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			PubMed Journals: Zoonoses Public Health

  Source:		PMID: 32112508


    		Zoonoses Public Health. 2020 Feb 29. doi:
     		10.1111/zph.12697. [Epub ahead of print]

			Spatial association between primary
			Middle East respiratory syndrome
			coronavirus infection and exposure to
			dromedary camels in Saudi Arabia.

			Al-Ahmadi K(1), Alahmadi M(1), Al-Zahrani A(2).

			Author Information
			(1) King Abdulaziz City for Science and
			Technology, Riyadh, Saudi Arabia.
			(2) King Faisal Specialist Hospital and Research
			Centre, Riyadh, Saudi Arabia.

			Middle East respiratory syndrome coronavirus
			(MERS-CoV) is an emerging zoonotic disease.
			Exposure to dromedary camels (Camelus
			dromedaries) has been consistently considered
			the main source of primary human infection.
			Although Saudi Arabia reports the highest rate
			of human MERS-CoV infection and has one of
			the largest populations of dromedary camels
			worldwide, their spatial association has not yet
			been investigated. Thus, this study aimed to
			examine the correlation between the spatial
			distribution of primary MERS-CoV cases with or
			without a history of camel exposure reported
			between 2012 and 2019 and dromedary
			camels at the provincial level in Saudi Arabia. In
			most provinces, a high proportion of older men
			develop infections after exposure to camels.
			Primary human infections during spring and
			winter were highest in provinces characterized
			by seasonal breeding and calving, increased
			camel mobilization and camel-human
			interactions. A strong and significant association
			was found between the total number of
			dromedary camels and the numbers of primary
			camel-exposed and non-exposed MERS-CoV
			cases. Furthermore, spatial correlations
			between MERS-CoV cases and camel sex, age
			and dairy status were significant. Via a cluster
			analysis, we identified Riyadh, Makkah and
			Eastern provinces as having the most primary
			MERS-CoV cases and the highest number of
			camels. Transmission of MERS-CoV from
			camels to humans occurs in most primary
			cases, but there is still a high proportion of
			primary infections with an ambiguous link to
			camels. The results from this study include
			significant correlations between primary
			MERS-CoV cases and camel populations in all
			provinces, regardless of camel exposure
			history. This supports the hypothesis of the role
			of an asymptomatic human carrier or, less
			likely, an unknown animal host that has direct
			contact with both infected camels and humans.
			In this study, we performed a preliminary risk
			assessment of prioritization measures to
			control the transmission of infection from
			camels to humans.

			©2020 Blackwell Verlag GmbH.

			DOI: 10.1111/zph.12697 PMID: 32112508

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