• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

Flublogia Interview: Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread - Ian Mackay

sharon sanders

Editor-in-Chief & President
Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread


There have been a seemingly continual and growing stream of Middle East respiratory syndrome coronavirus (MERS-CoV) cases of late, with a particular emphasis on what seem to be increasing numbers of healthcare worker infections, a possibly younger age group and less severe disease.

Professor Ali Mohamed Zaki, Faculty of Medicine, Ain Shams University, Cairo Egypt recently spoke to this in an MBC 2 TV interview.

I asked Prof. Zaki by email on Friday if he could cover what he said in that interview. He kindly replied with the following.....
"..more cases in humans appeared in hospitals in Jeddah, which may indicate increased virus transmission from man to man due to mutation in the genome leading to virus adaptation. This event may be associated with loss of some virulence elements in the virus."
This could be a possibility but not one we can check very easily right now because there are very few MERS-CoV sequences, complete or partial, on the public sequence databases from cases in 2014.

Prof. Zaki went on to talk about camels in the context of MERS-CoV clusters of person-to-person transmission seemingly on the rise among this flurry of cases in recent months. Prof Zaki noted that...

"..since the virus now is transmitted easily between humans, the role of camels may become less important."
Still, there was a heartening sign indicating some real intent to prevent the citizens and workers of the Kingdom Saudi Arabia (KSA) from acquiring MERS-CoV infections this week. The Governor of Jeddah, Prince Mishal Bin Majed, ordered a clamp down on camel breeding in the city, removal of camels from the streets and direction on the selling of camel milk.[1] Also something about vegetables, but perhaps best we move on from that one.[1]

A very hard look at infection control and prevention education and its practices in hospitals and ambulance settings is overdue in the KSA. Also needed are some more detailed molecular investigations into the virus itself. It is essential to monitor this slowly growing epidemic to ensure that the viral culprit hasn't undergone any significant changes. Such change may convey upon it the ability to spread more efficiently among people, perhaps, as Prof. Zaki notes, resulting in less severe pathology. Of more concern though is that enhanced spread, without any change in clicnial outcome will put at much greater risk the sizable proportion of older males with comorbidities that reside in the KSA.

Or course its possible that the rash of cases we are seeing are just due to:


  • Increased exposure to the source
  • Change(s) in seasons
  • Changes in camel, bat or other animal's breeding habits
  • Changes to tests or testing
  • Changes to the way reporting is conducted.
One thing is certain though, the quality and depth of information accompanying the KSA Ministry of Health MERS-CoV press releases is as poor as ever, if not worse than usual.

I sincerely thank Prof. Zaki for taking the time to reply to my email. Prof Zaki was instrumental in discovering the MERS-CoV during his time working in the Kingdom of Saudi Arabia. I have previously reviewed his role in this and related issues. [2,3,4]

I also thank Mike Coston for picking up on the TV interview that led me to contact Prof. Zaki.

Further reading...

  1. Camels to be off streets as precaution against MERS
    http://www.saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20140408201249
  2. Happy 1st birthday Middle East respiratory syndrome coronavirus (MERS-CoV)
    http://virologydownunder.blogspot.com.au/2013/09/happy-1st-birthday-middle-east.html
  3. Questions about MERS, MTAs and mistakes.
    http://virologydownunder.blogspot.com.au/2013/08/questions-about-mers-mtas-and-mistakes.html
  4. Dr Ziad Memish discusses MERS in the Kingdom of Saudi Arabia (KSA)
    http://virologydownunder.blogspot.com.au/2013/08/dr-ziad-memish-discusses-mers-in.html

Posted by Ian M Mackay
 
Re: Flublogia Interview: Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread - Ian Mackay

It is important to know the number of cases of MERS-CoV among HCWs, but it is also essential to make clear the role of these asymptomatic positive PCR cases in the epidemiology of current outbreak.

For example, whether the PCR+ asymptomatic cases close contacts will become infected, and the outcome.

Because, alone, accumulation of asymptomatic cases may have not a link to the alleged enhanced transmissibility of the virus.

gm
 
Re: Flublogia Interview: Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread - Ian Mackay

I am not convinced that this disease is more transmissible. I think that humans have always been the primary host with camels contributing and probably the original human contact source.
 
Re: Flublogia Interview: Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread - Ian Mackay

Sharon, as we are seeing so few cases outside of the Middle East, I am not sure I agree with your assessment regarding humans as the primary hosts. On the other hand I cannot explain why there is an obvious increase in the numbers we are seeing, the lowering of the age of its victims or, the milder cases. We should be seeing more cases outside of the region.
 
Re: Flublogia Interview: Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread - Ian Mackay

The role of asymptomatic PCR+ cases in epidemiology of MERS-CoV is not clear. It may have a little or no role at all. We do not know simply this feature that could drive the outbreak dynamic or not.

It could be the case that asymptomatic cases are reported only to lower the overall cfr.

No follow-up of close contacts is available.
 
Back
Top Bottom