Middle East respiratory syndrome (MERS): symptoms, risk and travel advice

Middle East respiratory syndrome is caused by a coronavirus called MERS-CoV. The UK Health Security Agency (UKHSA) describes it as a viral respiratory disease that was first identified in Saudi Arabia and Jordan in 2012. The virus circulates in dromedary camels across the Middle East, parts of Africa, and South and Central Asia, and camels usually show no symptoms when infected.

Since 2012, UKHSA reports that more than 2,600 laboratory-confirmed human cases have been notified to the World Health Organization, and around 84% of them were reported by Saudi Arabia. Cases outside the Middle East, including in the UK, have been sporadic and have typically been found in people who had travelled from the Middle East.

It helps to keep the scale in mind. UKHSA says the number of human cases reported per year globally has fallen to the lowest level since 2014, and between January 2025 and 29 April 2026 it counted 19 human cases, 17 from Saudi Arabia and 2 from France in people who had travelled to the Middle East. MERS remains a condition that UK health services stay alert to, rather than one that most people will ever encounter.

The NHS explains that MERS usually spreads from contact with infected camels. That includes touching them, being bitten, eating camel meat or drinking camel milk, and eating or drinking things that have been in contact with camel spit, urine or faeces. UKHSA adds that infection can follow direct contact with infected camels or indirect contact through handling or consuming raw camel products such as meat, milk and urine.

Human-to-human spread is possible but limited. UKHSA says it has been documented in people with close household contact with cases and in healthcare workers looking after them, and that evidence suggests transmission from mild cases is limited. Hospital outbreaks have been reported in Saudi Arabia, the United Arab Emirates and the Republic of Korea. In the UK, UKHSA notes that transmission between family members has occurred but was limited by effective public health measures.

The NHS lists the main symptoms as a high temperature (or feeling hot, cold or shivery), a cough, and shortness of breath or difficulty breathing. You may also have diarrhoea, feel or be sick, or have muscle aches and chills. UKHSA says the illness ranges from mild to severe respiratory disease and that some infections cause no symptoms at all, while others progress to severe pneumonia, acute respiratory distress syndrome and multi-organ failure.

Because these symptoms resemble many ordinary chest infections, the travel history is the key clue. The NHS advises asking for an urgent GP appointment or calling NHS 111 if you have recently travelled to an area where there is a risk of MERS, or have been in close contact with someone who has, and you think you might have it. Tell anyone you speak to about your travel and any contact with camels. If you become unwell while abroad, the NHS says to get medical help as soon as possible rather than waiting until you are back in the UK.

• Call 999 if you have severe difficulty breathing, such as gasping, choking or being unable to get words out.

• Call 999 if your skin, lips or tongue are pale, blue or blotchy (on brown or black skin this may be easier to see on the palms or soles).

• Call 999 if you suddenly feel confused, for example not knowing where you are.

• Do not drive yourself to A&E; the 999 call handler will advise what to do.

UKHSA explains that the symptoms resemble many other acute respiratory infections, so clinical diagnosis relies on identifying relevant travel history and risk factors. Laboratory confirmation is by a PCR test for viral genetic material (RNA), carried out in the UK by some NHS laboratories and the UKHSA Clinical Network Laboratories.

UKHSA also stresses early identification: prompt testing, communication with local health protection teams and rapid infection control measures for people who meet the possible case definition. For the person affected, this usually means a suspected case is assessed separately from other patients while results are awaited.

UKHSA says there are no specific antiviral treatments for MERS-CoV and that care is supportive. The NHS describes the same approach: medicine to lower a temperature or ease pain, and help with breathing, usually in isolation in hospital because the illness can be life-threatening.

UKHSA reports that death has occurred in 36% of MERS-CoV cases reported to date, and that severe disease and death are more likely in older adults with chronic health conditions such as diabetes, lung, cardiovascular or renal disease, and cancer. That figure reflects reported cases worldwide, many of them in hospital outbreaks, and should not be read as the risk for an individual traveller, which UKHSA describes as very low.

With no vaccine available, prevention depends on avoiding exposure. The NHS advice for travellers to affected areas is to avoid contact with camels, including touching and riding them, and to avoid farms, barns or market areas where camels are regularly kept. It also advises washing hands with soap and warm water, especially before or after touching camels or visiting such areas.

On food and drink, the NHS says not to eat raw or undercooked camel meat, not to drink unpasteurised camel milk or eat products made with it, and not to touch or go near sick animals. Food that may have come into contact with camels should only be eaten if well cooked, or washed and peeled yourself. UKHSA gives similar advice and adds that travellers should avoid any type of raw milk or raw milk product, and should follow local health authority advice; there are currently no travel restrictions.

UKHSA also says that travellers developing fever and cough within 14 days of travel from the Middle East should seek medical advice and report their travel history so that appropriate assessment, infection control and testing can take place. It notes that cases have been imported to other countries after return from Umrah, a separate pilgrimage that can be made throughout the year. The NHS directs travellers to the TravelHealthPro website for country-specific advice.

A suspected case of MERS is managed through the NHS and public health system rather than as a routine private appointment, because testing, isolation and contact tracing involve UKHSA and local health protection teams. If you are worried after travel, your first step is a GP or NHS 111 call, saying clearly where you have been.

Private travel clinics can give general pre-travel advice, and many people use them to check vaccinations for their destination. They cannot offer a vaccine for MERS because none exists. For anyone who becomes unwell with fever, cough or breathlessness after travel to the Middle East, the NHS route described above applies whichever sector you normally use.