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  • Health authorities in the UK and other countries are warning World Cup fans to be aware of the symptom of MERS.
  • MERS is a viral disease that can cause respiratory issues.
  • The disease is endemic to camels in certain Middle Eastern countries.

The FIFA World Cup in Qatar has brought together hundreds of thousands of people to see soccer’s greatest competition.

Amid the revelry, some health experts are warning about the possibility of a virus being spread among the crowd.

That condition is called Middle East respiratory syndrome (MERS).

MERS is a type of coronavirus that is associated most commonly with exposure to camels and their byproducts like meat and milk.

The disease was first identified in 2012.

Unlike SARS-CoV-2 the coronavirus that causes COVID-19, MERS has not spread widely across the globe in a pandemic.

The number of cases worldwide is recorded at 2,600 since it was first discovered and that includes the 185 confirmed cases found in South Korea in the summer of 2015, according to the Lancet.

While warnings have gone out from a number of countries with larger World Cup fan contingents, like Australia and the UK, Dr. Robert Almer, of New York Medical College, says that those who have traveled to the area, or who have been in contact with someone who has, should be aware of their risks of infection and how they can best communicate those concerns to their medical provider.

“If you experience these flu-like symptoms, and you’ve recently returned from a trip in the Arabian Peninsula countries you certainly should be prompted to seek at least initial medical attention and mention your travel history.”
The CDC does have guidelines for medical practitioners who are looking to test for MERS and the US does have testing capabilities.

It is unlikely to spread widely in the U.S. and the CDC has only officially reported two cases in the US, both in 2014.

Dr. Dele Ogunseitan, PhD, a professor at the University of California-Irvine and current visiting professor at Stanford’s Center for Innovation in Global Health, says that the World Cup coincided with a camel festival which has worried some in public health that there could be an increased risk of MERS.

“It’s kind of endemic in the[camel] population in the Middle East. And so when you have this festival that brings soccer fans from all over the world, at the same time, in the same country, as a camel showcase festival; physicians, and global health security people should be concerned.”

Symptoms of the viral disease include:

  • Shortness of breath
  • Fever
  • Cough
  • Diarrhea
  • Nausea/vomiting

The CDC reports that about 3 to 4 out of 10 people with MERS have died.

Between the relatively small number of cases, the difficulty of transmission between people, and no currently reported US cases connected to the World Cup, Dr. Brian Labus, PhD, of the University of Nevada-Las Vegas School of Public Health, says that the general public should not fear MERS at this stage.

“There have been about 2600 cases in the 10 years that we’ve known about it and there have only been a handful of cases total this year. So this is a really rare disease. It’s not something that would be the first thing you would think about if you saw somebody with a respiratory illness, especially given how common things like RSV, and COVID, and influenza are right now.”

With MERS sharing a common link with COVID-19, it’s fair to ask how the two compare.

Dr. William Haseltine, PhD who has worked in infectious disease for more than 40 years and is now chair and president of ACCESS Health International, says that MERS teaches us just how deadly COVID can become if left unchecked.

“We’re at a high risk of COVID mutations to become more deadly. The lesson from MERS is how deadly these viruses can be.”

Having said that, his suggestion for reducing risk is simple if you’re traveling to an area where MERS is more common.

“I would advise people who are going to [the] FIFA [World Cup] to stay away from camels. But other than that, it’s very unlikely they’ll contract it.”

With the advent of an ongoing pandemic, Ogunseitan says that we can now deploy the same risk mitigation strategies we’re using to decrease the spread of COVID-19.

“MERS was very scary in 2012. And it’s still scary because it’s more deadly, as far as we know. than COVID. But people are more aware of the hygienic practices that can prevent COVID and so there is more awareness, but probably a little bit more fatigue about all those hygienic practices.”

While there is no vaccine that can be taken to prevent contracting MERS, avoiding raw camel milk and meat is the most commonly cited way to prevent initial transmission. While person-to-person transfer is rare, those who have traveled to the areas at higher risk should be aware of their close contacts as well as their symptoms.

Amler said that the main focus when treating MERS is to treat the symptoms of the disease.

“We know how to manage a cough,” Amler said. “And we know people who have shortness of breath may sometimes need some respiratory support, we would call that ventilatory support, meaning they might need a little bit of oxygen.”

Research published in the Pan African Medical Journal in 2020 found that MERS was more likely to cause kidney issues than other coronaviruses and Amler also says that keeping patients hydrated, particularly if they’re experiencing symptoms like diarrhea is key to caring for those who have the virus.