Reported Direct and Indirect Contact with Dromedary Camels among Laboratory-Confirmed MERS-CoV Cases
Romy Conzade,
Rebecca Grant,
Mamunur Rahman Malik,
Amgad Elkholy,
Mohamed Elhakim,
Dalia Samhouri,
Peter K. Ben Embarek,
Maria D. Van Kerkhove
Affiliations
Romy Conzade
Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland
Rebecca Grant
Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland
Mamunur Rahman Malik
Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt
Amgad Elkholy
Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt
Mohamed Elhakim
Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt
Dalia Samhouri
Department of Country Preparedness and International Health Regulations, World Health Organization Regional Office for the Eastern Mediterranean, 11371 Cairo, Egypt
Peter K. Ben Embarek
Department of Food Safety and Zoonoses, World Health Organization, 1211 Geneva, Switzerland
Maria D. Van Kerkhove
Department of Infectious Hazard Management, Health Emergencies Programme, World Health Organization, 1211 Geneva, Switzerland
Dromedary camels (Camelus dromedarius) are now known to be the vertebrate animal reservoir that intermittently transmits the Middle East respiratory syndrome coronavirus (MERS-CoV) to humans. Yet, details as to the specific mechanism(s) of zoonotic transmission from dromedaries to humans remain unclear. The aim of this study was to describe direct and indirect contact with dromedaries among all cases, and then separately for primary, non-primary, and unclassified cases of laboratory-confirmed MERS-CoV reported to the World Health Organization (WHO) between 1 January 2015 and 13 April 2018. We present any reported dromedary contact: direct, indirect, and type of indirect contact. Of all 1125 laboratory-confirmed MERS-CoV cases reported to WHO during the time period, there were 348 (30.9%) primary cases, 455 (40.4%) non-primary cases, and 322 (28.6%) unclassified cases. Among primary cases, 191 (54.9%) reported contact with dromedaries: 164 (47.1%) reported direct contact, 155 (44.5%) reported indirect contact. Five (1.1%) non-primary cases also reported contact with dromedaries. Overall, unpasteurized milk was the most frequent type of dromedary product consumed. Among cases for whom exposure was systematically collected and reported to WHO, contact with dromedaries or dromedary products has played an important role in zoonotic transmission.
