High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia
Identifieur interne : 000568 ( Pmc/Checkpoint ); précédent : 000567; suivant : 000569High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia
Auteurs : Abeer N. Alshukairi ; Jian Zheng [États-Unis] ; Jingxian Zhao [République populaire de Chine] ; Atef Nehdi ; Salim A. Baharoon ; Laila Layqah ; Ahmad Bokhari ; Sameera M. Al Johani ; Nosaibah Samman ; Mohamad Boudjelal ; Patrick Ten Eyck [États-Unis] ; Maha A. Al-Mozaini ; Jincun Zhao [République populaire de Chine] ; Stanley Perlman [États-Unis, République populaire de Chine] ; Abdulaziz N. AlagailiSource :
- mBio [ 2150-7511 ] ; 2018.
Abstract
The Middle East respiratory syndrome (MERS) is a coronavirus (CoV)-mediated respiratory disease. Virus transmission occurs within health care settings, but cases also appear sporadically in the community. Camels are believed to be the source for community-acquired cases, but most patients do not have camel exposure. Here, we assessed whether camel workers (CWs) with high rates of exposure to camel nasal and oral secretions had evidence of MERS-CoV infection. The results indicate that a high percentage of CWs were positive for virus-specific immune responses but had no history of significant respiratory disease. Thus, a possible explanation for repeated MERS outbreaks is that CWs develop mild or subclinical disease. These CWs then transmit the virus to uninfected individuals, some of whom are highly susceptible, develop severe disease, and are detected as primary MERS cases in the community.
Url:
DOI: 10.1128/mBio.01985-18
PubMed: 30377284
PubMed Central: 6212820
Affiliations:
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Alshukairi</name><affiliation><nlm:aff id="aff1"><addr-line>Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudia Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudia Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Zheng, Jian" sort="Zheng, Jian" uniqKey="Zheng J" first="Jian" last="Zheng">Jian Zheng</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Zhao, Jingxian" sort="Zhao, Jingxian" uniqKey="Zhao J" first="Jingxian" last="Zhao">Jingxian Zhao</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong</wicri:regionArea><wicri:noRegion>Guangdong</wicri:noRegion></affiliation></author><author><name sortKey="Nehdi, Atef" sort="Nehdi, Atef" uniqKey="Nehdi A" first="Atef" last="Nehdi">Atef Nehdi</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Baharoon, Salim A" sort="Baharoon, Salim A" uniqKey="Baharoon S" first="Salim A." last="Baharoon">Salim A. Baharoon</name><affiliation><nlm:aff id="aff5"><addr-line>Department of Critical Care, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Layqah, Laila" sort="Layqah, Laila" uniqKey="Layqah L" first="Laila" last="Layqah">Laila Layqah</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Bokhari, Ahmad" sort="Bokhari, Ahmad" uniqKey="Bokhari A" first="Ahmad" last="Bokhari">Ahmad Bokhari</name><affiliation><nlm:aff id="aff6"><addr-line>Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Al Johani, Sameera M" sort="Al Johani, Sameera M" uniqKey="Al Johani S" first="Sameera M." last="Al Johani">Sameera M. Al Johani</name><affiliation><nlm:aff id="aff7"><addr-line>College of Science and Health Professions, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Samman, Nosaibah" sort="Samman, Nosaibah" uniqKey="Samman N" first="Nosaibah" last="Samman">Nosaibah Samman</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Boudjelal, Mohamad" sort="Boudjelal, Mohamad" uniqKey="Boudjelal M" first="Mohamad" last="Boudjelal">Mohamad Boudjelal</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Ten Eyck, Patrick" sort="Ten Eyck, Patrick" uniqKey="Ten Eyck P" first="Patrick" last="Ten Eyck">Patrick Ten Eyck</name><affiliation wicri:level="4"><nlm:aff id="aff8"><addr-line>Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Al Mozaini, Maha A" sort="Al Mozaini, Maha A" uniqKey="Al Mozaini M" first="Maha A." last="Al-Mozaini">Maha A. Al-Mozaini</name><affiliation><nlm:aff id="aff9"><addr-line>Department of Infection and Immunology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Zhao, Jincun" sort="Zhao, Jincun" uniqKey="Zhao J" first="Jincun" last="Zhao">Jincun