High proportion of MERS-CoV shedding dromedaries at slaughterhouse with a potential epidemiological link to human cases, Qatar 2014

Farag, Elmoubasher A. B. A.; Reusken, Chantal B. E. M.; Haagmans, Bart L.; Mohran, Khaled A.; Raj, V. Stalin; Pas, Suzan D.; Voermans, Jolanda; Smits, Saskia L.; Godeke, Gert-Jan; Al-Hajri, Mohd. M.; Alhajri, Farhoud H.; Al-Romaihi, Hamad E.; Ghobashy, Hazem; El-Maghraby, Mamdouh M.; El-Sayed, Ahmed M.; Al Thani, Mohamed H. J.; Al-Marri, Salih; Koopmans, Marion P. G.

Illness associated with infection with MERS-CoV is characterized primarily by mild-to-severe respiratory $ These authors contributed equally to the manuscript. complaints, most requiring hospital admission for pneumonitis or acute respiratory distress syndrome. As of June 11, 2015, ECDC has reported 1,288 laboratoryconfirmed cases, including 498 deaths (1) . Human-to-human transmission seems limited to family and health care settings. Overall, a large proportion of MERS cases is suspected to be a result of zoonotic transmission (1) with growing evidence for dromedary camels (Camelus dromedarius) as a reservoir. MERS-CoV-specific antibodies have been detected in camels across the Middle East and the African continent, suggesting a geographically widespread distribution (2) . Analysis of an outbreak associated with a barn in Qatar found dromedaries and humans to be infected with nearly identical strains of MERS-CoV (3) and further support for camels as reservoir came from a study in Saudi Arabia (KSA) that found widespread circulation of different genetic variants of MERS-CoV in camels, with geographic clustering of human and camel MERS-CoV sequences (4) . However, few other studies provided evidence for zoonotic transmission of MERS-CoV from camels (5) . The routes of direct or indirect zoonotic transmission are yet unknown. We investigated the rate of MERS-CoV circulation in dromedaries at the slaughterhouse in Qatar, previously linked to two MERS cases in Qatar.