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

In Saudi Arabia, in response to recent government regulations, cafés providing waterpipe smoking have been moved to areas outside city limits that frequently place them close to camels markets (i.e. Riyadh). Herein, our interest focused on waterpipe cafés in general, with a special emphasis on cafés close to camels markets. These cafés attract people visiting camels market, camels' market workers and owners who prefer to accompany their friends for a waterpipe smoking. Importantly, it should be noted that waterpipes and hoses are generally reused by other smoking customers at the same night and even shared between friends during the same visit to a café. Furthermore, the use of cold water in the water chamber for a cold air flow may facilitate the survival of viruses and bacteria. Here we report a surveillance study wherein waterpipe hoses throughout several regions in Saudi Arabia were tested for the presence of MERS-CoV to find out whether waterpipe smoking can be a risk factor for MERS CoV transmission. To our knowledge, this is the first study of this kind.