#Risk #Factors for #MERS-CoV #Seropositivity among #Animal #Market and #Slaughterhouse #Workers, Abu Dhabi, #UAE, 2014–2017 (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 5—May 2019 / Research

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

Ahmed Khudhair1, Marie E. Killerby1  , Mariam Al Mulla, Kheir Abou Elkheir, Wassim Ternanni, Zyad Bandar, Stefan Weber, Mary Khoury, George Donnelly, Salama Al Muhairi, Abdelmalik I. Khalafalla, Suvang Trivedi, Azaibi Tamin, Natalie J. Thornburg, John T. Watson, Susan I. Gerber, Farida Al Hosani1, and Aron J. Hall1

Author affiliations: Abu Dhabi Department of Health, Abu Dhabi, United Arab Emirates (A. Khudhair, M. Al Mulla, K.A. Elkheir, W. Ternanni, Z. Bandar, F. Al Hosani); Sheikh Khalifa Medical City, Abu Dhabi (M.E. Killerby, S. Weber, M. Khoury, G. Donnelly); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.E. Killerby, S. Trivedi, A. Tamin, N.J. Thornburg, J.T. Watson, S.I. Gerber, A.J. Hall); Abu Dhabi Food Control Authority, Abu Dhabi (S. Al Muhairi, A.I. Khalafalla)

 

Abstract

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. 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 combined with 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.

Keywords: MERS-CoV; Human; Camels; Seroprevalence; UAE.

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#Serologic follow-up of #MERS #Coronavirus #Cases and #Contacts – Abu Dhabi, #UAE (Clin Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Clin Infect Dis. 2018 Jun 13. doi: 10.1093/cid/ciy503. [Epub ahead of print]

Serologic follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts – Abu Dhabi, United Arab Emirates.

Al Hosani FI1, Kim L2,3, Khudhair A1, Pham H2, Al Mulla M1, Al Bandar Z1, Pradeep K1, Elkheir KA1, Weber S4, Khoury M4, Donnelly G4, Younis N1, El Saleh F1, Abdalla M1, Imambaccus H4, Haynes LM2, Thornburg NJ2, Harcourt JL2, Miao C2, Tamin A2, Hall AJ2, Russell ES5, Harris AM3,5, Kiebler C5, Mir RA6, Pringle K2,5, Alami NN5, Abedi GR2, Gerber SI2.

Author information: 1 Department of Health – Abu Dhabi, Abu Dhabi, United Arab Emirates. 2 Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3 United States Public Health Service, Commissioned Corps, Rockville, Maryland, USA. 4 Sheikh Khalifa Medical Laboratory, Abu Dhabi, United Arab Emirates. 5 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA. 6 Division of Health Informatics and Surveillance, Centers for Disease Control and Prevention, Atlanta, GA, USA.

 

Abstract

BACKGROUND:

Although there is evidence of person-to-person transmission of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent that disease severity affects transmission.

METHODS:

A sero-epidemiological investigation was conducted among Middle East Respiratory Syndrome Coronavirus (MERS-CoV) case-patients and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. Cases diagnosed between January 1, 2013-May 9, 2014 and their household contacts were approached for enrollment. Demographic, clinical, and exposure history data were collected. Sera were screened by MERS-CoV nucleocapsid protein (N) ELISA and indirect immunofluorescence, with results confirmed by microneutralization assay.

RESULTS:

Ninety-one percent (n=31/34) of case-patients were asymptomatic or mildly symptomatic and did not require oxygen during hospitalization. MERS-CoV antibodies were detected in 13 of 24 (54%) cases with available sera, including 3 asymptomatic, 9 mildly symptomatic, and 1 severely symptomatic case-patient. No serologic evidence of MERS-CoV transmission was found among 105 household contacts with available sera.

CONCLUSIONS:

Transmission of MERS-CoV was not documented in this investigation of mostly asymptomatic and mildly symptomatic cases and their household contacts. These results have implications for clinical management of cases and formulation of isolation policies to reduce the risk of transmission.

PMID: 29905769 DOI: 10.1093/cid/ciy503

Keywords: MERS-CoV; UAE; Seroprevalence.

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#CCHF in #Dubai, #UAE, 2010: Case #Report (Iran Red Crescent Med J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Iran Red Crescent Med J. 2016 Jul 27;18(8):e38374. eCollection 2016.

Crimean-Congo Hemorrhagic Fever in Dubai, United Arab Emirates, 2010: Case Report.

