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Spatial association between primary Middle East respiratory syndrome coronavirus infection and exposure to dromedary camels in Saudi Arabia.
Zoonoses Public Health. 2020 06; 67(4):382-390.ZP

Abstract

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.

Authors+Show Affiliations

King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia.King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32112508

Citation

Al-Ahmadi, Khalid, et al. "Spatial Association Between Primary Middle East Respiratory Syndrome Coronavirus Infection and Exposure to Dromedary Camels in Saudi Arabia." Zoonoses and Public Health, vol. 67, no. 4, 2020, pp. 382-390.
Al-Ahmadi K, Alahmadi M, Al-Zahrani A. Spatial association between primary Middle East respiratory syndrome coronavirus infection and exposure to dromedary camels in Saudi Arabia. Zoonoses Public Health. 2020;67(4):382-390.
Al-Ahmadi, K., Alahmadi, M., & Al-Zahrani, A. (2020). Spatial association between primary Middle East respiratory syndrome coronavirus infection and exposure to dromedary camels in Saudi Arabia. Zoonoses and Public Health, 67(4), 382-390. https://doi.org/10.1111/zph.12697
Al-Ahmadi K, Alahmadi M, Al-Zahrani A. Spatial Association Between Primary Middle East Respiratory Syndrome Coronavirus Infection and Exposure to Dromedary Camels in Saudi Arabia. Zoonoses Public Health. 2020;67(4):382-390. PubMed PMID: 32112508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spatial association between primary Middle East respiratory syndrome coronavirus infection and exposure to dromedary camels in Saudi Arabia. AU - Al-Ahmadi,Khalid, AU - Alahmadi,Mohammed, AU - Al-Zahrani,Ali, Y1 - 2020/02/29/ PY - 2019/08/01/received PY - 2020/01/10/revised PY - 2020/02/11/accepted PY - 2020/3/1/pubmed PY - 2020/9/20/medline PY - 2020/3/1/entrez KW - MERS-CoV KW - Saudi Arabia KW - dromedary camels KW - epidemiology KW - geographic information system KW - zoonosis SP - 382 EP - 390 JF - Zoonoses and public health JO - Zoonoses Public Health VL - 67 IS - 4 N2 - 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. SN - 1863-2378 UR - https://www.unboundmedicine.com/medline/citation/32112508/Spatial_association_between_primary_Middle_East_respiratory_syndrome_coronavirus_infection_and_exposure_to_dromedary_camels_in_Saudi_Arabia_ L2 - https://doi.org/10.1111/zph.12697 DB - PRIME DP - Unbound Medicine ER -