Abstract

BackgroundMiddle East respiratory syndrome coronavirus (MERS-CoV) remains a major concern for global public health. Dromedaries are the source of human zoonotic infection. MERS-CoV is enzootic among dromedaries on the Arabian Peninsula, the Middle East and in Africa. Over 70% of infected dromedaries are found in Africa. However, all known zoonotic cases of MERS have occurred in the Arabian Peninsula with none being reported in Africa.AimWe aimed to investigate serological evidence of MERS-CoV infection in humans living in camel-herding areas in Morocco to provide insights on whether zoonotic transmission is taking place.MethodsWe carried out a cross sectional seroprevalence study from November 2017 through January 2018. We adapted a generic World Health Organization MERS-CoV questionnaire and protocol to assess demographic and risk factors of infection among a presumed high-risk population. ELISA, MERS-CoV spike pseudoparticle neutralisation tests (ppNT) and plaque neutralisation tests (PRNT) were used to assess MERS-CoV seropositivity.ResultsSerum samples were collected from camel slaughterhouse workers (n = 137), camel herders (n = 156) and individuals of the general population without occupational contact with camels but living in camel herding areas (n = 186). MERS-CoV neutralising antibodies with ≥ 90% reduction of plaque numbers were detected in two (1.5%) slaughterhouse workers, none of the camel herders and one individual from the general population (0.5%).ConclusionsThis study provides evidence of zoonotic transmission of MERS-CoV in Morocco in people who have direct or indirect exposure to dromedary camels.

Highlights

  • The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging virus of great global public health concern [1,2]

  • Travel-associated cases have been reported from several countries, zoonotic MERS cases have only been reported in the Arabian Peninsula and the Middle East [2]

  • Human sera were tested for MERS-CoV IgG antibodies using a MERS-CoV S1 spike ELISA

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Summary

Introduction

The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging virus of great global public health concern [1,2]. Travel-associated cases have been reported from several countries, zoonotic MERS cases have only been reported in the Arabian Peninsula and the Middle East [2]. The reasons for the apparent absence of zoonotic MERS in Africa in spite of exposure to virus-infected dromedaries is unclear, but likely because of several factors [2]. This may be owed to genetic and phenotypic differences in virus strains circulating in Africa [8], behavioural factors relating patterns of exposure, or alternatively, that

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