Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
| Morphology | Enveloped, positive-sense, single-stranded RNA virus from the Coronaviridae family, in lineage C of the genus Beta-coronavirus. |
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| Growth Conditions | Cell culture (Vero cells and LLC-MK2 cells) |
| Host Range | Humans, bats and dromedary camels with camels serving as the intermediate reservoir. Virus may have originated from bats and later transmitted to camels. |
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Modes of Transmission | It is a zoonotic virus and dromedary camels are considered the primary source of human infection. Human-to-human transmission infections are very limited in the general population and have mainly occurred among close contacts and in health care settings. |
| Signs and Symptoms | Ranging from asymptomatic infection to acute upper respiratory illness, and rapidly progressive pneumonitis, respiratory failure, septic shock and multi-organ failure resulting in death. Early symptoms have included high fever (>100.4°F [>38.0°C]), headache, chills, myalgia, nausea/vomiting, and diarrhea. |
| Infectious Dose | Unknown. |
| Incubation Period | Ranges from 2 to 14 days (median 5 days). |
| Prophylaxis | None available. |
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| Vaccines | Real-Time Reverse Transcriptase (RT)-PCR for use with upper and lower respiratory specimens. |
| Treatment | Depopulation of infected animals |
Surveillance | Monitor for symptoms and confirm by serological or molecular tests. |
| Emory Requirements | Report all incidents/exposures. |
| Laboratory Acquired Infections (LAIs) | No data available. |
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| Sources | No data available. |
| CDC | |
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| Government of Canada | |
| European CDC | |
| World Health Organization (WHO) | Middle East respiratory syndrome coronavirus (MERS-CoV) |
| ABSL2/BSL2 | Pathologic examination and processing of formalin-fixed or otherwise inactivated tissues; molecular analysis of extracted nucleic acid preparations. |
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| ABSL3/BSL3 | Work with MERS-CoV and other associated infectious materials should be conducted in biocontainment level 3, including all procedures involving infected animals. |
| Small | Notify others working in the lab. Allow aerosols to settle. Don appropriate PPE. Contain the spill by covering with paper towels or damming to prevent spread. Apply an appropriate disinfectant, working from the perimeter towards the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials. |
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| Large | Contain the spill, notify and evacuate others in the area, then contact Emory’s Biosafety Officer (404-357-1821) or |
| Mucous membrane | Flush eyes, mouth or nose for 15 minutes at eyewash station. |
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| Other Exposures | Wash area with soap and water for 15 minutes. |
| Reporting | Immediately report incidents to supervisor. Accidents/Exposures must be reported in H.O.M.E. via HR Self-Service portal. Emory HR website > Self-Service > Workplace Health > Report |
| Seek Medical Attention |
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| Disinfection | 0.1% sodium hypochlorite and organochlorine, 10% Iodophor, 2% glutaraldehyde, 70% ethanol |
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| Inactivation | Sensitive to heat, lipid solvents, non-ionic detergents and oxidizing agents. |
| Survival Outside Host | Remains viable at 48 hours at 20 °C and 40% relative humidity, comparable to an indoor environment on plastic and metal surfaces. In unpasteurized camel milk, MERS-CoV remains infectious beyond 72 hours after introduction to the milk. |
| Minimum PPE Requirements | At minimum, personnel are required to wear lab coat plus fluid resistant gown, double gloves, eye protection with side shields, closed-toe shoes with shoe covers, long pants/skirt, and N95 respirator. Additional PPE may be required depending on lab specific or facility specific SOPs. |
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| Additional Precautions | Due to the mode of exposure, respirator is required when working with MERS-CoV. Fit testing, medical evaluation, and training is required annually per Emory’s Respiratory Protection Program. |