Serveur d'exploration MERS

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Cross-sectional study of MERS-CoV-specific RNA and antibodies in animals that have had contact with MERS patients in Saudi Arabia

Identifieur interne : 000E59 ( Pmc/Curation ); précédent : 000E58; suivant : 000E60

Cross-sectional study of MERS-CoV-specific RNA and antibodies in animals that have had contact with MERS patients in Saudi Arabia

Auteurs : Samy Kasem [Arabie saoudite, Égypte] ; Ibraheem Qasim [Arabie saoudite] ; Ali Al-Hufofi [Arabie saoudite] ; Osman Hashim [Arabie saoudite] ; Ali Alkarar [Arabie saoudite] ; Ali Abu-Obeida [Arabie saoudite] ; Albagir Gaafer [Arabie saoudite] ; Abdelhamid Elfadil [Arabie saoudite] ; Ahmed Zaki [Arabie saoudite] ; Ahmed Al-Romaihi [Arabie saoudite] ; Nasereldeen Babekr [Arabie saoudite] ; Nadr El-Harby [Arabie saoudite] ; Raed Hussien [Arabie saoudite] ; Ali Al-Sahaf [Arabie saoudite] ; Ali Al-Doweriej [Arabie saoudite] ; Faisal Bayoumi [Arabie saoudite] ; Leo L. M. Poon [République populaire de Chine] ; Daniel K. W. Chu [République populaire de Chine] ; Malik Peiris [République populaire de Chine] ; Ranawaka A. P. M. Perera [République populaire de Chine]

Source :

RBID : PMC:7102853

Abstract

Background

Middle East respiratory syndrome coronavirus (MERS-CoV) is a newly emerged coronavirus that is associated with a severe respiratory disease in humans in the Middle East. The epidemiological profiles of the MERS-CoV infections suggest zoonotic transmission from an animal reservoir to humans.

Methods

This study was designed to investigate animal herds associated with Middle East respiratory syndrome (MERS)-infected patients in Saudi Arabia, during the last three years (2014–2016). Nasal swabs and serum samples from 584 dromedary camels, 39 sheep, 51 goats, and 2 cattle were collected. Nasal samples from camels, sheep, goats, and cattle were examined by real-time reverse-transcription PCR (RT-PCR) to detect MERS-CoV RNA, and the Anti-MERS ELISA assay was performed to detect camel humeral immune response (IgG) to MERS-CoV S1 antigen infection. The complete genome sequencing of ten MERS-CoV camel isolates and phylogenetic analysis was performed.

Results

The data indicated that seventy-five dromedary camels were positive for MERS-CoV RNA; the virus was not detected in sheep, goats, and cattle. MERS-CoV RNA from infected camels was not detected beyond 2 weeks after the first positive result was detected in nasal swabs obtained from infected camels. Anti-MERS ELISA assays showed that 70.9% of camels related to human cases had antibodies to MERS-CoV. The full genome sequences of the ten MERS-CoV camel isolates were identical to their corresponding patients and were grouped together within the larger MERS-CoV sequences cluster for human and camel isolates reported form the Arabian Peninsula.

Conclusions

These findings indicate that camels are a significant reservoir for the maintenance of MERS-CoVs, and they are an important source of human infection with MERS.