Zhao</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong</wicri:regionArea><wicri:noRegion>Guangdong</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff10"><addr-line>Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Perlman, Stanley" sort="Perlman, Stanley" uniqKey="Perlman S" first="Stanley" last="Perlman">Stanley Perlman</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong</wicri:regionArea><wicri:noRegion>Guangdong</wicri:noRegion></affiliation></author><author><name sortKey="Alagaili, Abdulaziz N" sort="Alagaili, Abdulaziz N" uniqKey="Alagaili A" first="Abdulaziz N." last="Alagaili">Abdulaziz N. Alagaili</name><affiliation><nlm:aff id="aff11"><addr-line>KSU Mammals Research Chair, Zoology Department, King Saud University, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30377284</idno><idno type="pmc">6212820</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212820</idno><idno type="RBID">PMC:6212820</idno><idno type="doi">10.1128/mBio.01985-18</idno><date when="2018">2018</date><idno type="wicri:Area/Pmc/Corpus">001237</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001237</idno><idno type="wicri:Area/Pmc/Curation">001237</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001237</idno><idno type="wicri:Area/Pmc/Checkpoint">000568</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000568</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia</title><author><name sortKey="Alshukairi, Abeer N" sort="Alshukairi, Abeer N" uniqKey="Alshukairi A" first="Abeer N." last="Alshukairi">Abeer N. Alshukairi</name><affiliation><nlm:aff id="aff1"><addr-line>Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudia Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudia Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Zheng, Jian" sort="Zheng, Jian" uniqKey="Zheng J" first="Jian" last="Zheng">Jian Zheng</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Zhao, Jingxian" sort="Zhao, Jingxian" uniqKey="Zhao J" first="Jingxian" last="Zhao">Jingxian Zhao</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong</wicri:regionArea><wicri:noRegion>Guangdong</wicri:noRegion></affiliation></author><author><name sortKey="Nehdi, Atef" sort="Nehdi, Atef" uniqKey="Nehdi A" first="Atef" last="Nehdi">Atef Nehdi</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Baharoon, Salim A" sort="Baharoon, Salim A" uniqKey="Baharoon S" first="Salim A." last="Baharoon">Salim A. Baharoon</name><affiliation><nlm:aff id="aff5"><addr-line>Department of Critical Care, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Layqah, Laila" sort="Layqah, Laila" uniqKey="Layqah L" first="Laila" last="Layqah">Laila Layqah</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Bokhari, Ahmad" sort="Bokhari, Ahmad" uniqKey="Bokhari A" first="Ahmad" last="Bokhari">Ahmad Bokhari</name><affiliation><nlm:aff id="aff6"><addr-line>Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Al Johani, Sameera M" sort="Al Johani, Sameera M" uniqKey="Al Johani S" first="Sameera M." last="Al Johani">Sameera M. Al Johani</name><affiliation><nlm:aff id="aff7"><addr-line>College of Science and Health Professions, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Samman, Nosaibah" sort="Samman, Nosaibah" uniqKey="Samman N" first="Nosaibah" last="Samman">Nosaibah Samman</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Boudjelal, Mohamad" sort="Boudjelal, Mohamad" uniqKey="Boudjelal M" first="Mohamad" last="Boudjelal">Mohamad Boudjelal</name><affiliation><nlm:aff id="aff4"><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Ten Eyck, Patrick" sort="Ten Eyck, Patrick" uniqKey="Ten Eyck P" first="Patrick" last="Ten Eyck">Patrick Ten Eyck</name><affiliation wicri:level="4"><nlm:aff id="aff8"><addr-line>Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Al Mozaini, Maha A" sort="Al Mozaini, Maha A" uniqKey="Al Mozaini M" first="Maha A." last="Al-Mozaini">Maha A. Al-Mozaini</name><affiliation><nlm:aff id="aff9"><addr-line>Department of Infection and Immunology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Zhao, Jincun" sort="Zhao, Jincun" uniqKey="Zhao J" first="Jincun" last="Zhao">Jincun Zhao</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong</wicri:regionArea><wicri:noRegion>Guangdong</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff10"><addr-line>Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Perlman, Stanley" sort="Perlman, Stanley" uniqKey="Perlman