Wednesday, November 13, 2013

ProMED - MERS-CoV - Eastern Mediterranean (85): animal reservoir, camel, susp, official

Published Date: 2013-11-12 13:01:10
Archive Number: 20131112.2051424

Date: Tue 12 Nov 2013
From: Ziad Memish <> [edited]

The Saudi Ministry of Health [MoH] continues to follow carefully all new cases of MERS-CoV diagnosed in KSA [Kingdom of Saudi Arabia] with routine contact tracing of all contacts inclusive of family contacts and HCWs [healthcare workers] who cared for the patient. On 7 Nov 2013 the Saudi MoH reported a new case: a 43-year-old male from Jeddah, who developed symptoms on 27 Oct 2013. He sought medical treatment on 3 Nov 2013. He is currently in an intensive care unit. The patient does not have any underlying chronic disease. He has no recent travel history outside of Jeddah. He had significant contact with animals but no contact with a known positive human case. To complete the investigation extensive environmental/animal contact sources were pursued. Camels owned by the patient which were symptomatic with fever and rhinorrhea were tested for MERS-CoV and tested positive.

This is the 1st time that a camel related to a case tests positive for MERS-CoV by PCR. Further testing is ongoing to sequence the patient and the camel virus and compare genetic similarity level to conclude causality.

The Saudi MoH will continue to follow the situation carefully with the Ministry of Agriculture and keep the public health community informed of any new developments.

Ziad A Memish, MD, FRCP(Can), FRCP(Edin), FRCP(Lond), FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia

[ProMED-mail is very grateful to Prof Ziad Memish for the firsthand, authoritative information above. It also adds data on the clinical signs observed in the camels owned by the human patient, as earlier requested by us. 'Rhinorrhea' is a medical term for 'runny nose' (from the Greek words "rhinos" meaning "of the nose" and "rhoia" meaning "a flowing"). The term commonly applied in veterinary medicine for such condition in animals is 'rhinitis' (in some instances, 'catarrh').

From previous, media-derived information, it appears that the tissue sampled was mucous or saliva; confirmation will help. In case the saliva includes the virus, the unpleasant habitude of camels to spit may add effectiveness and actual range to their potential role as virus disseminators.

Some perspective can be found at - Mod.AS]

[If the virus isolates are shown to be genetic matches, this will serve as the 1st confirmation of the previously suspected possibility of transmission from camels to humans.

As a reminder, the role of the camel in transmission of the MERS-CoV to humans was raised as a possibility early on in the history of this emerging disease. A Qatari national was treated in Germany for severe illness associated with MERS-CoV infection beginning in late October 2012. Investigations at that time noted that the case owned a camel and goat farm, with a number of the goats at that time noted to be ill as well as the animal caretaker (see ProMED-mail Novel coronavirus - East. Med. (07): Saudi Arabia, UK, Germany 20130221.1554109). In April 2013 there was a report of a UAE national with severe illness associated with MERS-CoV infection. This individual was the owner of racing camels. The possibility of transmission from the camels was raised at the time (see ProMED-mail Novel coronavirus - Eastern Mediterranean (15): camel exposure 20130405.1623188). We await the results of the genetic sequencing. - Mod.MPP

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