Url:
DOI: 10.1016/j.jiph.2017.09.022
PubMed: 28993171
PubMed Central: 7102853

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PMC:7102853

Le document en format XML

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<name sortKey="Bayoumi, Faisal" sort="Bayoumi, Faisal" uniqKey="Bayoumi F" first="Faisal" last="Bayoumi">Faisal Bayoumi</name>
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<name sortKey="Poon, Leo L M" sort="Poon, Leo L M" uniqKey="Poon L" first="Leo L. M." last="Poon">Leo L. M. Poon</name>
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<name sortKey="Chu, Daniel K W" sort="Chu, Daniel K W" uniqKey="Chu D" first="Daniel K. W." last="Chu">Daniel K. W. Chu</name>
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<title xml:lang="en" level="a" type="main">Cross-sectional study of MERS-CoV-specific RNA and antibodies in animals that have had contact with MERS patients in Saudi Arabia</title>
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<name sortKey="Kasem, Samy" sort="Kasem, Samy" uniqKey="Kasem S" first="Samy" last="Kasem">Samy Kasem</name>
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<country xml:lang="fr">Arabie saoudite</country>
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<name sortKey="Qasim, Ibraheem" sort="Qasim, Ibraheem" uniqKey="Qasim I" first="Ibraheem" last="Qasim">Ibraheem Qasim</name>
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<name sortKey="Al Hufofi, Ali" sort="Al Hufofi, Ali" uniqKey="Al Hufofi A" first="Ali" last="Al-Hufofi">Ali Al-Hufofi</name>
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<name sortKey="Hashim, Osman" sort="Hashim, Osman" uniqKey="Hashim O" first="Osman" last="Hashim">Osman Hashim</name>
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<name sortKey="Alkarar, Ali" sort="Alkarar, Ali" uniqKey="Alkarar A" first="Ali" last="Alkarar">Ali Alkarar</name>
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<name sortKey="Gaafer, Albagir" sort="Gaafer, Albagir" uniqKey="Gaafer A" first="Albagir" last="Gaafer">Albagir Gaafer</name>
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<name sortKey="Elfadil, Abdelhamid" sort="Elfadil, Abdelhamid" uniqKey="Elfadil A" first="Abdelhamid" last="Elfadil">Abdelhamid Elfadil</name>
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<name sortKey="Zaki, Ahmed" sort="Zaki, Ahmed" uniqKey="Zaki A" first="Ahmed" last="Zaki">Ahmed Zaki</name>
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<name sortKey="Al Romaihi, Ahmed" sort="Al Romaihi, Ahmed" uniqKey="Al Romaihi A" first="Ahmed" last="Al-Romaihi">Ahmed Al-Romaihi</name>
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<nlm:aff id="aff0015">Department of Veterinary Laboratory, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</nlm:aff>
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<name sortKey="Babekr, Nasereldeen" sort="Babekr, Nasereldeen" uniqKey="Babekr N" first="Nasereldeen" last="Babekr">Nasereldeen Babekr</name>
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<wicri:regionArea>Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195</wicri:regionArea>
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<name sortKey="El Harby, Nadr" sort="El Harby, Nadr" uniqKey="El Harby N" first="Nadr" last="El-Harby">Nadr El-Harby</name>
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<nlm:aff id="aff0005">Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Hussien, Raed" sort="Hussien, Raed" uniqKey="Hussien R" first="Raed" last="Hussien">Raed Hussien</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0005">Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195</wicri:regionArea>
</affiliation>
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<author>
<name sortKey="Al Sahaf, Ali" sort="Al Sahaf, Ali" uniqKey="Al Sahaf A" first="Ali" last="Al-Sahaf">Ali Al-Sahaf</name>
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<nlm:aff id="aff0005">Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Al Doweriej, Ali" sort="Al Doweriej, Ali" uniqKey="Al Doweriej A" first="Ali" last="Al-Doweriej">Ali Al-Doweriej</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0005">Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Bayoumi, Faisal" sort="Bayoumi, Faisal" uniqKey="Bayoumi F" first="Faisal" last="Bayoumi">Faisal Bayoumi</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0005">Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</nlm:aff>
<country xml:lang="fr">Arabie saoudite</country>
<wicri:regionArea>Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Poon, Leo L M" sort="Poon, Leo L M" uniqKey="Poon L" first="Leo L. M." last="Poon">Leo L. M. Poon</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0020">Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong, China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Chu, Daniel K W" sort="Chu, Daniel K W" uniqKey="Chu D" first="Daniel K. W." last="Chu">Daniel K. W. Chu</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0020">Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong, China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Peiris, Malik" sort="Peiris, Malik" uniqKey="Peiris M" first="Malik" last="Peiris">Malik Peiris</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0020">Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong, China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Perera, Ranawaka A P M" sort="Perera, Ranawaka A P M" uniqKey="Perera R" first="Ranawaka A. P. M." last="Perera">Ranawaka A. P. M. Perera</name>
