‘Camel flu’: Experts call for surveillance, research

‘Camel flu’: Experts call for surveillance, research

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As the FIFA World Cup 2022 in Qatar draws to a close, health experts in some countries have warned football fans returning from Qatar about the risk of bringing home the ‘camel flu’, a respiratory infection which is from the same family as the virus behind the COVID-19 pandemic. It is caused by the Middle East respiratory syndrome coronavirus (MERS or MERS-CoV).

On the Australian health ministry’s website, fans returning from Qatar were told to be aware of MERS, and asked to reduce their risk of contracting the infection by “observing good hygiene practices, avoiding close contacts with camels and avoiding consuming uncooked meat or unpasteurised milk”.

The UK Health Security Agency (UKHSA) also asked doctors to look for people suffering from fever and breathing difficulties. UKHSA stated, “The risk of infection to UK residents is very low but may be higher in those with exposure to specific risk factors within the region, such as to camels.”

In Australia, the government issued a notice on December 2, asking that anyone travelling from the Middle East, including those returning to Australia from attending the 2022 FIFA World Cup, should be aware of MERS.

Many excited fans are reported to have enjoyed camel rides in Qatar while following the matches in the World Cup and during safaris.

However, at the World Cup event in Qatar, there have been no MERS cases reported as of December 12, 2022, even though there is an increase in the number of MERS cases across the globe. Also, since 2012, about 2,600 MERS cases with 935 associated fatalities have been reported from 27 countries to the World Health Organisation (WHO).

A recent disease outbreak alert released by the World Health Organisation (WHO) reported four laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) from three regions in the Kingdom of Saudi Arabia.

The recent four cases experienced cough, fever, and shortness of breath and had consumed raw camel milk or being around dromedary camels in the two weeks before the onset of symptoms. The patients fell within a broad age group of 23 to 74 years old.

MERS is a zoonotic virus, believed to have been transmitted from bats to camels, which causes similar symptoms to COVID-19 in humans: fever, coughing and respiratory difficulties. There is no specific treatment for the illness, so doctors work to ease a patient’s symptoms.

So far, all cases of MERS have been linked through travel to, or resident in, countries in and near the Arabian Peninsula. The largest known outbreak of MERS outside the Arabian Peninsula occurred in the Republic of Korea in 2015. The outbreak was associated with a traveller returning from the Arabian Peninsula.

The emergence of COVID-19, which has killed almost three million people worldwide in 16 months, has sharpened the focus on the next virus which could jump from animals to humans, or in the case of MERS, mutate to become even more transmissible.

In a reaction, Dr Abdulazeez Anjorin, a medical virologist at the Lagos State University, says MERS-CoV should be of concern in Nigeria because the coronavirus is a major threat to the entire world and previous studies indicated that camels in Nigeria also have a MERS-CoV in them.

Researchers in a report from Emerging Infectious Diseases reported the discovery of MERS-CoV–like antibodies in camels in Nigeria, Tunisia, and Ethiopia, expanding the geographic range of the virus beyond the Middle East and raising the possibility of unrecognised human cases in Africa.

In the study of African camels, researchers tested for MERS-CoV–like antibodies in serum samples that had been collected from 2009 to 2011 during the workup of other infectious diseases in camel herds in Tunisia, Nigeria, and Ethiopia.

The camels from Nigeria were in herds raised for meat in four different provinces, Tunisian camels were meat or tourist-attraction animals from three provinces, and Ethiopian dromedaries were from three different provinces. The researchers looked at 750 samples from camels ages 1 to 16 years.

MERS-CoV–like antibodies were extremely common in camels from Nigeria and Ethiopia—found in 94% of adult camels from Nigeria and 93% and 97% of juvenile and adult animals, respectively, from Ethiopia. In Tunisia, the prevalence varied and was higher in adult camels than young ones, while tests showed seropositivity in 100% of one herd in the southern part of the country.

However, Dr Anjorin declared that not much surveillance is ongoing on MERS-CoV in Nigeria to know if there is a direct transmission of the virus to humans in herding communities and abattoir workers or transmission of the virus back to camels considering its possible implication on health and trade across the globe. It can also mutate to become even more transmissible.

“He added: “MERS-CoV is also a major problem in other continents and so it can also be a problem because other continents will move away from taking camels and its products from Africa because of the fear of contracting this virus. Africa remains a big threat to other global communities from its nomadic’s migratory animals.”

He stated that surveillance for MERS-CoV also needs to be extended to sheep, goats and cattle in the community considering increased human interference with the ecosystem, climate change, hunting and increasingly these animals are being discovered as reservoirs for different disease-causing germs.

Dr Anjorin also warned that bats are also reservoirs of viruses like MERS-CoV and as such the need to maintain a clean and bat-free environment as well as regular hand washing with soap and water.

Meanwhile, Oyewale Tomori, a professor of Virology, stated that the possibility of a cover-up for cases of ‘camel flu’ at the FIFA World Cup 2022, was slim.

According to him, “I don’t think there is a reason for people to be scared; it is a fairly mild infection but with that large number of people gathering together in a place and without the use of face masks, if MERS-CoV had spread, it would be known. The report that said seven other diseases also occur is also doubtful.”

Given previous reports of outbreaks of MERS-CoV in the Middle East, Professor Tanimola Akande, a public health physician with the University of Ilorin Teaching Hospital, stated the need to have a high index of suspicion and necessary surveillance put in place.

Professor Akande declared: “If an outbreak is confirmed, the likelihood of a global spread, given the 2022 World Cup that attracted people from so many countries, is possible.”

Researchers have observed that some coronaviruses like MERS-CoV have never caused a pandemic, while others, such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), have. However, they agreed that outside the healthcare setting, there has been limited human-to-human transmission of MERS-CoV.


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