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).
(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