S" first="Stanley" last="Perlman">Stanley Perlman</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa</wicri:regionArea><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong</wicri:regionArea><wicri:noRegion>Guangdong</wicri:noRegion></affiliation></author><author><name sortKey="Alagaili, Abdulaziz N" sort="Alagaili, Abdulaziz N" uniqKey="Alagaili A" first="Abdulaziz N." last="Alagaili">Abdulaziz N. Alagaili</name><affiliation><nlm:aff id="aff11"><addr-line>KSU Mammals Research Chair, Zoology Department, King Saud University, Riyadh, Kingdom of Saudi Arabia</addr-line></nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author></analytic><series><title level="j">mBio</title><idno type="eISSN">2150-7511</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The Middle East respiratory syndrome (MERS) is a coronavirus (CoV)-mediated respiratory disease. Virus transmission occurs within health care settings, but cases also appear sporadically in the community. Camels are believed to be the source for community-acquired cases, but most patients do not have camel exposure. Here, we assessed whether camel workers (CWs) with high rates of exposure to camel nasal and oral secretions had evidence of MERS-CoV infection. The results indicate that a high percentage of CWs were positive for virus-specific immune responses but had no history of significant respiratory disease. Thus, a possible explanation for repeated MERS outbreaks is that CWs develop mild or subclinical disease. These CWs then transmit the virus to uninfected individuals, some of whom are highly susceptible, develop severe disease, and are detected as primary MERS cases in the community.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hui, Ds" uniqKey="Hui D">DS Hui</name></author><author><name sortKey="Azhar, Ei" uniqKey="Azhar E">EI Azhar</name></author><author><name sortKey="Kim, Yj" uniqKey="Kim Y">YJ Kim</name></author><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author><author><name sortKey="Oh, Md" uniqKey="Oh M">MD Oh</name></author><author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM 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<front><journal-meta><journal-id journal-id-type="nlm-ta">mBio</journal-id><journal-id journal-id-type="iso-abbrev">MBio</journal-id><journal-id journal-id-type="hwp">mbio</journal-id><journal-id journal-id-type="pmc">mbio</journal-id><journal-id journal-id-type="publisher-id">mBio</journal-id><journal-title-group><journal-title>mBio</journal-title></journal-title-group><issn pub-type="epub">2150-7511</issn><publisher><publisher-name>American Society for Microbiology</publisher-name><publisher-loc>1752 N St., N.W., Washington, DC</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30377284</article-id><article-id pub-id-type="pmc">6212820</article-id><article-id pub-id-type="publisher-id">mBio01985-18</article-id><article-id pub-id-type="doi">10.1128/mBio.01985-18</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="overline"><subject>Clinical Science and Epidemiology</subject></subj-group></article-categories><title-group><article-title>High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia</article-title><alt-title alt-title-type="running-head">High Prevalence of MERS Immunopositivity in Camel Workers</alt-title><alt-title alt-title-type="short-authors">Alshukairi et al.</alt-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes"><name><surname>Alshukairi</surname><given-names>Abeer N.</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Zheng</surname><given-names>Jian</given-names></name><xref ref-type="aff" rid="aff2"><sup>b</sup></xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Zhao</surname><given-names>Jingxian</given-names></name><xref ref-type="aff" rid="aff3"><sup>c</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Nehdi</surname><given-names>Atef</given-names></name><xref ref-type="aff" rid="aff4"><sup>d</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Baharoon</surname><given-names>Salim A.</given-names></name><xref ref-type="aff" rid="aff5"><sup>e</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Layqah</surname><given-names>Laila</given-names></name><xref ref-type="aff" rid="aff4"><sup>d</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Bokhari</surname><given-names>Ahmad</given-names></name><xref ref-type="aff" rid="aff6"><sup>f</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Al Johani</surname><given-names>Sameera M.