MERS-CoV spillover at the camel-human interface

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic virus from camels causing significant mortality and morbidity in humans in the Arabian Peninsula. The epidemiology of the virus remains poorly understood, and while case-based and seroepidemiological studies have been employed extensively throughout the epidemic, viral sequence data have not been utilised to their full potential. Here, we use existing MERS-CoV sequence data to explore its phylodynamics in two of its known major hosts, humans and camels. We employ structured coalescent models to show that long-term MERS-CoV evolution occurs exclusively in camels, whereas humans act as a transient, and ultimately terminal host. By analysing the distribution of human outbreak cluster sizes and zoonotic introduction times, we show that human outbreaks in the Arabian peninsula are driven by seasonally varying zoonotic transfer of viruses from camels. Without heretofore unseen evolution of host tropism, MERS-CoV is unlikely to become endemic in humans.

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

“…A retrospective study 27 29 In 2014, the nosocomial outbreaks in Abu Dhabi, United Arab Emirates, 50 were due to the spread of MERS-CoV in health-care settings, predominantly occurring well before MERS-CoV infections were recognised and diagnosed. The rapid spread was attributed to poor compliance among health-care workers with wearing personal protection equipment while interacting with patients and application of AGPs, including intubation, manual ventilation before intubation, nebulised medications, and oxygen therapy.…”

Genetic diversity of MERS-CoV spike protein gene in Saudi Arabia

“…Additionally, the zoonotic introduction time and seasons play an important role in the disease spread. Based on the analysis of the distribution of human outbreak cluster size, it has also been demonstrated that the time of zoonotic introduction and season plays a significant role in human outbreak driven by MERS-CoV in Arabian Peninsula [22]. The MERS-CoV is known to have genetic diversity.…”

Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV

“…MERS-CoV is endemic in camels, the zoonotic reservoir host, with evidence of infection going back at least 30 years 2 . Camels in the Middle East and perhaps in East Africa continue to seed human infections which may require hospitalization especially in aged individuals with preexisting comorbidities 1,3,4 . Similar to severe acute respiratory syndrome CoV (SARS-CoV), MERS-CoV has spread to over 27 countries via air travel of infected people 5 .…”