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Publication Details

Title :

High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia

Journal:

mBio

Impact Factor:

6.689

Authors:

Abeer N. Alshukairia, Jian Zhengb, Jingxian Zhaoc, Atef Nehdid, Salim A. Baharoone, Laila Layqahd, Ahmad Bokharif, Sameera M. Al Johanig, Nosaibah Sammand, Mohamad Boudjelald, Patrick Ten Eyckh, Maha A. Al-Mozainii, Jincun Zhaoc,j, Stanley Perlmanb,c, Abdulaziz N. Alagailik

Affiliations:

a Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudia Arabia

b Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA  

c State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China

d Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia  

e Department of Critical Care, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia  

f Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia  

g College of Science and Health Professions, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia  

h Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA  

I Department of Infection and Immunology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia  

j Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou, China  

k KSU Mammals Research Chair, Zoology Department, King Saud University, Riyadh, Kingdom of Saudi Arabia

Year of Publication:

2018

DOI:

https://doi.org/10.1128/mBio.01985-18

Abstract:

Middle East respiratory syndrome (MERS), a highly lethal respiratory disease caused by a novel coronavirus (MERS-CoV), is an emerging disease with high potential for epidemic spread. It has been listed by the WHO and the Coalition for Epidemic Preparedness Innovations (CEPI) as an important target for vaccine development. While initially the majority of MERS cases were hospital acquired, continued emergence of MERS is attributed to community acquisition, with camels likely being the direct or indirect source. However, the majority of patients do not describe camel exposure, making the route of transmission unclear. Here, using sensitive immunological assays and a cohort of camel workers (CWs) with well-documented camel exposure, we show that approximately 50% of camel workers (CWs) in the Kingdom of Saudi Arabia (KSA) and 0% of controls were previously infected. We obtained blood samples from 30 camel herders, truck drivers, and handlers with well-documented camel exposure and from healthy donors, and measured MERS-CoV-specific enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), and neutralizing antibody titers, as well as T cell responses. Totals of 16/30 CWs and 0/30 healthy control donors were seropositive by MERS-CoV-specific ELISA and/or neutralizing antibody titer, and an additional four CWs were seronegative but contained virus-specific T cells in their blood. Although virus transmission from CWs has not been formally demonstrated, a possible explanation for repeated MERS outbreaks is that CWs develop mild disease and then transmit the virus to uninfected individuals. Infection of some of these individuals, such as those with comorbidities, results in severe disease and in the episodic appearance of patients with MERS.