</given-names></name><xref ref-type="aff" rid="aff7"><sup>g</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Samman</surname><given-names>Nosaibah</given-names></name><xref ref-type="aff" rid="aff4"><sup>d</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Boudjelal</surname><given-names>Mohamad</given-names></name><xref ref-type="aff" rid="aff4"><sup>d</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Ten Eyck</surname><given-names>Patrick</given-names></name><xref ref-type="aff" rid="aff8"><sup>h</sup></xref></contrib><contrib contrib-type="author" equal-contrib="no"><name><surname>Al-Mozaini</surname><given-names>Maha A.</given-names></name><xref ref-type="aff" rid="aff9"><sup>i</sup></xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Zhao</surname><given-names>Jincun</given-names></name><xref ref-type="aff" rid="aff3"><sup>c</sup></xref><xref ref-type="aff" rid="aff10"><sup>j</sup></xref></contrib><contrib contrib-type="author" corresp="yes" equal-contrib="yes"><contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0003-4213-2354</contrib-id><name><surname>Perlman</surname><given-names>Stanley</given-names></name><xref ref-type="aff" rid="aff2"><sup>b</sup></xref><xref ref-type="aff" rid="aff3"><sup>c</sup></xref></contrib><contrib contrib-type="author" corresp="yes" equal-contrib="yes"><name><surname>Alagaili</surname><given-names>Abdulaziz N.</given-names></name><xref ref-type="aff" rid="aff11"><sup>k</sup></xref></contrib><aff id="aff1"><label>a</label><addr-line>Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudia Arabia</addr-line></aff><aff id="aff2"><label>b</label><addr-line>Department of Microbiology and Immunology, University of Iowa, Iowa City, Iowa, USA</addr-line></aff><aff id="aff3"><label>c</label><addr-line>State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China</addr-line></aff><aff id="aff4"><label>d</label><addr-line>Department of Medical Research Core Facility and Platforms, King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></aff><aff id="aff5"><label>e</label><addr-line>Department of Critical Care, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia</addr-line></aff><aff id="aff6"><label>f</label><addr-line>Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia</addr-line></aff><aff id="aff7"><label>g</label><addr-line>College of Science and Health Professions, King Saud Bin Abdulaziz for Health Sciences University, Riyadh, Kingdom of Saudi Arabia</addr-line></aff><aff id="aff8"><label>h</label><addr-line>Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA</addr-line></aff><aff id="aff9"><label>i</label><addr-line>Department of Infection and Immunology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia</addr-line></aff><aff id="aff10"><label>j</label><addr-line>Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou, China</addr-line></aff><aff id="aff11"><label>k</label><addr-line>KSU Mammals Research Chair, Zoology Department, King Saud University, Riyadh, Kingdom of Saudi Arabia</addr-line></aff></contrib-group><contrib-group><contrib contrib-type="editor"><name><surname>Denison</surname><given-names>Mark R.</given-names></name><role>Editor</role><aff>Vanderbilt University Medical Center</aff></contrib></contrib-group><contrib-group><contrib contrib-type="reviewer"><name><surname>Haagmans</surname><given-names>Bart</given-names></name><role>Solicited external reviewer</role><aff>Erasmus MC</aff></contrib><contrib contrib-type="reviewer"><name><surname>Drosten</surname><given-names>Christian</given-names></name><role>Solicited external reviewer</role><aff>Charité</aff></contrib></contrib-group><author-notes><corresp id="cor1">Address correspondence to Stanley Perlman, <email>stanley-perlman@uiowa.edu</email>, or Abdulaziz N. Alagaili, <email>aalagaili@ksu.edu.sa</email>.</corresp><fn fn-type="equal"><p>A. N. Alshukairi, J. Zheng, and Jingxian Zhao contributed equally to the work. A. N. Alshukairi, Jincun Zhao, S. Perlman, and A. N. Alagaili contributed equally as senior authors.