Risk Factors for MERS-CoV Seropositivity among Animal Market and Slaughterhouse Workers, Abu Dhabi, United Arab Emirates, 2014–2017

Camel contact is a recognized risk factor for Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Because specific camel exposures associated with MERS-CoV seropositivity are not fully understood, we investigated worker–camel interactions and MERS-CoV seroprevalence. We assessed worker seroprevalence in 2 slaughterhouses and 1 live-animal market in Abu Dhabi, United Arab Emirates, during 2014–2017 and administered an epidemiologic survey in 2016 and 2017. Across 3 sampling rounds during 2014–2017, we sampled 100–235 workers, and 6%–19% were seropositive for MERS-CoV at each sampling round. One (1.4%) of 70 seronegative workers tested at multiple rounds seroconverted. On multivariable analyses, working as a camel salesman, handling live camels or their waste, and having diabetes were associated with seropositivity among all workers, whereas handling live camels and either administering medications or cleaning equipment was associated with seropositivity among market workers. Characterization of high-risk exposures is critical for implementation of preventive measures.

[1]  Dewi Murniati,et al.  Middle East respiratory syndrome coronavirus (MERS-CoV) , 2017, Saudi Medical Journal.

[2]  P. T. Ten Eyck,et al.  High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia , 2018, mBio.

[3]  R. Webby,et al.  MERS coronaviruses from camels in Africa exhibit region-dependent genetic diversity , 2018, Proceedings of the National Academy of Sciences.

[4]  M. Shi,et al.  Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE , 2017, Zoonoses and public health.

[5]  M. Nsour,et al.  Inclusion of MERS‐spike protein ELISA in algorithm to determine serologic evidence of MERS‐CoV infection , 2017, Journal of medical virology.

[6]  P. T. Ten Eyck,et al.  Recovery from the Middle East respiratory syndrome is associated with antibody and T cell responses , 2017, Science Immunology.

[7]  Kyoung-Ho Song,et al.  MERS-CoV Antibody Responses 1 Year after Symptom Onset, South Korea, 2015 , 2017, Emerging infectious diseases.

[8]  M. Koopmans,et al.  Risk Factors for Primary Middle East Respiratory Syndrome Coronavirus Infection in Camel Workers in Qatar During 2013–2014: A Case-Control Study , 2017, The Journal of infectious diseases.

[9]  V. Chevalier,et al.  Risk factors for MERS coronavirus infection in dromedary camels in Burkina Faso, Ethiopia, and Morocco, 2015 , 2017, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[10]  M. Shi,et al.  Diversity of Middle East respiratory syndrome coronaviruses in 109 dromedary camels based on full-genome sequencing, Abu Dhabi, United Arab Emirates , 2017, Emerging microbes & infections.

[11]  Geethamma Jolly,et al.  Middle East Respiratory Syndrome Coronavirus (MERS-CoV) , 2016 .

[12]  Z. Memish,et al.  Middle East Respiratory Syndrome Coronavirus (MERS-CoV) origin and animal reservoir , 2016, Virology Journal.

[13]  J. Joh,et al.  Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea , 2016, Infection & chemotherapy.

[14]  Mohammad A. Almazroa,et al.  Risk Factors for Primary Middle East Respiratory Syndrome Coronavirus Illness in Humans, Saudi Arabia, 2014 , 2016, Emerging infectious diseases.

[15]  L. Poon,et al.  Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels in Nigeria, 2015. , 2015, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[16]  Z. Memish,et al.  Middle East respiratory syndrome coronavirus (MERS-CoV): animal to human interaction , 2015, Pathogens and global health.

[17]  B. Bosch,et al.  Occupational Exposure to Dromedaries and Risk for MERS-CoV Infection, Qatar, 2013–2014 , 2015, Emerging infectious diseases.

[18]  Tiaji Salaam-Blyther.  Middle East Respiratory Syndrome (MERS-CoV): World Health Organization Responses , 2015 .

[19]  V. Corman,et al.  Acute Middle East Respiratory Syndrome Coronavirus Infection in Livestock Dromedaries, Dubai, 2014 , 2015, Emerging infectious diseases.

[20]  Victor M Corman,et al.  Presence of Middle East respiratory syndrome coronavirus antibodies in Saudi Arabia: a nationwide, cross-sectional, serological study , 2015, The Lancet Infectious Diseases.

[21]  Mohammed F. Yusof,et al.  Prevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels in Abu Dhabi Emirate, United Arab Emirates , 2015, Virus Genes.

[22]  M. Koopmans,et al.  High proportion of MERS-CoV shedding dromedaries at slaughterhouse with a potential epidemiological link to human cases, Qatar 2014 , 2015, Infection ecology & epidemiology.

[23]  B. Bosch,et al.  Antibodies against MERS Coronavirus in Dromedary Camels, Kenya, 1992–2013 , 2014, Emerging infectious diseases.

[24]  B. Bosch,et al.  Geographic Distribution of MERS Coronavirus among Dromedary Camels, Africa , 2014, Emerging infectious diseases.

[25]  Y. Guan,et al.  MERS Coronavirus in Dromedary Camel Herd, Saudi Arabia , 2014, Emerging infectious diseases.

[26]  B. Bosch,et al.  Middle East respiratory syndrome coronavirus (MERS-CoV) RNA and neutralising antibodies in milk collected according to local customs from dromedary camels, Qatar, April 2014. , 2014, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[27]  Martin Beer,et al.  Human Infection with MERS Coronavirus after Exposure to Infected Camels, Saudi Arabia, 2013 , 2014, Emerging infectious diseases.

[28]  B. Bosch,et al.  Antibodies against MERS Coronavirus in Dromedary Camels, United Arab Emirates, 2003 and 2013 , 2014, Emerging infectious diseases.

[29]  J. Epstein,et al.  Middle East Respiratory Syndrome Coronavirus Infection in Dromedary Camels in Saudi Arabia , 2014, mBio.

[30]  Marion P G Koopmans,et al.  Middle East respiratory syndrome coronavirus in dromedary camels: an outbreak investigation , 2013, The Lancet Infectious Diseases.

[31]  Z. Memish,et al.  Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study , 2013, The Lancet Infectious Diseases.

[32]  A. Osterhaus,et al.  Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. , 2012, The New England journal of medicine.