<affiliation wicri:level="1">
<nlm:aff id="aff0020">Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong, China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong</wicri:regionArea>
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</author>
</analytic>
<series>
<title level="j">Journal of Infection and Public Health</title>
<idno type="ISSN">1876-0341</idno>
<idno type="eISSN">1876-035X</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec>
<title>Background</title>
<p>Middle East respiratory syndrome coronavirus (MERS-CoV) is a newly emerged coronavirus that is associated with a severe respiratory disease in humans in the Middle East. The epidemiological profiles of the MERS-CoV infections suggest zoonotic transmission from an animal reservoir to humans.</p>
</sec>
<sec>
<title>Methods</title>
<p>This study was designed to investigate animal herds associated with Middle East respiratory syndrome (MERS)-infected patients in Saudi Arabia, during the last three years (2014–2016). Nasal swabs and serum samples from 584 dromedary camels, 39 sheep, 51 goats, and 2 cattle were collected. Nasal samples from camels, sheep, goats, and cattle were examined by real-time reverse-transcription PCR (RT-PCR) to detect MERS-CoV RNA, and the Anti-MERS ELISA assay was performed to detect camel humeral immune response (IgG) to MERS-CoV S1 antigen infection. The complete genome sequencing of ten MERS-CoV camel isolates and phylogenetic analysis was performed.</p>
</sec>
<sec>
<title>Results</title>
<p>The data indicated that seventy-five dromedary camels were positive for MERS-CoV RNA; the virus was not detected in sheep, goats, and cattle. MERS-CoV RNA from infected camels was not detected beyond 2 weeks after the first positive result was detected in nasal swabs obtained from infected camels. Anti-MERS ELISA assays showed that 70.9% of camels related to human cases had antibodies to MERS-CoV. The full genome sequences of the ten MERS-CoV camel isolates were identical to their corresponding patients and were grouped together within the larger MERS-CoV sequences cluster for human and camel isolates reported form the Arabian Peninsula.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>These findings indicate that camels are a significant reservoir for the maintenance of MERS-CoVs, and they are an important source of human infection with MERS.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Infect Public Health</journal-id>
<journal-id journal-id-type="iso-abbrev">J Infect Public Health</journal-id>
<journal-title-group>
<journal-title>Journal of Infection and Public Health</journal-title>
</journal-title-group>
<issn pub-type="ppub">1876-0341</issn>
<issn pub-type="epub">1876-035X</issn>
<publisher>
<publisher-name>The Authors. Production and hosting by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">28993171</article-id>
<article-id pub-id-type="pmc">7102853</article-id>
<article-id pub-id-type="publisher-id">S1876-0341(17)30257-5</article-id>
<article-id pub-id-type="doi">10.1016/j.jiph.2017.09.022</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Cross-sectional study of MERS-CoV-specific RNA and antibodies in animals that have had contact with MERS patients in Saudi Arabia</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" id="aut0005">
<name>
<surname>Kasem</surname>
<given-names>Samy</given-names>
</name>
<email>samy_kasem1976@yahoo.com</email>
<email>samy.kassem@vet.kfs.edu.eg</email>
<xref rid="aff0005" ref-type="aff">a</xref>
<xref rid="aff0010" ref-type="aff">b</xref>
<xref rid="cor0005" ref-type="corresp"></xref>
</contrib>
<contrib contrib-type="author" id="aut0010">
<name>
<surname>Qasim</surname>
<given-names>Ibraheem</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0015">
<name>
<surname>Al-Hufofi</surname>
<given-names>Ali</given-names>
</name>
<xref rid="aff0015" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="aut0020">
<name>
<surname>Hashim</surname>
<given-names>Osman</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0025">
<name>
<surname>Alkarar</surname>
<given-names>Ali</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0030">
<name>
<surname>Abu-Obeida</surname>
<given-names>Ali</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0035">
<name>
<surname>Gaafer</surname>
<given-names>Albagir</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0040">
<name>
<surname>Elfadil</surname>
<given-names>Abdelhamid</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0045">
<name>
<surname>Zaki</surname>
<given-names>Ahmed</given-names>
</name>
<xref rid="aff0015" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="aut0050">
<name>
<surname>Al-Romaihi</surname>
<given-names>Ahmed</given-names>
</name>
<xref rid="aff0015" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="aut0055">
<name>
<surname>Babekr</surname>
<given-names>Nasereldeen</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0060">
<name>
<surname>El-Harby</surname>
<given-names>Nadr</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0065">
<name>
<surname>Hussien</surname>
<given-names>Raed</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0070">
<name>
<surname>AL-Sahaf</surname>
<given-names>Ali</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0075">
<name>
<surname>Al-Doweriej</surname>
<given-names>Ali</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0080">