</p></fn></author-notes><pub-date pub-type="epub"><day>30</day><month>10</month><year>2018</year></pub-date><pub-date pub-type="collection"><season>Sep-Oct</season><year>2018</year></pub-date><volume>9</volume><issue>5</issue><elocation-id>e01985-18</elocation-id><history><date date-type="received"><day>13</day><month>9</month><year>2018</year></date><date date-type="accepted"><day>24</day><month>9</month><year>2018</year></date></history><permissions><copyright-statement>Copyright © 2018 Alshukairi et al.</copyright-statement><copyright-year>2018</copyright-year><copyright-holder>Alshukairi et al.</copyright-holder><license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International license</ext-link>.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="mbo005184142001.pdf"></self-uri><abstract abstract-type="precis"><p>The Middle East respiratory syndrome (MERS) is a coronavirus (CoV)-mediated respiratory disease. Virus transmission occurs within health care settings, but cases also appear sporadically in the community. Camels are believed to be the source for community-acquired cases, but most patients do not have camel exposure. Here, we assessed whether camel workers (CWs) with high rates of exposure to camel nasal and oral secretions had evidence of MERS-CoV infection. The results indicate that a high percentage of CWs were positive for virus-specific immune responses but had no history of significant respiratory disease. Thus, a possible explanation for repeated MERS outbreaks is that CWs develop mild or subclinical disease. These CWs then transmit the virus to uninfected individuals, some of whom are highly susceptible, develop severe disease, and are detected as primary MERS cases in the community.</p></abstract><abstract><title>ABSTRACT</title><p>Middle East respiratory syndrome (MERS), a highly lethal respiratory disease caused by a novel coronavirus (MERS-CoV), is an emerging disease with high potential for epidemic spread. It has been listed by the WHO and the Coalition for Epidemic Preparedness Innovations (CEPI) as an important target for vaccine development. While initially the majority of MERS cases were hospital acquired, continued emergence of MERS is attributed to community acquisition, with camels likely being the direct or indirect source. However, the majority of patients do not describe camel exposure, making the route of transmission unclear. Here, using sensitive immunological assays and a cohort of camel workers (CWs) with well-documented camel exposure, we show that approximately 50% of camel workers (CWs) in the Kingdom of Saudi Arabia (KSA) and 0% of controls were previously infected. We obtained blood samples from 30 camel herders, truck drivers, and handlers with well-documented camel exposure and from healthy donors, and measured MERS-CoV-specific enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), and neutralizing antibody titers, as well as T cell responses. Totals of 16/30 CWs and 0/30 healthy control donors were seropositive by MERS-CoV-specific ELISA and/or neutralizing antibody titer, and an additional four CWs were seronegative but contained virus-specific T cells in their blood. Although virus transmission from CWs has not been formally demonstrated, a possible explanation for repeated MERS outbreaks is that CWs develop mild disease and then transmit the virus to uninfected individuals. Infection of some of these individuals, such as those with comorbidities, results in severe disease and in the episodic appearance of patients with MERS.</p></abstract><kwd-group><title>Keywords</title><kwd>human Middle East respiratory syndrome</kwd><kwd>coronavirus</kwd><kwd>virus-specific antibody response</kwd><kwd>virus-specific T cell response</kwd><kwd>antibody</kwd><kwd>camel workers</kwd><kwd>Middle East respiratory syndrome</kwd><kwd>T cells</kwd></kwd-group><funding-group><award-group id="award1"><funding-source><institution-wrap><institution>National Key Research and Development Program of China</institution></institution-wrap></funding-source><award-id>2018YFC1200100</award-id><principal-award-recipient><name><surname>Zhao</surname><given-names>Jincun</given-names></name></principal-award-recipient></award-group><award-group id="award2"><funding-source><institution-wrap><institution>National Science and Technology Major Project</institution></institution-wrap></funding-source><award-id>2018ZX10101002</award-id><principal-award-recipient><name><surname>Zhao</surname><given-names>Jingxian</given-names></name></principal-award-recipient></award-group><award-group