Middle East respiratory syndrome coronavirus in dromedary camels: an outbreak investigation.

Bart L Haagmans1 Said H S Al Dhahiry2 Chantal B E M Reusken3 V Stalin Raj1 Monica Galiano4 Richard Myers4 Gert-Jan Godeke3 Marcel Jonges3 Elmoubasher Farag5 Ayman Diab5 Hazem Ghobashy5 Farhoud Alhajri5 Mohamed Al-Thani5 Salih A Al-Marri5 Hamad E Al Romaihi5 Abdullatif Al Khal5 Alison Bermingham4 Albert D M E Osterhaus1 Mohd M AlHajri6 Marion P G Koopmans7,8
Affiliations 8 institutions
  1. Department of Viroscience, Erasmus Medical Center, Rotterdam, Netherlands.
  2. Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
  3. Centre for Infectious Disease Research, Diagnostics and Screening, Division of Virology, National Institute for Public Health and the Environment, Bilthoven, Netherlands.
  4. Virus Reference Department, Public Health England, London, UK.
  5. Supreme Council of Health, Doha, Qatar.
  6. Supreme Council of Health, Doha, Qatar. Electronic address: [email protected].
  7. Department of Viroscience, Erasmus Medical Center, Rotterdam, Netherlands
  8. Centre for Infectious Disease Research, Diagnostics and Screening, Division of Virology, National Institute for Public Health and the Environment, Bilthoven, Netherlands. Electronic address: [email protected].

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe lower respiratory tract infection in people. Previous studies suggested dromedary camels were a reservoir for this virus. We tested for the presence of MERS-CoV in dromedary camels from a farm in Qatar linked to two human cases of the infection in October, 2013. We took nose swabs, rectal swabs, and blood samples from all camels on the Qatari farm. We tested swabs with RT-PCR, with amplification targeting the E gene (upE), nucleocapsid (N) gene, and open reading frame (ORF) 1a. PCR positive samples were tested by different MERS-CoV specific PCRs and obtained sequences were used for phylogentic analysis together with sequences from the linked human cases and other human cases. We tested serum samples from the camels for IgG immunofluorescence assay, protein microarray, and virus neutralisation assay. We obtained samples from 14 camels on Oct 17, 2013. We detected MERS-CoV in nose swabs from three camels by three independent RT-PCRs and sequencing. The nucleotide sequence of an ORF1a fragment (940 nucleotides) and a 4·2 kb concatenated fragment were very similar to the MERS-CoV from two human cases on the same farm and a MERS-CoV isolate from Hafr-Al-Batin. Eight additional camel nose swabs were positive on one or more RT-PCRs, but could not be confirmed by sequencing. All camels had MERS-CoV spike-binding antibodies that correlated well with the presence of neutralising antibodies to MERS-CoV. Our study provides virological confirmation of MERS-CoV in camels and suggests a recent outbreak affecting both human beings and camels. We cannot conclude whether the people on the farm were infected by the camels or vice versa, or if a third source was responsible. European Union projects EMPERIE (contract number 223498), ANTIGONE (contract number 278976), and the VIRGO consortium.

Supporting text Virus Host Location
Adult 71 Animals 1948 Base Sequence 52 Camelus 39 Coronavirus 92 Coronavirus Infections 171 Disease Outbreaks 170 Disease Reservoirs 149 Humans 1440 Male 224 Middle Aged 60 Molecular Sequence Data 160 Phylogeny 805 Qatar 1 Reverse Transcriptase Polymerase Chain Reaction 35 RNA, Viral 193 Sequence Analysis, RNA 13 Zoonoses 397

Evidence records

2 total
Zoonotic Surveillance
2 records · 2 evidence types
Evidence type
1 records
OVE11517
Key finding

MERS-CoV RNA was detected in nose swabs from dromedary camels on a farm in Qatar using RT-PCR and sequencing.

Virus
Host
Location
Supporting text

We tested for the presence of MERS-CoV in dromedary camels from a farm in Qatar linked to two human cases of the infection in October, 2013. We detected MERS-CoV in nose swabs from three camels by three independent RT-PCRs and sequencing.

Method
RT-PCR | sequencing
Sample type
nose swabs
Geographic raw
Qatar
Country inferred
QAT
Evidence type
1 records
OVE11518
Key finding

All sampled dromedary camels in Qatar had antibodies to MERS-CoV, including spike-binding and neutralising antibodies, indicating prior exposure.

Virus
Host
Location
Not specified
Supporting text

All camels had MERS-CoV spike-binding antibodies that correlated well with the presence of neutralising antibodies to MERS-CoV.

Method
IgG immunofluorescence assay | protein microarray | virus neutralisation assay
Sample type
serum