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| ==Overview== | | ==Overview== |
| | | Symptoms of MERS-CoV typically include high-grade [[fever]], [[cough]], [[headache]], [[dyspnea]], and [[myalgia]]. Gastrointestinal symptoms such as [[diarrhea]], [[vomiting]], and [[abdominal pain]] may also be present. |
| The most common symptoms at presentation include [[fever]], with or without [[chills]] or [[rigors]], [[cough]], [[shortness of breath]], and [[myalgia]]. Gastrointestinal symptoms such as [[diarrhea]], [[vomiting]], or [[abdominal pain]] are also frequent. [[Acute kidney injury]], [[pericarditis]], and [[disseminated intravascular coagulation]] and other serious complications may occur in some cases.
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| ==History and Symptoms== | | ==History and Symptoms== |
| | *The majority of patients infected with MERS-CoV present with high-grade [[fever]], [[headache]], non-productive [[cough]], [[dyspnea]], and [[myalgia]]. |
| | *Other symptoms include [[sore throat]], [[coryza]], [[sputum]] production, [[dizziness]], [[nausea]] and [[vomiting]], [[diarrhea]], and [[abdominal pain]]. |
| | *Atypical presentations, such afebrile mild respiratory illnesses with [[diarrhea]] preceding the development of pneumonia, have been reported. |
| | ===Common Symptoms=== |
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| ===Criteria for Suspected Case of MERS-CoV Infection===
| | * Symptoms associated with MERS are non-specific, with or without multisystem involvement. |
| | **[[Fever]] (most common) |
| | **[[Cough]] |
| | **[[Hemoptysis]] |
| | **[[Dyspnea]] |
| | **[[Myalgia]] |
| | **[[Diarrhea]] |
| | **[[Sore throat]] |
| | **[[Nausea]] and [[vomiting]] |
| | **[[Chest pain]] |
| | **[[Abdominal pain]] |
| | **[[Headache]] |
| | **[[Runny nose]] |
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| {| style="border: 0px; font-size: 85%; margin: 3px;"
| | * [[Neuromuscular]] manifestations include |
| ! style="background:#4479BA; width:500px" colspan=2 | {{fontcolor|#FFF|Patients should meet the following criteria, either A or B}}
| | ** Hypersomnolence |
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| | ** [[Weakness]] |
| |style="padding: 5px 5px; background: #DCDCDC;width:250px" |'''A.''' [[ Fever]] (≥38°C, 100.4°F) and [[pneumonia]] or [[acute respiratory distress syndrome]] (based on clinical or radiological evidence)
| | ** [[Tingling]] in the extremities similar to [[Guillain-Barré syndrome]] or virus-related sensory [[neuropathy]]. |
| |style="padding: 5px 5px; background: #DCDCDC;width:250px" |'''B.''' [[Fever]] (≥38°C, 100.4°F)
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| |style="padding: 5px 5px; background: #F5F5F5; text-align:center" |''AND EITHER''
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| |style="padding: 5px 5px; background: #F5F5F5;text-align:center" |''AND''
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| |style="padding: 5px 5px; background: #DCDCDC;" | • History of travel from countries in or near the Arabian Peninsula within 14 days before symptom onset
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| |style="padding: 5px 5px; background: #DCDCDC;" | • Symptoms of respiratory illness (not necessarily pneumonia; e.g., [[cough]], [[shortness of breath]])
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| |-
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| |style="padding: 5px 5px; background: #F5F5F5;text-align:center" |''OR''
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| |style="padding: 5px 5px; background: #F5F5F5;text-align:center" |''AND''
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| |style="padding: 5px 5px; background: #DCDCDC;" | • Close contact with a symptomatic traveler who developed [[fever]] and acute [[respiratory illness]] (not necessarily [[pneumonia]]) within 14 days after traveling from countries in or near the Arabian Peninsula
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| |style="padding: 5px 5px; background: #DCDCDC;" | • Being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula in which recent healthcare-associated cases of MERS have been identified
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| |-
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| |style="padding: 5px 5px; background: #F5F5F5;text-align:center" |''OR''
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| |style="padding: 5px 5px; background: #F5F5F5;text-align:center" |
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| |-
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| |style="padding: 5px 5px; background: #DCDCDC;" | • Member of a cluster of patients with severe acute [[respiratory illness]] (e.g.[[ fever]] and [[pneumonia]] requiring hospitalization) of unknown [[etiology]] in which [[MERS-CoV]] is being evaluated, in consultation with state and local health departments
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| |style="padding: 5px 5px; background: #DCDCDC;" |
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| |style="padding: 5px 5px; background: #F5F5F5;" colspan=2|<small> Table adapted from CDC-MERS-Interim Guidance <ref>“CDC-MERS-Interim Guidance.” Accessed June 20, 2014. http://www.cdc.gov/coronavirus/mers/interim-guidance.html.</ref></small>
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| |}
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| ===Symptoms===
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| Most patients present with [[fever]], [[chills]], [[headache]], non-productive [[cough]], [[dyspnea]], and [[myalgia]]. Other symptoms can include [[sore throat]], [[coryza]], [[sputum]] production, [[dizziness]], [[nausea]] and [[vomiting]], [[diarrhea]], and [[abdominal pain]]. Atypical presentations including mild respiratory illness without [[fever]] and with [[diarrhea]] preceding the development of pneumonia have been reported. The table below describes the [[symptoms]] of [[MERS-CoV]] [[infection]].<ref name="pmid23891402">{{cite journal| author=Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A et al.| title=Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. | journal=Lancet Infect Dis | year= 2013 | volume= 13 | issue= 9 | pages= 752-61 | pmid=23891402 | doi=10.1016/S1473-3099(13)70204-4 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23891402 }} </ref>
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| {|style=" border: 0px; font-size: 90%; margin: 3px;"
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| ! style="padding: 0 5px; width: 150px; background: #4479BA; font-weight: bold;"| {{fontcolor|#FFFFFF|Symptom}}
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| ! style="padding: 0 5px; width: 50px; background: #4479BA; font-weight: bold;" | {{fontcolor|#FFFFFF|Percentage}}
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Fever]] <br> [[Fever]] with [[chills]] or [[rigors]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 98% <br> 87%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[ Cough]] <br> [[dry cough|Dry]] <br> [[productive cough|Productive]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 83% <br> 47% <br> 36%
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Hemoptysis]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 17%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Shortness of breath]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 72%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Chest Pain]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 15%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Sore throat]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 21%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Runny nose]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 4%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Abdominal Pain]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 17%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Nausea]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 21%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Vomiting]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 21%
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Diarrhoea]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 26%
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| | style="padding: 0 5px; background: #DCDCDC;" | [[ Myalgia]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 32%
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| |-
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| | style="padding: 0 5px; background: #DCDCDC;" | [[Headache]]
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| | style="padding: 0 5px; background: #F5F5F5;" | 13%
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| |}
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| ==References== | | ==References== |
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| [[Category:Disease]] | | [[Category:Disease]] |
| [[Category:Infectious disease]]
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| [[Category:Virology]] | | [[Category:Virology]] |
| [[Category:Up-To-Date]] | | [[Category:Up-To-Date]] |