MERS-COV (64): SAUDI ARABIA, ANIMAL RESERVOIR, HUMAN, CAMEL MILK

Posted on 12TH OCT 2017
tagged MERS-CoV, Saudi Arabia

A ProMED-mail post
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International Society for Infectious Diseases
http://www.isid.org

Date: Mon 9 Oct 2017
Source: Center for Infectious Disease Research & Policy (CIDRAP) [summ., edited]
http://www.cidrap.umn.edu/news-perspective/2017/10/camel-contact-common-...

Direct contact with camels, a known risk factor for contracting MERS-CoV has been reported in most recent cases, according to new reports from the Saudi Arabian Ministry of Health (MOH) and the World Health Organization (WHO).

After a lapse in daily reports since 3 Oct 2017, the Saudi MOH said today [9 Oct 2017] that a 77-year-old Saudi man from Al Bukayriyah has MERS-CoV (Middle East respiratory syndrome coronavirus). The man presented with symptoms of the virus and is in critical condition. He had direct contact with camels.

Also today, the MOH reported the death of a 72-year-old man from Tabuk. He also had contact with camels, according to an earlier MOH report. On 4 Oct 2017 the agency reported that a 52-year-old man from Taif also passed away from infection with MERS-CoV, but that notification hadn't been posted on the MOH site until recently.

Since 2012, Saudi Arabia has confirmed 1728 MERS cases, including 701 deaths. 2 people are being treated for the disease.

Also today, the WHO released new details on 9 cases of MERS-CoV reported in Saudi Arabia between 31 Aug and 26 Sep 2017. 5 of the patients had camel contact. 4 of the patients died, and another 4 deaths were reported in previously recorded cases [see comment].

The 5 patients with camel contact all reported drinking raw camel's milk.

Since 2012, a total of 2090 laboratory-confirmed MERS cases worldwide, including at least 730 related deaths, have been reported to the WHO.

[Byline: Stephanie Soucheray]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[The report above includes information on human MERS-CoV cases, which is similar to the information included in posting 20171009.5369268, while underlining the high percentage, among them, of primary cases who underwent contacts with camels: 5 of the 9 new MERS cases, and 4 of the 5 fatalities among them, "had a history of contact with camels in the 14 days preceding onset of illness". The CIDRAP report added, "The 5 patients with camel contact all reported drinking raw camel's milk." The camel-milk source of infection was reported by the WHO; see http://www.who.int/csr/don/09-october-2017-mers-saudi-arabia/en/. A patient infected by the consumption of (raw) camel milk is defined as a "primary case with a history of indirect contact with camels."

It will be interesting to obtain summarized quantitative information on the number of primary MERS-CoV patients, in Saudi Arabia and elsewhere, who were suspected to acquire their infection from camel milk. This food product is traditionally regarded, particularly in the Middle East, as a remedy and a beneficial contributor to health. Its continuously propagated medical properties include the treatment of diabetes, autism, and allergic reactions, as well as "boosting immunity, promoting development, stimulating circulation and heart health." In this respect, reference is made to WHO's updated advice re MERS-CoV, at http://www.who.int/csr/don/09-october-2017-mers-saudi-arabia/en/. The following excerpt is of particular significance:

"Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, in addition to avoiding close contact with suspected or confirmed human cases of the disease, people with these conditions should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals, and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked".

The following commentary, by Mod MPP, in the recent posting 20171001.5353977, addressing MERS-CoV in Saudi Arabia, is of relevance: "In reviewing the cases classified as primary cases in the past year, slightly more than half of these cases did not have a history of known contact -- neither direct nor indirect -- with camels in the 14 days preceding the onset of their illness. And given the high prevalence of MERS-CoV antibodies in camels from the region, why are 80 percent of the reported cases being reported from Saudi Arabia? Why not from other countries?"

Epidemiological studies in Saudi Arabia and elsewhere should cover the respective consumption data of (raw?) camel milk, in particular by the MERS-CoV-susceptible population described in the above WHO advise.

Pasteurization of drinking milk and dairy products (from all animal species!), is an essential food hygiene requirement, globally. - Mod.AS

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/131.]