Mohamed Al Dabal L1, Rahimi Shahmirzadi MR1, Baderldin S2, Abro A1, Zaki A2, Dessi Z1, Al Eassa E1, Khan G3, Shuri H1, Alwan AM1.

Author information: 1Infectious Diseases and Microbiology Units, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates. 2Virology laboratory, Dr. Sulaiman Faqih Hospital, Jeddah, Kingdom of Saudi Arabia. 3Department of Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.

 

Abstract

INTRODUCTION:

Crimean-Congo hemorrhagic fever (CCHF) is a severe infectious disease that is not endemic in the United Arab Emirates (UAE).

CASE PRESENTATION:

We report two cases of confirmed CCHF diagnosed in Dubai, UAE, during Hajj season 2010. Both patients presented with an acute history of high-grade fever, skin rash, and hematemesis.

CONCLUSIONS:

In spite of maximal supportive measures and intravenous ribavirin therapy, both patients died within a few days from start of illness. More than 250 health care workers came into variable degrees of contact with the index cases, and none of them developed signs or symptoms suggestive of acquiring the illness. Health care workers from nonendemic regions should be aware of zoonotic hemorrhagic fevers imported via infected cattle and ticks and be able to diagnose and properly manage suspected cases in a timely manner. In addition, proper infection-control measures should be undertaken to prevent nosocomial spread of infection.

KEYWORDS: CCHF; Health Care Workers; Infection Control; UAE

PMID: 27795839 DOI: 10.5812/ircmj.38374

[PubMed – in process]

Keywords: CCHF; UAE.

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#Epidemiological #investigation of #MERS-CoV in dromedary #camel #farms linked with #human #infection in Abu Dhabi Emirate, #UAE (Virus Genes, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Virus Genes. 2016 Jun 29. [Epub ahead of print]

Epidemiological investigation of Middle East respiratory syndrome coronavirus in dromedary camel farms linked with human infection in Abu Dhabi Emirate, United Arab Emirates.

Muhairi SA1, Hosani FA2, Eltahir YM3, Mulla MA2, Yusof MF4, Serhan WS4, Hashem FM4, Elsayed EA5, Marzoug BA5, Abdelazim AS5.

Author information: 1Veterinary Laboratories Division, Animal Wealth Sector, Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates. salama.almuhairi@adfca.ae. 2Department of Communicable Diseases, Public Health and Research, Abu Dhabi Health Authority, Abu Dhabi, United Arab Emirates. 3Epidemiology Section, Animal Wealth Sector, Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates. 4Veterinary Laboratories Division, Animal Wealth Sector, Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates. 5Veterinary services Section, Animal Wealth Sector, Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates.

 

Abstract

The objective of this research was to investigate the prevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) infection primarily in dromedary camel farms and the relationship of those infections with infections in humans in the Emirate of Abu Dhabi. Nasal swabs from 1113 dromedary camels (39 farms) and 34 sheep (1 farm) and sputum samples from 2 MERS-CoV-infected camel farm owners and 1 MERS-CoV-infected sheep farm owner were collected. Samples from camels and humans underwent real-time reverse-transcription quantitative PCR screening to detect MERS-CoV. In addition, sequencing and phylogenetic analysis of partially characterized MERS-CoV genome fragments obtained from camels were performed. Among the 40 farms, 6 camel farms were positive for MERS-CoV; the virus was not detected in the single sheep farm. The maximum duration of viral shedding from infected camels was 2 weeks after the first positive test result as detected in nasal swabs and in rectal swabs obtained from infected calves. Three partial camel sequences characterized in this study (open reading frames 1a and 1ab, Spike1, Spike2, and ORF4b) together with the corresponding regions of previously reported MERS-CoV sequence obtained from one farm owner were clustering together within the larger MERS-CoV sequences cluster containing human and camel isolates reported for the Arabian Peninsula. Data provided further evidence of the zoonotic potential of MERS-CoV infection and strongly suggested that camels may have a role in the transmission of the virus to humans.

KEYWORDS: Dromedary camel; Middle East respiratory syndrome coronavirus; Zoonosis

PMID: 27357298 DOI: 10.1007/s11262-016-1367-1

[PubMed – as supplied by publisher]

Keywords: Research; Abstracts; MERS-CoV; Camels; Human; UAE.

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#Response to #Emergence of #MERS #Coronavirus, Abu Dhabi, #UAE, 2013–2014 (@CDC_EIDjournal, abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases  Journal, full page: (LINK). Abstract, edited.]

