Waterpipe smoking as a public health risk: Potential risk for transmission of MERS-CoV

Alagaili, Abdulaziz N.; Briese, Thomas; Amor, Nabil M.S.; Mohammed, Osama B.; Lipkin, W. Ian

We did not detect MERS-CoV RNA in waterpipe hoses in several regions within Saudi Arabia where MERS-CoV cases were recorded. We cannot, however, exclude the possibility that this failure reflects inadequate sampling. Irrespective of the negative results of our survey, the public health risk of waterpipe smoking should not be underestimated. Close contact between camel workers and individuals coming for waterpipe smoking should be investigated and evaluated. For instance, we noticed several camel transportation trucks parked outside a café during one of our field visits to Bisha (on a highway to Riyadh city). The practice amongst elderly men who smoke Jurak of sharing hoses also poses a risk of communicable diseases other than MERS-CoV. Accordingly, we recommend the replacement of resusable hoses with ''one-timeuse" hoses or consumer use of their own hoses. Close inspection to assure the appropriate cleaning and sanitization of waterpipe components (i.e. autoclaving or air drying), not only to avoid transmission of MERS-CoV but also other respiratory pathogens should also be adopted.