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. 2019 Dec:29:100350.
doi: 10.1016/j.epidem.2019.100350. Epub 2019 Jun 5.

A systematic review of MERS-CoV seroprevalence and RNA prevalence in dromedary camels: Implications for animal vaccination

Amy Dighe  1 , Thibaut Jombart  2 , Maria D Van Kerkhove  3 , Neil Ferguson  4
Affiliations

A systematic review of MERS-CoV seroprevalence and RNA prevalence in dromedary camels: Implications for animal vaccination

Amy Dighe et al. Epidemics. 2019 Dec.

Abstract

Human infection with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is driven by recurring dromedary-to-human spill-over events, leading decision-makers to consider dromedary vaccination. Dromedary vaccine candidates in the development pipeline are showing hopeful results, but gaps in our understanding of the epidemiology of MERS-CoV in dromedaries must be addressed to design and evaluate potential vaccination strategies. We aim to bring together existing measures of MERS-CoV infection in dromedary camels to assess the distribution of infection, highlighting knowledge gaps and implications for animal vaccination. We systematically reviewed the published literature on MEDLINE, EMBASE and Web of Science that reported seroprevalence and/or prevalence of active MERS-CoV infection in dromedary camels from both cross-sectional and longitudinal studies. 60 studies met our eligibility criteria. Qualitative syntheses determined that MERS-CoV seroprevalence increased with age up to 80-100% in adult dromedaries supporting geographically widespread endemicity of MERS-CoV in dromedaries in both the Arabian Peninsula and countries exporting dromedaries from Africa. The high prevalence of active infection measured in juveniles and at sites where dromedary populations mix should guide further investigation - particularly of dromedary movement - and inform vaccination strategy design and evaluation through mathematical modelling.

Keywords: Dromedary camels; MERS-CoV; Prevalence of infection; Seroprevalence.

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Figures

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Graphical abstract
Fig. 1
Fig. 1
Review strategy. Published studies found with all three of our selected search term groups were then assessed against the exclusion criteria resulting in a final selection of 60 publications.
Fig. 2
Fig. 2
Map of MERS-CoV seroprevalence in dromedaries. Measures of MERS-CoV seroprevalence in dromedaries, aggregated at the country level. Total sample size tested is given in parenthesis. Camel density is calculated using FAOSTAT country-level camel population data (FAO, 2016) and World Bank data on country surface area (World Bank, 2016) *value calculated by us from disaggregated sub-national measures of seroprevalence. Red text highlights studies conducted in dromedary populations in response to an epidemiologically linked human MERS-CoV infection. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
Age stratified seroprevalence. Measures grouped by available stratification and arranged in order of increasing adult seroprevalence. Bars indicate 95% confidence intervals, calculated by us when not stated in the study, if age class size was available (not available for the population in Mali). *indicates that calves <1-year-old were not included. **indicates that the study was conducted in dromedary populations in response to an epidemiologically linked human MERS-CoV infection.
Fig. 4
Fig. 4
Map of prevalence of active MERS-CoV infection in dromedaries. Measures of MERS-CoV RNA prevalence in dromedaries, aggregated at the country level. Total sample size tested is given in parenthesis. Camel density is calculated using FAOSTAT country-level camel population data (FAO, 2016) and World Bank data (World Bank, 2016) on country surface area. *value calculated by us from disaggregated sub-national measures of RNA prevalence. Red text highlights studies conducted in dromedary populations in response to an epidemiologically linked human MERS-CoV infection. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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