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Antibodies Raise Surveillance Concerns
Sera from dromedary camels had a high prevalence of antibody reactive to MERS-CoV by MERS NT (93.6%) and MERS ppNT (98.2%) assay. The antibody titres ranged up to 1,280 and higher in MN assays and 10,240 and higher in ppNT assays.
The above comments from a recent Eurosurveillance paper describe results that are similar to an earlier report in Lancet Infectios Diseases on MERS related antibodies in racing camels from Oman. In that study titers and frequencies were higher in camels from Oman tan those on the Canary Island, and activity was not detected in other species. Moreover, the activity was specific for MERS-CoV. Other beta coronavirus targets (OC43 and SARS-CoV) were negative, indicating the activity was against a beta coronavirus that was closely related to MERS-CoV, which was probably MERS-CoV.
The data from Egypt ex-Sudan camels is supported by a recently released bat sequence from Bisha, Taper/CII_KSA_287/Bisha/Saudi Arabia/2012 . The bat species, Taphozous perforatus, with the MERS-CoV sequences (203 BP exact match with EMC/12), has a limited geographic range in Saudi Arabia (limited to the area around Bisha), but is much larger in Egypt and Sudan (corresponding to the regions flanking the Nile River).
Moreover, recent media reports in the familial MERS-CoV cluster in Batin indicate the index case (38M) had close contact with a symptomatic camel prior to disease onset. Similar linkage was reported for the confirmed UAE case (73M treated in Germany) as well as his untested brother (who was also symptomatic).
The recent results with camel antibodies and bat sequences suggest that MERS-CoV cases in the Middle East are much more widespread than indicated by confirmed cases, which are largely concentrated in Saudi Arabia with a limited number of cases confirmed in Jordan, Qatar, and UAE. One of the Saudi Arabia case developed symptoms while in Egypt, lending further support of MERS-CoV cases in the Middle east and northeastern Africa. Egypt, Sudan, and Oman have not reported any human cases, raising serious surveillance concerns.
The recent results highlight a need for aggressive testing of bat droppings in the Middle East, northeast Africa and western India, as well as increased testing of symptomatic camels in these areas.