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Commentary
Batin KSA Camel
Contact Raises Surveillance Concerns
Recombinomics
Commentary 03:00
September 10, 2013
The patient owned racing camels. One of them got ill and was very weak; the patient was in close contact with that camel, and on the evening the camel got very sick, the patient developed flulike symptoms. Three days later, he was in a medical unit in Abu Dhabi. There is another family member who also had close contact with the camel, he also got ill, but we could not follow up with that gentleman.
The above translation (in red) describes the exposure of the Batin index case (38M) to a symptomatic camel prior to disease onset. The above comments (in blue) describe the exposure of a UAE (73M) case to another symptomatic camel (full sequence here). Both of these cases were fatal. A relative of the UAE case also developed symptoms after exposure, but he refused testing.
These cases support recent papers citing high titer and high frequency of MERS antibodies in racing camel in Oman as well as camels in Egypt imported from Sudan for slaughter. The camel samples in Egypt were from two geographically distinct regions. The antibody activity was specific for a MERS target and was not detected when other beta coronaviruses (OC43 and SARS) were used as targets.
Although comments from KSA MoH noted a novel immune system in camels, an explanation for the MERS activity in absence of activity for OC43 and SARS was not forthcoming. The MERS antibodies raised serious surveillance concerns since no human MERS cases have been reported in Egypt, Sudan, or Oman, and as noted above, cases in UAE and KSA developed symptoms after contact with symptomatic camels.
Aggressive testing of camels in the Middle East and northeastern Africa for MERS-CoV sequences is long overdue.
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