Middle East Respiratory Syndrome (MERS) is an emerging viral respiratory disease that primarily affects the lungs and breathing passages. It is caused by the coronavirus MERS-CoV.† MERS was first reported in Saudi Arabia in 2012. At least 25 other countries have reported confirmed cases of MERS. So far all cases of MERS link to countries in and near the Arabian Peninsula. The disease has spread to other regions, including the United States (U.S.), Europe, and South Korea through travel-associated cases. Only two (2) patients in the U.S. have tested positive for MERS-CoV infection out of more than 500 suspected cases of MERS. Both positive cases occurred in May 2014 in individuals visiting the U.S. from Saudi Arabia.1
The most recent MERS-CoV outbreak-primarily impacting South Korea-is the largest outside the Middle East. The World Health Organization (WHO) provides up-to-date information on outbreaks of MERS on its Outbreaks and Emergencies web page.
MERS-CoV does not generally spread among the general population in areas affected by an outbreak, but is thought to spread from person to person through close contact, such as healthcare workers caring for infected patients, or people living with an infected person. There is no evidence to date of MERS-CoV spread in a sustained pattern in communities.2,3
MERS symptoms – in the majority of cases – include cough, shortness of breath, and fever. Some people may also experience gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. More severe complications such as pneumonia and kidney failure can also occur.4 Approximately 35 percent of patients infected with MERS-CoV die from the illness.5 Treatment for this viral infection is supportive based on the medical condition of the patient. No vaccine or chemoprophylaxis (e.g., an effective antiviral medicine) currently exists for MERS.
Most workers in the U.S. are unlikely to encounter MERS-CoV or individuals with MERS. People who may be at increased risk for MERS include travelers returning from the Arabian Peninsula, close contacts with an ill traveler from the Arabian Peninsula, close contacts with a confirmed case of MERS, and healthcare personnel not following recommended infection-control practices. The majority of cases in the South Korean outbreak resulted from human-to-human transmission in healthcare settings, including some cases attributable to suboptimal infection prevention and control in such facilities.6 In addition to healthcare, other sectors with some risk for exposure include laboratories, mortuaries, medical transportation and airlines.
This web page provides information about MERS-CoV and MERS for workers and employers. The web page includes sections on:
Elements of infection control for MERS-CoV, including a number of precautions for diseases for which the route(s) of transmission may be uncertain, are covered under OSHA's PPE standards, the BBP standard, as well as Section 5(a)(1) of the OSH Act of 1970, 29 USC 654(a)(1), (often referred to as the General Duty Clause).
For information on the 2019 novel coronavirus, please visit OSHA's new webpage addressing the outbreak. Guidance from this MERS Safety and Health Topics page may also be useful in protecting workers from exposure to the 2019-nCoV.
- At this time, there are no cases of MERS in the U.S. The ongoing outbreak is limited to Saudi Arabia and the United Arab Emirates (UAE). South Korea, China, Thailand, and the Philippines have experienced recent cases of MERS.
- Currently, there is minimal risk of exposure to MERS and MERS-CoV to U.S. workers. However, exposure to the virus or someone with MERS may be more likely in certain jobs, including in healthcare, medical transport, laboratories, mortuary/death care, and airline operations.
- MERS-CoV is not transmitted readily among the general population. Scientists believe the virus spreads from person-to-person through close contact, such as healthcare workers caring for infected patients or people living with an infected person.
- Employers must take steps to protect their workers from exposure to MERS-CoV on the job. OSHA has developed interim guidance to help prevent worker exposure to MERS-CoV and persons with the disease.
1 National Library of Medicine, "Middle East Respiratory Syndrome (MERS)."
2 California Department of Public Health, "Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Quicksheet".
3 WHO MERS-CoV Research Group, "State of Knowledge and Data Gaps of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Humans," PLOS Currents Outbreaks, 1 (2013).
4 Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, "Patient Under Investigation (PUI)."
5 Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, "People Who May Be at Increased Risk for MERS."
6 World Health Organization, "Summary and risk assessment of current situation in Republic of Korea and China."
7 De Groot, R.J., Baker, S.C., Baric, R.S., et al., "Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group," Journal of Virology, 87, 7790-7792 (2013).