<name>
<surname>Bayoumi</surname>
<given-names>Faisal</given-names>
</name>
<xref rid="aff0005" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="aut0085">
<name>
<surname>Poon</surname>
<given-names>Leo L.M.</given-names>
</name>
<xref rid="aff0020" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="aut0090">
<name>
<surname>Chu</surname>
<given-names>Daniel K.W.</given-names>
</name>
<xref rid="aff0020" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="aut0095">
<name>
<surname>Peiris</surname>
<given-names>Malik</given-names>
</name>
<xref rid="aff0020" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="aut0100">
<name>
<surname>Perera</surname>
<given-names>Ranawaka A.P.M.</given-names>
</name>
<xref rid="aff0020" ref-type="aff">d</xref>
</contrib>
</contrib-group>
<aff id="aff0005">
<label>a</label>
Department of Animal Resources, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</aff>
<aff id="aff0010">
<label>b</label>
Department of Virology, Faculty of Veterinary Medicine, Kafrelsheikh University, El Geish Street, Kafrelsheikh 33516, Egypt</aff>
<aff id="aff0015">
<label>c</label>
Department of Veterinary Laboratory, Ministry of Environment, Water and Agriculture, 65 King Abdulaziz Road, Riyadh 11195, Saudi Arabia</aff>
<aff id="aff0020">
<label>d</label>
Public Health Laboratory Sciences, School of Public Health, The University of Hong Kong, Hong Kong, China</aff>
<author-notes>
<corresp id="cor0005">
<label></label>
Corresponding author at: Department of Virology, Faculty of Veterinary Medicine, Kafrelsheikh University, El Geish Street, Kafrelsheikh 33516, Egypt. Fax: +20 47 3231311.
<email>samy_kasem1976@yahoo.com</email>
<email>samy.kassem@vet.kfs.edu.eg</email>
</corresp>
</author-notes>
<pub-date pub-type="pmc-release">
<day>6</day>
<month>10</month>
<year>2017</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub" iso-8601-date="2018-06-01">
<season>May-June</season>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>6</day>
<month>10</month>
<year>2017</year>
</pub-date>
<volume>11</volume>
<issue>3</issue>
<fpage>331</fpage>
<lpage>338</lpage>
<history>
<date date-type="received">
<day>26</day>
<month>3</month>
<year>2017</year>
</date>
<date date-type="rev-recd">
<day>22</day>
<month>8</month>
<year>2017</year>
</date>
<date date-type="accepted">
<day>9</day>
<month>9</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© 2017 The Authors</copyright-statement>
<copyright-year>2017</copyright-year>
<license>
<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<abstract id="abs0005">
<sec>
<title>Background</title>
<p>Middle East respiratory syndrome coronavirus (MERS-CoV) is a newly emerged coronavirus that is associated with a severe respiratory disease in humans in the Middle East. The epidemiological profiles of the MERS-CoV infections suggest zoonotic transmission from an animal reservoir to humans.</p>
</sec>
<sec>
<title>Methods</title>
<p>This study was designed to investigate animal herds associated with Middle East respiratory syndrome (MERS)-infected patients in Saudi Arabia, during the last three years (2014–2016). Nasal swabs and serum samples from 584 dromedary camels, 39 sheep, 51 goats, and 2 cattle were collected. Nasal samples from camels, sheep, goats, and cattle were examined by real-time reverse-transcription PCR (RT-PCR) to detect MERS-CoV RNA, and the Anti-MERS ELISA assay was performed to detect camel humeral immune response (IgG) to MERS-CoV S1 antigen infection. The complete genome sequencing of ten MERS-CoV camel isolates and phylogenetic analysis was performed.</p>
</sec>
<sec>
<title>Results</title>
<p>The data indicated that seventy-five dromedary camels were positive for MERS-CoV RNA; the virus was not detected in sheep, goats, and cattle. MERS-CoV RNA from infected camels was not detected beyond 2 weeks after the first positive result was detected in nasal swabs obtained from infected camels. Anti-MERS ELISA assays showed that 70.9% of camels related to human cases had antibodies to MERS-CoV. The full genome sequences of the ten MERS-CoV camel isolates were identical to their corresponding patients and were grouped together within the larger MERS-CoV sequences cluster for human and camel isolates reported form the Arabian Peninsula.</p>
</sec>
<sec>
<title>Conclusions</title>
<p>These findings indicate that camels are a significant reservoir for the maintenance of MERS-CoVs, and they are an important source of human infection with MERS.</p>
</sec>
</abstract>
<kwd-group id="kwd0005">
<title>Abbreviations</title>
<kwd>MERS, Middle East respiratory syndrome</kwd>
<kwd>MERS-CoV, Middle East respiratory syndrome coronavirus</kwd>
<kwd>TUU, Tabuk</kwd>
<kwd>AJF, Jouf</kwd>
<kwd>HAS, Hail</kwd>
<kwd>RAH, Northern Boundaries</kwd>
<kwd>ELQ, El-Qassim</kwd>
<kwd>MED, Al-Madina</kwd>
<kwd>RUH, Riyadh</kwd>
<kwd>DWD, El-Dowadmi</kwd>
<kwd>SHG, Shagraa</kwd>
<kwd>AKH, Alkharj</kwd>
<kwd>WAE, Wadi El-Dwasir</kwd>
<kwd>ZUL, Zulfi</kwd>
<kwd>MJH, Majmaa</kwd>
<kwd>TIF, Taif</kwd>
<kwd>MAK, Makkah</kwd>
<kwd>ABT, Bahaa</kwd>
<kwd>AHB, Asir</kwd>
<kwd>GIZ, Gizan</kwd>
<kwd>EAM, Najran</kwd>
<kwd>DMM, Shargia</kwd>
<kwd>HOF, Ihsaa</kwd>
</kwd-group>
<kwd-group id="kwd0010">
<title>Keywords</title>
<kwd>MERS</kwd>
<kwd>Dromedary camel</kwd>
<kwd>Real time-PCR</kwd>
<kwd>ELISA</kwd>
<kwd>Saudi Arabia</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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