On May 15, 2013, the responsible international commission officially assigned the name MERS-CoV to the virus.
With over 30,000 nucleotides in some cases, Coronaviridae have the longest genomes within the RNA viruses, which indicates a high stability of the genome and thus only a low susceptibility to mutations. This plays a major role in assessing whether and how quickly MERS-CoV can adapt to the new human host through mutations.
Causes
The corona virus MERS-CoV can be transmitted from person to person via the classic route of droplet and smear infection, but is only considered weakly contagious in people with an intact immune system. According to the theory that has prevailed so far, bats on the Arabian Peninsula form the source reservoir of MERS-CoV. The virus spread from bats to dromedaries, which are kept and bred as livestock in the Middle East.
Studies from 2013 showed that up to 74 percent of the animals in individual herds on the Arabian Peninsula had formed antibodies against the virus. Dromedaries, which themselves show only mild symptoms after infection with MERS-CoV, form a large animal reservoir. The virus can jump from dromedaries to humans through droplet or smear infection in people who are in close contact with the animals. Another transmission route could be the consumption of camel milk, which is very popular in the Arab world, if it is untreated, i.e. not pasteurized.
Symptoms, Ailments & Signs
The incubation period after an infection is usually less than a week, but can also be up to twelve days. The first symptoms resemble those of a viral cold with cough, sputum production and fever. In people with a weakened or suppressed immune system, pneumonia with acute shortness of breath can develop in the second week or so.
Diarrhea occurs in severe cases and renal insufficiency has also been observed. According to statistics from the Saudi health authority as of June 1, 2015, a total of 1,150 laboratory-confirmed infections have been reported since September 2012, of which 427 were fatal.
Diagnosis & course of disease
A first suspicion of an infection with the MERS-CoV arises in people who suffer from symptoms such as cough, fever and breathing difficulties after traveling to risk areas or after contact with infected people. In the above cases, it should be clarified diagnostically whether a MERS-CoV infection is present.
For the direct detection of the MERS virus, the so-called polymerase chain reaction is used, in which the genetic material of the virus – if it is present in the sample – is multiplied under laboratory conditions (in vitro) and certain nucleotide sequences are compared with those of the MERS virus be able. Throat swabs or material from a tracheal lavage (bronchoalveolar lavage) serve as the starting material. Methods for detecting antibodies that specifically indicate the MERS virus are only available to a limited extent.
Complications
In many cases, MERS-CoV can only be diagnosed late because the incubation period of this disease is relatively long. Those affected primarily suffer from fever or a strong cough with sputum. Since the symptoms are usually very similar to a flu or a cold, they are often ignored. However, the disease also leads to shortness of breath, so that the patient becomes tired.
Pneumonia can also occur and significantly reduce the patient’s quality of life. It is not uncommon for renal insufficiency to occur without treatment, which if left untreated can ultimately lead to the death of the patient. Those affected are then dependent on dialysis or a kidney transplant.
The breathing difficulties can also lead to a loss of consciousness, in which those affected can possibly injure themselves if they fall. The treatment of this disease is carried out with the help of antibiotics and usually leads to a positive course of the disease. There are no special complications either. Life expectancy is also not reduced if treatment is started early.
When should you go to the doctor?
If the person concerned suffers from a persistent cough, phlegm or a feeling of irritation in the throat, a doctor should be consulted. If there are disturbances in breathing activity, shortness of breath sets in or the person concerned suddenly wakes up during the night sleep due to a lack of oxygen, he needs medical help. If you experience anxiety, tachycardia or a cardiac arrhythmia, consult a doctor. Fever, pain or a dry feeling in the throat are other indications that should be followed up.
If the irregularities persist for several days or if they gradually increase in intensity, a doctor is needed. Discomfort in the intestinal tract is also a cause for concern. A doctor’s visit is necessary as soon as diarrhea, abdominal pain or unusual bowel movements occur. Difficulty urinating is an additional sign of health impairment that needs to be monitored. If there is a reduced amount of urine, pain in the kidney region or discoloration of the urine, a doctor’s visit must take place.