See Also
MERS-CoV (63): Saudi Arabia (QS, TB), WHO 20171009.5369268
MERS-CoV (62): animal reservoir, camels, FAO, OIE, WHO 20171002.5354608
MERS-CoV (61): Saudi Arabia 20171001.5353977
MERS-CoV (40): animal reservoir, camels, review, FAO 20170619.5115999
MERS-CoV (29): Qatar, animal reservoir, camels 20170527.5066519
MERS-CoV (28): Qatar, Saudi Arabia (HA) 20170524.5059234
MERS-CoV (23): Saudi Arabia (AS) animal reservoir, human contact, OIE, RFI 20170421.4986081
MERS-CoV (21): Egypt, animal reservoir, camel, ex Sudan, control, RFI 20170405.4948727
MERS-CoV (18): Africa, animal reservoir, camels, 2015, research 20170331.4939980
2016
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MERS-CoV (87): Jordan, animal reservoir, camelids, OIE 20160802.4385317
MERS-CoV (66): Saudi Arabia, animal reservoir, camelids, OIE, RFI 20160618.4294807
MERS-CoV (59): animal reservoir, review 20160610.4275921
MERS-CoV (40): Egypt, animal reservoir, camel, ex Sudan, susp. 20160316.4097730
MERS-CoV (21): Saudi Arabia, animal reservoir, camel, comment 20160216.4023772
MERS-CoV (19): Saudi Arabia, animal reservoir, camel, prevention, RFI 20160204.3995194
MERS-CoV (18): Saudi Arabia, animal reservoir, camel, vaccination, comment 20160203.3990284
MERS-CoV (16): Saudi Arabia (MK) animal reservoir, OIE, RFI 20160201.3985175
MERS-CoV (11): Saudi Arabia, animal reservoir, camel, vaccination, comment 20160126.3966528
MERS-CoV (09): Saudi Arabia, animal reservoir, camel, vaccination considered 20160125.3963370
2015
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MERS-CoV (163): Saudi Arabia, animal reservoir, camel, research, vaccine 20151219.3873486
MERS-CoV (155): animal reservoir, camel, research, RFI 20151110.3781744
MERS-CoV (104): Saudi Arabia, animal reservoir, camel debate 20150810.3569207
MERS-CoV (63): animal reservoir, bat 20150612.3432410
MERS-CoV (48): UAE (Dubai) animal reservoir, camel 20150527.3386738
MERS-CoV (27): Saudi Arabia, animal reservoir, camel 20150302.3200502
MERS-CoV (12): animal reservoir, camels debated, case-control study, RFI 20150122.3109335
MERS-CoV (09): Saudi Arabia, animal reservoir, camels debated 20150117.3098294
2014
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MERS-CoV (67): Iran (SB) animal reservoir, camel, ex Pakistan, RFI 20141219.3039497
MERS-CoV (49): Iran (SB), animal reservoir, camel conf, OIE 20141029.2912385
MERS-CoV (40): animal reservoir, camel, milk susp, RFI 20141022.2889778
MERS-CoV (24): animal reservoir, camel, experimental infection 20140929.2813981
MERS-CoV (09): animal reservoir, update, OIE, WHO 20140818.2700879
MERS-CoV (07): animal reservoir, camel, bat 20140720.2623848
MERS-CoV - Eastern Mediterranean (79): Qatar (OIE) Kuwait (susp) animal res, RFI 20140611.2533756
MERS-CoV - Eastern Mediterranean (77): S Arabia, Qatar, animal res, control, RFI 20140607.2525113
MERS-CoV - Eastern Mediterranean (75): Animal res, camel, zoonotic aspects 20140604.2518134
MERS-CoV - Eastern Mediterranean (66): Oman (SH), camel conf, OIE 20140523.2493556
MERS-CoV - Eastern Mediterranean (10): camel, Sudan, Ethiopia 20140228.2307254
MERS-CoV - Eastern Mediterranean (09): animal reservoir, camel, Saudi Arabia 20140227.2303420
MERS-CoV - Eastern Mediterranean (02): animal reservoir, camel, UAE, serology 20140104.2151807
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