07 April 2016 - Egypt is ready to begin longitudinal studies of Middle East Respiratory Syndrome caused by Corona virus (MERS-CoV) in camel populations as part of Emerging Pandemic Threats 2 (EPT-2), a programme funded by the United States Agency for International Development (USAID). The programme aims to prevent, detect and respond to infectious diseases that have an adverse impact on health (both human and animal), such as MERS-CoV, but also Ebola and avian influenza. Under the FAO component of EPT-2, Egypt is conducting MERS-CoV surveillance in camels and other domestic species. In addition, camel value chains will be explored and characterized. Similar work is also being conducted in Jordan, Sudan, Ethiopia and Kenya as part of the FAO regional MERS-CoV programme. MERS-CoV emerged in the Middle East in 2012 as a severe respiratory disease of humans. Even though human to human transmission is the main route for infection today, it is thought that the virus mainly circulates in camel populations, and can jump to humans that are in close contact with an infected camel. MERS-CoV surveillance is conducted in two phases. Phase 1 consists of cross-sectional studies at different nodes along the value chain (border points, markets, slaughterhouses, farms, etc.) in order to provide rough estimates of MERS-CoV seroprevalence and virus shedding in different camel populations. Phase 2 consists of different types of longitudinal studies that will be tailored according to the results of the cross-sectional study and the structure and composition of the camel value chain.
Egypt is the first country to have completed phase 1 of the FAO regional MERS-CoV programme under EPT-2. Dr. Mohamed Ali, National Research Centre (NRC) Group Leader said that ‘cross-sectional studies conducted between August 2015 – January 2016 revealed high seroprevalence at all nodes of the value chain (84.5% seroprevalence out of 1031 camels tested), and virus ribonucleic acid (RNA - indicating the possibility of infectious, shedding animals) was detected and confirmed in a small number of camels (3.8% of 1078 camels tested) (Mohamed Ali, in press). The cross sectional study included 145 domestic animals in contact with tested camels. The nasal swabs and serum samples were negative for MERS-CoV except one serum sample collected from a sheep and gave a neutralizing antibody titre of 1:640. This turned our attention to continue working on the domestic animals in contact with camels to study the possible transmission of the virus to them. The suggested longitudinal study will clarify gaps in our understanding of MERS-CoV infection and dynamic and immune response kinetics.’
With these results in hand, the Cairo-based team quickly started drafting surveillance plans for phase 2 – longitudinal sampling at specific sites identified as high-risk.
In support of the planning for phase 2, Emma Gardner, an epidemiologist from FAO headquarters, joined the local team in Cairo to discuss the results of the cross-sectional surveys and assist in drafting the longitudinal plan. “I was impressed about the achievements of the ECTAD Cairo team in implementing MERS-CoV activities in Egypt.” said Dr Gardner. “The plan for the longitudinal study is already in its final stages and the purpose of my visit was primarily to help fine-tune the plan and facilitate the streamlining of activities at the global level”.
Dr. Heba Mahrous, MERS-CoV project coordinator in Egypt, explains that sampling for phase 2 is scheduled to begin in mid April – ahead of the expected timeline: “We have conducted site visits and enrolled camel owners in the study”, she said. “Egypt is unique in that almost all the camels in the country were born elsewhere, and most move through the value chain quickly to slaughter. We have therefore chosen a particular population of camels in a village that remain in one place for fattening so that we can follow over the course of a few months”. In addition to this specific study, markets, slaughterhouses, and quarantine stations will continue to be sampled monthly. A third study following a closed camel herd is also in the works. The efficient sampling timeline is in large part due to a well-established national animal health network, including epidemiological and laboratory expertise in the public sector. “The FAO is leveraging EPT-2 as an opportunity to build livestock surveillance capacity in the region. Because Egypt has a robust MERS-CoV laboratory expertise, it can provide training to other target countries that are building their laboratory capacity in anticipation of sampling” said Dr. Yilma Makonnen, ECTAD-Egypt Team Leader. “Through our long-term engagement in Egypt regarding avian influenza and other transboundary animal diseases (TADs), FAO has developed strong partnerships with the National Research Centre (NRC) and the General Organization for Veterinary Services (GOVS). This enabled us, with the support of USAID, to timely start investigating this recently emerged public health threat”.