People living in Arab countries or returning from a stay there are particularly at risk. However, since MERS-CoV is a viral disease, people who have been in direct physical contact with people who have been in the region can also show the symptoms described.
Treatment & Therapy
As of mid-2015, there is still no proven antiviral therapy to directly combat MERS-CoV, so the treatments are aimed at relieving the symptoms and strengthening the body’s immune system. It is important to drink enough fluids and to avoid a secondary bacterial infection, which can be minimized by administering certain antibiotics.
Several treatment options are discussed that may have an impact on reduced replication of the virus. Such an effect is expected from a combination of interferon-a2b and ribavirin. While interferon is used to support the body’s own interferon synthesis, ribavirin is an antiviral that is used in certain viral infections. An interesting theoretical approach, which has already been successful in animal experiments, is the administration of immunoglobulins obtained from the serum of infected dromedaries.
Outlook & Forecast
The infectious disease has a good prognosis in people with a basically stable immune system and no other previous illnesses. In some cases, healing can also take place without medical care being initiated. The prerequisite for this, however, is that the person concerned initiates self-help measures, has a healthy body’s own defense system and uses alternative healing methods. However, it must be taken into account that the healing path is usually longer if this procedure is chosen. Without sufficient rest and protection of the organism at the same time, an increase in the symptoms is to be expected.
In drug therapy, the immune system is supported by the administration of certain active ingredients. This kills the pathogen and then transports it out of the body. Within a few days, a significant improvement in the general state of health can be documented. Recovery occurs within a few weeks.
The prognosis worsens if the disease is diagnosed at a very late stage and there are other pre-existing conditions. The pathogen has already spread widely and weakens general health. Pneumonia can develop which, if left untreated, is potentially life-threatening for those affected. If there are disorders of the respiratory tract, an additional deterioration in health is to be expected. If complications arise, the patient may die prematurely.
Prevention
Preventive measures against infection for people who are in risk areas consist primarily of observing special hygiene regulations and avoiding certain foods such as raw camel milk. The MERS virus can be rendered harmless by washing hands and clothes and is not particularly contagious from person to person.
For people who are in contact with infected people, effective class FFP 2 or FFP 3 respirators are also recommended to prevent infections from inhaled aerosols. It is helpful if the infected person can also wear a respirator. Several international institutes are working on the development of a vaccine for immunization. As of mid-2015, there is still no effective vaccine.
Aftercare
In the case of a coronavirus infection caused by the MERS virus, the affected person usually has no options for aftercare. The patient is primarily dependent on an early diagnosis so that further complications can be prevented. The earlier the coronavirus infection is detected, the better the further course of treatment is usually.
If left untreated, serious complications can develop. Strict bed rest and the avoidance of excessive exertion or physical activity is advisable in order not to unnecessarily stress the body. In some cases, the help or support of one’s own family and friends is also very helpful in relieving the burden on those affected.
However, contact with other people should be kept to a minimum during the acute aftercare phase to prevent infection. If there is no improvement after taking the medication, it is advisable to consult a doctor immediately, since the coronavirus infection can also be fatal in the worst case. However, the course is usually harmless. Those affected do not have to fear a reduction in life expectancy.
You can do that yourself
In the case of MERS-CoV, those affected have a number of options for self-help. However, care should be taken to take antibiotics to avoid further infections and transmission to other people. When taking antibiotics, possible interactions with other medications should be taken into account, so regular consultation with a doctor is advisable. The consumption of alcohol must be strictly avoided.
Furthermore, the person affected by MERS-CoV should not do any strenuous activities and generally not unnecessarily burden the body. Bed rest has a very positive effect on the course of the disease and can alleviate the symptoms.
However, since the disease can also be fatal, it should always be treated by a doctor, which may also require hospitalization.
The common cold-like symptoms can be alleviated with the usual home remedies. Throat lozenges and teas help against coughs and sore throats. The patient should ensure that they drink enough fluids, especially if MERS-CoV causes diarrhea. In the case of kidney failure, however, dialysis is necessary. If MERS-CoV leads to psychological problems, talking to your closest friends or relatives will help.
