Coronaviruses: severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus in travelers

Curr Opin Infect Dis. 2014 Oct;27(5):411-7. doi: 10.1097/QCO.0000000000000089.


Purpose of review: Middle East respiratory syndrome coronavirus (MERS-CoV) is currently the focus of global attention. In this review, we describe virological, clinical, epidemiological features and interim travel advice and guidelines regarding MERS-CoV. We compare and contrast these with the severe acute respiratory syndrome coronavirus (SARS-CoV).

Recent findings: MERS-CoV is a novel β CoV that causes a spectrum of clinical illness from asymptomatic to the rapidly fatal disease mainly in those with comorbid conditions. Epidemiological and genomic studies show zoonotic transmission to humans from camels and possibly bats. In contrast to the SARS-CoV pandemic, very limited global spread of fatal MERS-CoV has occurred outside the Arabian Peninsula. Although mainly currently restricted to Middle Eastern countries, MERS-CoV was reported from at least 10 other countries in Europe, Asia and the United States. All primary cases have been linked to travel to the Middle East. Nosocomial transmission of MERS-CoV has occurred because of poor infection control measures. Specific molecular diagnostic tests are available. Currently, there are no specific drugs for prevention or treatment for MERS-CoV and vaccine development is in the early stages. Advice and guidance for travelers to the Middle East are updated regularly by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

Summary: Like SARS-CoV, MERS-CoV threatens global health security. All physicians and travelers to the Middle East should be aware of the new threat caused by MERS-CoV and follow CDC and WHO guidelines. Those who develop ill health during their trip or soon after their return should seek medical care.

Publication types

  • Review

MeSH terms

  • Aircraft
  • Antibodies, Neutralizing / therapeutic use
  • Cross Infection / prevention & control*
  • Cytochrome P-450 CYP3A Inhibitors / therapeutic use
  • Europe / epidemiology
  • Guidelines as Topic
  • Hand Hygiene
  • Humans
  • Infection Control / methods*
  • Infection Control / organization & administration
  • Middle East / epidemiology
  • Middle East Respiratory Syndrome Coronavirus / isolation & purification*
  • Middle East Respiratory Syndrome Coronavirus / pathogenicity
  • Pandemics
  • SARS Virus / isolation & purification*
  • SARS Virus / pathogenicity
  • Severe Acute Respiratory Syndrome / drug therapy
  • Severe Acute Respiratory Syndrome / immunology
  • Severe Acute Respiratory Syndrome / prevention & control
  • Severe Acute Respiratory Syndrome / transmission*
  • Time Factors
  • Travel*
  • United States / epidemiology


  • Antibodies, Neutralizing
  • Cytochrome P-450 CYP3A Inhibitors