id="award3"><funding-source><institution-wrap><institution>HHS | National Institutes of Health (NIH)</institution><institution-id>https://doi.org/10.13039/100000002</institution-id></institution-wrap></funding-source><award-id>PO1 AI060699</award-id><principal-award-recipient><name><surname>Perlman</surname><given-names>Stanley</given-names></name></principal-award-recipient></award-group><award-group id="award4"><funding-source><institution-wrap><institution>National Natural Science Foundation of China (NSFC)</institution><institution-id>https://doi.org/10.13039/501100001809</institution-id></institution-wrap></funding-source><award-id>81772191</award-id><principal-award-recipient><name><surname>Zhao</surname><given-names>Jincun</given-names></name></principal-award-recipient></award-group><award-group id="award5"><funding-source><institution-wrap><institution>National Natural Science Foundation of China (NSFC)</institution><institution-id>https://doi.org/10.13039/501100001809</institution-id></institution-wrap></funding-source><award-id>81702047</award-id><principal-award-recipient><name><surname>Zhao</surname><given-names>Jincun</given-names></name></principal-award-recipient></award-group></funding-group><counts><count count="4" count-type="supplementary-material"></count><fig-count count="3"></fig-count><table-count count="2"></table-count><equation-count count="0"></equation-count><ref-count count="33"></ref-count><page-count count="10"></page-count><word-count count="6412"></word-count></counts><custom-meta-group><custom-meta><meta-name>cover-date</meta-name><meta-value>September/October 2018</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Guangdong</li><li>Iowa</li></region><settlement><li>Iowa City</li><li>Jiangmen</li></settlement><orgName><li>Université de l'Iowa</li></orgName></list><tree><noCountry><name sortKey="Al Johani, Sameera M" sort="Al Johani, Sameera M" uniqKey="Al Johani S" first="Sameera M." last="Al Johani">Sameera M. Al Johani</name><name sortKey="Al Mozaini, Maha A" sort="Al Mozaini, Maha A" uniqKey="Al Mozaini M" first="Maha A." last="Al-Mozaini">Maha A. Al-Mozaini</name><name sortKey="Alagaili, Abdulaziz N" sort="Alagaili, Abdulaziz N" uniqKey="Alagaili A" first="Abdulaziz N." last="Alagaili">Abdulaziz N. Alagaili</name><name sortKey="Alshukairi, Abeer N" sort="Alshukairi, Abeer N" uniqKey="Alshukairi A" first="Abeer N." last="Alshukairi">Abeer N. Alshukairi</name><name sortKey="Baharoon, Salim A" sort="Baharoon, Salim A" uniqKey="Baharoon S" first="Salim A." last="Baharoon">Salim A. Baharoon</name><name sortKey="Bokhari, Ahmad" sort="Bokhari, Ahmad" uniqKey="Bokhari A" first="Ahmad" last="Bokhari">Ahmad Bokhari</name><name sortKey="Boudjelal, Mohamad" sort="Boudjelal, Mohamad" uniqKey="Boudjelal M" first="Mohamad" last="Boudjelal">Mohamad Boudjelal</name><name sortKey="Layqah, Laila" sort="Layqah, Laila" uniqKey="Layqah L" first="Laila" last="Layqah">Laila Layqah</name><name sortKey="Nehdi, Atef" sort="Nehdi, Atef" uniqKey="Nehdi A" first="Atef" last="Nehdi">Atef Nehdi</name><name sortKey="Samman, Nosaibah" sort="Samman, Nosaibah" uniqKey="Samman N" first="Nosaibah" last="Samman">Nosaibah Samman</name></noCountry><country name="États-Unis"><region name="Iowa"><name sortKey="Zheng, Jian" sort="Zheng, Jian" uniqKey="Zheng J" first="Jian" last="Zheng">Jian Zheng</name></region><name sortKey="Perlman, Stanley" sort="Perlman, Stanley" uniqKey="Perlman S" first="Stanley" last="Perlman">Stanley Perlman</name><name sortKey="Ten Eyck, Patrick" sort="Ten Eyck, Patrick" uniqKey="Ten Eyck P" first="Patrick" last="Ten Eyck">Patrick Ten Eyck</name></country><country name="République populaire de Chine"><noRegion><name sortKey="Zhao, Jingxian" sort="Zhao, Jingxian" uniqKey="Zhao J" first="Jingxian" last="Zhao">Jingxian Zhao</name></noRegion><name sortKey="Perlman, Stanley" sort="Perlman, Stanley" uniqKey="Perlman S" first="Stanley" last="Perlman">Stanley Perlman</name><name sortKey="Zhao, Jincun" sort="Zhao, Jincun" uniqKey="Zhao J" first="Jincun" last="Zhao">Jincun Zhao</name><name sortKey="Zhao, Jincun" sort="Zhao, Jincun" uniqKey="Zhao J" first="Jincun" last="Zhao">Jincun Zhao</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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