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Researchers identify potential risk factors for MERS-CoV
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Milking camels, cleaning farm equipment, and living near animal feces and dogs were among several factors associated with an increased risk for Middle East respiratory syndrome coronavirus, or MERS-CoV, according to recent study findings.
Reina S. Sikkema, MSc, DMV, PhD candidate from the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues, reported in the Journal of Infectious Diseases that these and other identified risk factors can be used to establish infection prevention and control measures for MERS-CoV infection.
“A recent MERS-CoV WHO consultation on public health goals and global research activities called upon researchers to address knowledge gaps related to, amongst other topics, animal reservoirs and transmission routes to humans of MERS-CoV,” they wrote. “This study adds to the understanding of MERS-CoV transmission on the human-animal interface and informs risk management.”
Using the WHO questionnaire for case-control studies, Sikkema and colleagues assessed risk factors for the presence of MERS-CoV antibodies in workers at a camel farm complex in West Qatar, where the virus is known to be circulating. The analysis included data on nine seropositive camel workers and 43 seronegative workers, all of whom were men with a mean age of 28 years.
A univariate analysis showed that seropositive participants were more likely to be involved in camel training and herding (44% vs. 7%; P = .01), cleaning farm equipment (67% vs. 26%; P = .05) and milking camels (55% vs. 19%; P = .03) compared with seronegative participants. Seropositivity was also associated with an overnight hospital stay with respiratory complaints in the past year (33% vs. 2%; P = .01), as well as living near animal feces (44% vs. 9%; P = .02) and dogs (33% vs. 5%; P = .03).
“There is currently no evidence of a role for dogs in MERS-CoV epidemiology,” the researchers wrote. “A possible explanation for the association between the presence of dogs and MERS-CoV seropositive humans could be that dogs mechanically spread contaminated camel products around the farm complex, [such as] feces and urine.”
In addition, seropositive workers were less likely to wash their hands before and after animal contact (44% vs. 86%; P = .01), and were more likely to handle camels that traveled abroad (44% vs. 14%).
“Prevention of MERS-CoV infection or exposure by handwashing possibly indicates that MERS-CoV may be indirectly transmitted via fomites,” the researchers wrote. “Contact with camel excretions and subsequent touching of mucous membranes may be an important source of infection. Human-to-human transmission may also take place via fomites. This can explain why many primary MERS-CoV human cases do not report direct camel contact and in some cases report a household member who recently visited a camel farm.”
Although the study was restricted to univariate analyses and very limited multivariate analyses, the researchers noted that a larger study was launched to further examine MERS-CoV risk factors in different segments of the population in Qatar.– by Stephanie Viguers
Disclosure : The researchers report no relevant financial disclosures.
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