Middle East respiratory syndrome coronavirus in dromedary camels: An outbreak investigation

Bart L. Haagmans, Said H.S. Al Dhahiry, Chantal B.E.M. Reusken, V. Stalin Raj, Monica Galiano, Richard Myers, Gert Jan Godeke, Marcel Jonges, Elmoubasher Farag, Ayman Diab, Hazem Ghobashy, Farhoud Alhajri, Mohamed Al-Thani, Salih A. Al-Marri, Hamad E. Al Romaihi, Abdullatif Al Khal, Alison Bermingham, Albert D.M.E. Osterhaus, Mohd M. AlHajri*, Marion P.G. Koopmans

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

462 Citations (Scopus)


Background: Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe lower respiratory tract infection in people. Previous studies suggested dromedary camels were a reservoir for this virus. We tested for the presence of MERS-CoV in dromedary camels from a farm in Qatar linked to two human cases of the infection in October, 2013. Methods: We took nose swabs, rectal swabs, and blood samples from all camels on the Qatari farm. We tested swabs with RT-PCR, with amplification targeting the E gene (upE), nucleocapsid (N) gene, and open reading frame (ORF) 1a. PCR positive samples were tested by different MERS-CoV specific PCRs and obtained sequences were used for phylogentic analysis together with sequences from the linked human cases and other human cases. We tested serum samples from the camels for IgG immunofluorescence assay, protein microarray, and virus neutralisation assay. Findings: We obtained samples from 14 camels on Oct 17, 2013. We detected MERS-CoV in nose swabs from three camels by three independent RT-PCRs and sequencing. The nucleotide sequence of an ORF1a fragment (940 nucleotides) and a 4·2 kb concatenated fragment were very similar to the MERS-CoV from two human cases on the same farm and a MERS-CoV isolate from Hafr-Al-Batin. Eight additional camel nose swabs were positive on one or more RT-PCRs, but could not be confirmed by sequencing. All camels had MERS-CoV spike-binding antibodies that correlated well with the presence of neutralising antibodies to MERS-CoV. Interpretation: Our study provides virological confirmation of MERS-CoV in camels and suggests a recent outbreak affecting both human beings and camels. We cannot conclude whether the people on the farm were infected by the camels or vice versa, or if a third source was responsible. Funding: European Union projects EMPERIE (contract number 223498), ANTIGONE (contract number 278976), and the VIRGO consortium.

Original languageEnglish
Pages (from-to)140-145
Number of pages6
JournalThe Lancet Infectious Diseases
Issue number2
Publication statusPublished - Feb 2014

Bibliographical note

Funding Information:
We thank WHO and the Food and Agriculture Organization of the United Nations for their generous help in organisation of the study, Theo Bestebroer for providing Middle East respiratory syndrome coronavirus specific primer sets, Berend Jan Bosch for providing antigens for the microarray, and Jeroen Cremer for technical support. Contributions to the study were funded through the European Union FP7 projects EMPERIE (contract number 223498; to BLH and ADMEO) and ANTIGONE (contract number 278976; to MPGK and ADMEO).


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