Middle East respiratory syndrome coronavirus infection history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
The most common symptoms at presentation include fever, with or without chills or rigors, cough, shortness of breath, and myalgia. Gastrointestinal symptoms such as diarrhea, vomiting, or abdominal pain are also frequent. Acute kidney injury, pericarditis, and disseminated intravascular coagulation and other serious complications may occur in some cases.
History and Symptoms
Criteria for Suspected Case of MERS-CoV Infection
Patients should meet the following criteria, either A or B | |
---|---|
A. Fever (≥38°C, 100.4°F) and pneumonia or acute respiratory distress syndrome (based on clinical or radiological evidence) | B. Fever (≥38°C, 100.4°F) |
AND EITHER | AND |
• History of travel from countries in or near the Arabian Peninsula within 14 days before symptom onset | • Symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath) |
OR | AND |
• 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 | • Being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula in which recent healthcare-associated cases of MERS have been identified |
OR | |
• 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 | |
Table adapted from CDC-MERS-Interim Guidance [1] |
Symptoms
Most patients present with fever, chills, headache, non-productive cough, dyspnea, and myalgia. Other symptoms can include sore throat, coryza, sputum production, dizziness, nausea and vomiting, diarrhea, and abdominal pain. Atypical presentations including mild respiratory illness without fever and with diarrhea preceding the development of pneumonia have been reported.
The following table describes the symptoms of MERS-CoV infection.[2]
Symptom | Percentage |
---|---|
Fever Fever with chills or rigors |
98% 87% |
Cough Dry Productive |
83% 47% 36% |
Hemoptysis | 17% |
Shortness of breath | 72% |
Chest Pain | 15% |
Sore throat | 21% |
Runny nose | 4% |
Abdominal Pain | 17% |
Nausea | 21% |
Vomiting | 21% |
Diarrhoea | 26% |
Myalgia | 32% |
Headache | 13% |
References
- ↑ “CDC-MERS-Interim Guidance.” Accessed June 20, 2014. http://www.cdc.gov/coronavirus/mers/interim-guidance.html.
- ↑ Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A; et al. (2013). "Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study". Lancet Infect Dis. 13 (9): 752–61. doi:10.1016/S1473-3099(13)70204-4. PMID 23891402.