Epidemiology of Middle East Respiratory Syndrome

This report observes the effect of the outbreak of Middle East Respiratory Syndrome among population through survey. It is transmitted from animals to human as well as from infected person to normal healthy individual. The data collected from the survey will then be analyzed.

Running head: EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
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1EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
Executive summary
Middle East Respiratory Syndrome is a communicable disease induced by coronavirus. The
purpose of this report is to observe the effect of the outbreak of the disease among population
through survey. It is transmitted from animals to human as well as from infected person to
normal healthy individual. The question in the survey will be based on symptoms, source,
prevention and treatment. To investigate the outbreak, the questionnaire will be distributed
among the areas having maximum cases of the infection. The data collected from the survey will
then be analyzed.

2EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
Table of Contents
1. Introduction..............................................................................................................................3
2. Discussion....................................................................................................................................4
2.1 Selection of the question........................................................................................................4
 Symptoms..........................................................................................................................4
 Transmission.....................................................................................................................4
 Source:..............................................................................................................................5
 Prevention and treatment..................................................................................................6
2.2 Selection of the respondents..................................................................................................6
2.3 Location to be surveyed:........................................................................................................6
2.4 Distribution of the questionnaire:..........................................................................................7
3. Conclusion...................................................................................................................................8
4. Reference.....................................................................................................................................9

3EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
Epidemiology of Middle East Respiratory Syndrome
1. Introduction
Outbreak of any disease means the sudden appearance of the contagious disease. The
disease mentioned in the report is Middle East Respiratory syndrome, which is a contagious
disease induced by coronavirus and is also known as camel flu. It is supposed to be derived from
bats and then transferred to camel. Dromedary animals, especially camel are considered as the
major host of the disease. It is a transmissible disease and is transmitted either from infected
individual to healthy individual or from animals to human (Madani, 2014). People suffering from
the outbreak has common symptoms such as fever, cough, nausea and vomiting and severe
symptoms which include pneumonia, diarrhea, renal disease and gastrointestinal problems which
if ignored can lead to death also. It is mainly occur in individual who are close contact with
infected individual or in close contact with dromedary animals (World Health Organization,
2015). To observe the effect of the outbreak, a survey was conducted based on the questionnaire
prepared. The questionnaire deals with symptoms, source, treatment and prevention of the
disease.

4EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
2. Discussion
Middle Eastern Respiratory Syndrome is a contagious viral disease caused by MERS-
CoV. It is a communicable disease which if left untreated or ignored can lead to death.
2.1 Selection of the question
MERS is an infectious disease and to investigate the outbreak of the disease, a
questionnaire is prepared. Questionnaire is prepared based on the symptoms, source,
transmission, prevention, and treatment of the syndrome.
 Symptoms
Middle East Respiratory Syndrome have some common symptoms as well as some
severe symptoms. Common symptoms include breathing complication, cough, fever, vomiting,
nausea and gastro intestinal problem. Some people with MERS have severe symptoms which
include pneumonia, diarrhea, respiratory-system failure and kidney problem. In people suffering
from cancer, lung disease, diabetes and renal complication, Middle East Respiratory Syndrome
makes the situation worse. People unaware of the symptoms tends to ignore it in the initial phase
of the syndrome which leads to further complication. Hence, in order to spread the awareness
regarding the syndrome, question based on the symptoms is selected.
 Transmission
MERS-COV is a transmissible disease and is transferred from human to human as well,
as animals to human.
Transmission of disease from infected person to healthy individual

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Disease is also transmitted from a person suffering from the syndrome to a healthy
individual, but cases regarding human to human transmission is less as compared to animal to
human transmission of the disease. From the respiratory secretions of the infected person such as
coughing, it is transmitted to a healthy individual (Bin, 2015). People in close contact with the
infected person or the people working in hospitals have higher risk of infection.
Transmission from dromedary animals to healthy individual
Dromedary animals especially camel is considered as the major host of the disease. The
risk of infection increases, if a person is in contact with domestic animals either direct or
indirect. As stated above camel is considered as major source, hence person consuming camel’s
milk, discarding their wastes and taking care of them have higher risk of infection (Azhar, 2014).
To deal with the outbreak, it is necessary for every individual to know the route of transmission.
Hence it is included in the question to spread the awareness of the disease.
 Source:
The origin of coronavirus responsible for the disease is still unclear. According to the
study conducted on the virus genome, bats are believed to be the original source and from the
bats it is transmitted to camels (Lu et al., 2013). In various countries such as Qatar, Saudi Arabia,
Egypt and Oman, MERS-CoV’s strain which is similar to human strains have been derived from
camels.
Prevention and treatment
As there is no vaccine available for the syndrome till date. Hence in order to prevent the
syndrome certain general rules should be followed. According to Madani, Althaqafi and
Alraddadi, (2014), common hygiene measures should be followed by the people visiting

6EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
markets, farms and other places having easy access to camels and other dromedary animals
frequently such da washing hands before and after touching dromedary animals, eating proper
cooked animal meat, drinking camel’s milk after boiling properly. General hygiene is also
followed in case of dealing infected person (de Wit, 2016). People suffering from disease such as
diabetes, kidney problem, lung disease and cancer should take proper care as they have high risk
of getting infected.
2.2 Selection of the respondents
MERS-CoV is mainly transmitted either from dromedary animals to healthy individual or
from infected person to normal person. For the survey, people from rural areas and the people are
in close contact with infected individual are selected as respondents. The population of rural
areas are in close contact with dromedary animals and have higher risk of infection (World
Health Organization, 2014). People who are in close contact with affected individual are also
surveyed. Major rural population are unaware of the prevention, symptoms, treatment, source
and severity of the disease. Hence to spread awareness among them, they are selected as
respondents.
2.3 Location to be surveyed:
Saudi Arabia has highest number of people suffering from the syndrome. Maximum
number of cases reported about MERS-CoV are from rural areas or from areas having more
number of dromedary animals. Hence, that areas of the Saudi Arabia are chosen for conducting
the survey to investigate the outbreak of the disease and to spread awareness as well (World
Health Organization, 2014).

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2.4 Distribution of the questionnaire:
The distribution of the questionnaire is done in two ways – online and offline. People
having access to internet are surveyed online, whereas the rural population are surveyed offline,
either by handling questionnaire to them or by asking questions face to face and recording the
response. After the survey, results are analysed based on the data obtained.

8EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
3. Conclusion
From the report it is concluded that, MERS-CoV is a contagious disease. They are mainly
transmitted either from dromedary animals to healthy individual or from infected person to
normal person. The outbreak is mainly observed in people from rural areas and the people who
are in close contact with affected individual as they have higher risk of infection. Hence the
questionnaire is prepared based on this to investigate the results of the outbreak as well as to
spread awareness among the population.

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4. Reference
Azhar, E. I., El-Kafrawy, S. A., Farraj, S. A., Hassan, A. M., Al-Saeed, M. S., Hashem, A. M., &
Madani, T. A. (2014). Evidence for camel-to-human transmission of MERS coronavirus.
New England Journal of Medicine, 370(26), 2499-2505. DOI: 10.1056/NEJMoa1401505
Bin, S. Y., Heo, J. Y., Song, M. S., Lee, J., Kim, E. H., Park, S. J., ... & Lee, I. W. (2015).
Environmental contamination and viral shedding in MERS patients during MERS-CoV
outbreak in South Korea. Clinical Infectious Diseases, 62(6), 755-760.
https://doi.org/10.1093/cid/civ1020
de Wit, E., van Doremalen, N., Falzarano, D., & Munster, V. J. (2016). SARS and MERS: recent
insights into emerging coronaviruses. Nature Reviews Microbiology, 14(8), 523.
Lu, L., Liu, Q., Du, L., & Jiang, S. (2013). Middle East respiratory syndrome coronavirus
(MERS-CoV): challenges in identifying its source and controlling its spread. Microbes
and Infection, 15(8-9), 625-629. https://doi.org/10.1016/j.micinf.2013.06.003
Madani, T. A., Althaqafi, A. O., & Alraddadi, B. M. (2014). Infection prevention and control
guidelines for patients with Middle East Respiratory Syndrome Coronavirus (MERS-
CoV) infection. Saudi medical journal, 35(8), 897-913.
Madani, T. A., Azhar, E. I., & Hashem, A. M. (2014). Evidence for camel-to-human
transmission of MERS coronavirus. N Engl J Med, 371(14), 1360.
World Health Organization. (2014). Middle East respiratory syndrome coronavirus (MERS-
CoV)–update. Saudi Medical Journal, 35(6), 633-634.

10EPIDEMIOLOGY OF MIDDLE EAST RESPIRATORY SYNDROME
World Health Organization. (2015). Middle East respiratory syndrome coronavirus (MERS-
CoV): summary of current situation, literature update and risk assessment.