[10] One review of 47 laboratory confirmed cases in Saudi Arabia gave the most common presenting symptoms as fever in 98%, cough in 83%, shortness of breath in 72% and myalgia in 32% of people.

[13] MERS can range from asymptomatic disease to severe pneumonia leading to acute respiratory distress syndrome (ARDS).

[21] A study performed between 2010 and 2013, in which the incidence of MERS was evaluated in 310 dromedary camels, revealed high titers of neutralizing antibodies to MERS-CoV in the blood serum of these animals.

In 2014, the Saudi Ministry of Agriculture advised people to avoid contact with camels or wear breathing masks when around them.

[32] According to the WHO, a probable case is:[32] In the United States, the Centers for Disease Control and Prevention (CDC) recommend investigating any person with:[33][34] Chest X-ray findings tend to show bilateral patchy infiltrates consistent with viral pneumonitis and acute respiratory distress syndrome (ARDS).

[12] Several highly sensitive, confirmatory real-time RT-PCR assays exist for rapid identification of MERS-CoV from patient-derived samples.

[35] Protocols for biologically safe immunofluorescence assays (IFA) have also been developed; however, antibodies against betacoronaviruses are known to cross-react within the genus.

[37] A more specific protein-microarray based assay has also been developed that did not show any cross-reactivity against population samples and serum known to be positive for other betacoronaviruses.

"[35] While the mechanism of spread of MERS-CoV is currently not known, based on experience with prior coronaviruses, such as SARS, the WHO currently recommends that all individuals coming into contact with MERS suspects should (in addition to standard precautions):[citation needed] For procedures which carry a risk of aerosolization, such as intubation, the WHO recommends that care providers also:[citation needed] The duration of infectivity is also unknown so it is unclear how long people must be isolated, but current recommendations are for 24 hours after resolution of symptoms.

[41] It is believed that the existing SARS research may provide a useful template for developing vaccines and therapeutics against a MERS-CoV infection.

[citation needed] A hospital-related outbreak in Riyadh in the summer of 2015 increased fears of an epidemic occurring during the annual Hajj pilgrimage that was to begin in late September.

[72][73] On 2 May 2014, the Centers for Disease Control and Prevention (CDC) confirmed the first diagnosis of MERS in the United States at Community Hospital in Munster, Indiana.

The man diagnosed was a health care worker who had been in Saudi Arabia a week earlier, and was reported to be in good condition.

[78] In May 2015, the first case in South Korea was confirmed in a man who had visited Saudi Arabia, United Arab Emirates and Bahrain.

[82][83][84][85][86][87][excessive citations] In 2018 a case was found in South Korea; the patient had recently returned from Kuwait (via Dubai).

[89] In April 2014, MERS emerged in the Philippines with a suspected case of a home-bound Overseas Filipino Worker (OFW).

Another suspected MERS-involved death in Sultan Kudarat province caused the Department of Health (DOH) to put out an alert.

[94] On 27 July 2015, the accident and emergency department at Manchester Royal Infirmary closed after two patients were treated for suspected MERS infection.

[95] The facility was reopened later that evening, and it was later confirmed by Public Health England that the two patients had tested negative for the disease.

[102] Egyptian virologist Dr. Ali Mohamed Zaki isolated and identified a previously unknown coronavirus from the lungs of a 60-year-old Saudi Arabian man with pneumonia and acute kidney injury.

[10] After routine diagnostics failed to identify the causative agent, Zaki contacted Ron Fouchier, a leading virologist at the Erasmus Medical Center (EMC) in Rotterdam, the Netherlands, for advice.

[102] On 15 September 2012, Dr. Zaki's findings were posted on ProMED-mail, the Program for Monitoring Emerging Diseases, a public health on-line forum.

[15] The United Kingdom's Health Protection Agency (HPA) confirmed the diagnosis of severe respiratory illness associated with a new type of coronavirus in a second patient, a 49-year-old Qatari man who had recently been flown into the UK.

[18] On 8 November 2012, in an article published in the New England Journal of Medicine, Dr. Zaki and co-authors from the Erasmus Medical Center published more details, including a tentative name, Human Coronavirus-Erasmus Medical Center (HCoV-EMC), the virus's genetic makeup, and closest relatives (including SARS).

[108] Five critically ill people with MERS in Saudi Arabia with acute respiratory distress syndrome (ARDS) and on ventilators were given interferon-α2b and ribavirin but all ended up dying of the disease.

[112] Researchers are investigating a number of medications, including using interferon, chloroquine, chlorpromazine, loperamide, lopinavir,[113] remdesivir and galidesivir as well as other agents such as mycophenolic acid,[114][115] camostat[116][117] and nitazoxanide.