Middle East respiratory syndrome coronavirus (MERS-CoV) neutralising antibodies in a high-risk human population, Morocco, November 2017 to January 2018

Abstract

The Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging virus of great global public health concern [1,2]. From its initial recognition in 2012 in Saudi Arabia [3] to August 2019, there have been 2,468 patients with confirmed MERS-CoV infection, including 850 deaths, reported to the World Health Organization (WHO) from 27 countries [4]. Dromedary camels are known to be the source of human infection [5]. The virus is enzootic in dromedaries in the Arabian Peninsula, the Middle East, many regions of Africa, as well as Pakistan and Bangladesh. Over 70% of the global population of infected dromedaries are found in Africa, including Morocco [6,7]. Although travel-associated cases have been reported from several countries, zoonotic MERS cases have only been reported in the Arabian Peninsula and the Middle East [2]. The reasons for the apparent absence of zoonotic MERS in Africa in spite of exposure to virus-infected dromedaries is unclear, but likely because of several factors [2]. This may be owed to genetic and phenotypic differences in virus strains circulating in Africa [8], behavioural factors relating patterns of exposure, or alternatively, that MERS is not being detected because of the assumption that zoonotic MERS does not occur in Africa which may lead to a lack of testing for MERS-CoV.