Volume 22, Number 7—July 2016 / Synopsis

Response to Emergence of Middle East Respiratory Syndrome Coronavirus, Abu Dhabi, United Arab Emirates, 2013–2014

Farida Ismail Al Hosani1, Kimberly Pringle1, Mariam Al Mulla, Lindsay Kim, Huong Pham, Negar N. Alami, Ahmed Khudhair, Aron Hall, Bashir Aden, Feda El Saleh, Wafa Al Dhaheri, Zyad Al Bandar, Sudhir Bunga, Kheir Abou Elkheir, Ying Tao, Jennifer C. Hunter, Duc Nguyen, Andrew Turner, Krishna Pradeep, Jurgen Sasse, Stefan Weber, Suxiang Tong, Brett L. Whitaker, Lia M. Haynes, Aaron Curns, and Susan I. Gerber

Author affiliations: Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates (F.I. Al Hosani, M. Al Mulla, A. Khudhair, B. Aden, F. El Saleh, W. Al Dhaheri, Z. Al Bandar, K. Abou Elkheir, A. Turner, K. Pradeep); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Pringle, L. Kim, H. Pham, N.N. Alami, A. Hall, S. Bunga, Y. Tao, J.C. Hunter, D. Nguyen, S. Tong, B.L. Whitaker, L.M. Haynes, A. Curns, S.I. Gerber); Sheikh Khalifa Medical Laboratory, Abu Dhabi (J. Sasse, S. Weber).

 

Abstract

In January 2013, several months after Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia, Abu Dhabi, United Arab Emirates, began surveillance for MERS-CoV. We analyzed medical chart and laboratory data collected by the Health Authority–Abu Dhabi during January 2013–May 2014. Using real-time reverse transcription PCR, we tested respiratory tract samples for MERS-CoV and identified 65 case-patients. Of these patients, 23 (35%) were asymptomatic at the time of testing, and 4 (6%) showed positive test results for >3 weeks (1 had severe symptoms and 3 had mild symptoms). We also identified 6 clusters of MERS-CoV cases. This report highlights the potential for virus shedding by mildly ill and asymptomatic case-patients. These findings will be useful for MERS-CoV management and infection prevention strategies.

Keywords: Research; Abstracts; MERS-CoV; UAE.

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#Clinicopathologic, #Immunohistochemical, and #Ultrastructural #Findings of a Fatal Case of #MERS-CoV #Infection in #UAE, April 2014 (Am J Pathol., abstract)

[Source: American Journal of Pathology, full page: (LINK). Abstract, edited.]

Clinicopathologic, Immunohistochemical, and Ultrastructural Findings of a Fatal Case of Middle East Respiratory Syndrome Coronavirus Infection in United Arab Emirates, April 2014 [      ]

Dianna L. Ng, Farida Al Hosani, M. Kelly Keating, Susan I. Gerber, Tara L. Jones, Maureen G. Metcalfe, Suxiang Tong, Ying Tao, Negar N. Alami, Lia M. Haynes, Mowafaq Ali Mutei, Laila Abdel-Wareth, Timothy M. Uyeki, David L. Swerdlow, Maha Barakat, Sherif R. Zaki

DOI: http://dx.doi.org/10.1016/j.ajpath.2015.10.024

Published Online: February 05, 2016Accepted: October 30, 2015

 

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) infection causes an acute respiratory illness and is associated with a high case fatality rate; however, the pathogenesis of severe and fatal MERS-CoV infection is unknown. We describe the histopathologic, immunohistochemical, and ultrastructural findings from the first autopsy performed on a fatal case of MERS-CoV in the world, which was related to a hospital outbreak in the United Arab Emirates in April 2014. The main histopathologic finding in the lungs was diffuse alveolar damage. Evidence of chronic disease, including severe peripheral vascular disease, patchy cardiac fibrosis, and hepatic steatosis, was noted in the other organs. Double staining immunoassays that used anti–MERS-CoV antibodies paired with immunohistochemistry for cytokeratin and surfactant identified pneumocytes and epithelial syncytial cells as important targets of MERS-CoV antigen; double immunostaining with dipeptidyl peptidase 4 showed colocalization in scattered pneumocytes and syncytial cells. No evidence of extrapulmonary MERS-CoV antigens were detected, including the kidney. These results provide critical insights into the pathogenesis of MERS-CoV in humans.

See related Commentary on page 507

Supported by CDC operational funds.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

Disclosures: None reported.

Current address of M.G.M., National Cancer Institute–Shady Grove, Rockville, MD.

© 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Keywords: Research; Abstracts; MERS-CoV; UAE.

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