Map 1. MERS-CoV livestock field surveys by country*

*Positive findings in Spain refer to samples taken in the Canary Islands. Livestock surveillance in Chile, not pictured, resulted negative.

Notes: Refer to the disclaimer available on this webpage for the names and boundaries in this map. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. Final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. Final status of the Abyei area is not yet determined.
Source: xxx.

Map 2. Global distribution of human cases of MERS-CoV

Stars highlight countries reporting human cases since 2020 (Oman, Saudi Arabia, Qatar, and United Arab Emirates).

Notes: Refer to the disclaimer available on this webpage for the names and boundaries in this map. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. Final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. Final status of the Abyei area is not yet determined.
Source: xxx.

Recent publications

Alatawi A, Gumel AB. Mathematical assessment of control strategies against the spread of MERS-CoV in humans and camels in Saudi Arabia. Math Biosci Eng. 2024 Jul 1;21(7):6425-6470. doi: 10.3934/mbe.2024281.PMID: 39176403. [reference] The authors designed a mathematical model to study the transmission dynamics of the disease in a human-camel population within the KSA. Among other results, the simulation showed that an intervention strategy based on vaccinating camels only resulted in a significant reduction in the disease burden in camels.

Lawrence TJ, Kangogo GK, Fredman A, Deem SL, Fèvre EM, Gluecks I, Brien JD, Shacham E. Spatial examination of social and environmental drivers of Middle East respiratory syndrome coronavirus (MERS-CoV) across Kenya. Ecohealth. 2024 Jun 25. doi: 10.1007/s10393-024-01684-9. Epub ahead of print. PMID: 38916836. [reference] The study aimed to spatially examine the climate, agriculture, and socio-demographic factors related to agro-pastoralism, effects of these variables on the prevalence of MERS-CoV in dromedary camels across northern Kenya.

Holloway PM, Gibson MD, Holloway TT, van Doremalen N, Munster VJ, Al-Omari B, Letko MC, Nash S, Cardwell JM, Abu-Basha EA, Hayajneh W, Mangtani P, Guitian J. MERS-CoV exposure and risk factors for MERS-CoV ELISA seropositivity among members of livestock-owning households in southern Jordan: a population based cross-sectional study. Lancet Microbe. 2024 Jul 22:100866. doi: 10.1016/S2666-5247(24)00082-X. Epub ahead of print. PMID: 39053480. [reference] This study assesses MERS-CoV seroprevalence and risk factors in high-risk Jordanian communities, highlighting juvenile dromedaries as a priority for vaccination. Camel interactions, especially close contact with respiratory aerosols, are key transmission routes. Camel races are important transmission nodes, and vaccination should target camel-owning households, particularly older or diabetic members.

Country-level actions

Egypt

• Abattoir and quarantine-based surveillance of MERS-CoV in camels is being conducted in two slaughterhouses (El-Warak and El-Bastein) and Abu Simbel (Border with Sudan). The plan aims to isolate and characterize MERS-CoV to understand if the virus being maintained in the camel population of Egypt is similar to the clades in other countries. The samples collected from the surveillance plan are currently being tested.
• Surveillance activities targeting farms and camel gatherings have been conducted.
• FAO ECTAD Egypt has supported the procurement of laboratory and field consumables for MERS-CoV surveillance and molecular testing.
• A joint study of MERS-COV with public health partners to better understand the transmission dynamic of the virus is under discussion.

Ethiopia

• Three abstracts titled (1) Monitoring Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Ethiopia: A Multi-Year Surveillance and Capacity Strengthening Project; and (2) Enhancing Regional Surveillance: MERS-CoV and Zoonotic Coronaviruses Surveillance Framework in Horn of Africa and Near East/North Africa have been submitted and accepted for poster presentation at the 8th World One Health Congress scheduled to take place in 20-23 September 2024 in Cape town, South Africa.
• Laboratory materials, consumables and reagents procured through the FAO long term agreement has been handed over to the National Veterinary Institute.
• MERS-CoV surveillance screening activities, which include monitoring and testing camels for the virus as part of a broader effort to identify undiagnosed or unknown diseases in camel populations, are supported by the Ethio-Pandemic Preparedness and Response Project.

Kenya

• Kenya contributed to review the Regional MERS-CoV surveillance framework that was conducted through a virtual process.
• Kenya participated in the 2023 Quadripartite Global Technical Meeting. Several presentations regarding the MERS-CoV surveillance on the country were delivered, including a poster on "Antibody Dynamics for MERS-CoV in pastoral and ranched camel herds in Kenya; A longitudinal study” from the Directorate of Veterinary Services supported by FAO, as well as a video showcasing the achievements of FAO’s MERS-CoV project in Kenya.
• FAO Kenya has supported procurement of laboratory and field consumables for MERS-CoV Surveillance and molecular testing.
• FAO Kenya has supported shipment of positive controls from Hong Kong University to Kenya Directorate of Veterinary Services (DVS) Laboratories for use in molecular testing.

Jordan

• As part of the Global Health Security Program (GHSP):
  • A Joint Risk Assessment was conducted with participation of a One Health Thematic group.
  • MERS-CoV contingency plan was generated and shared with Ministry of Agriculture.

FAO and partners

• FAO, WHO and the University of Calgary launched the MERS-tracker: An interactive dashboard to support evidence-based decision making. The tool consists of a data tracker platform and dashboard showcasing results from published human and animal viral and sero-prevalence field studies. The dashboard was launched in an EPI WIN webinar [reference] and is accessible here: MERStracker.
• FAO published a highlight paper for the International Year of Camelids 2024 entitled “Dromedary camels and MERS-CoV: filling knowledge gaps”. [reference]
• FAO, WHO, WOAH and UNEP, together with the Public Health Authority of the Kingdom of Saudi Arabia (KSA), held the Quadripartite Global Technical Meeting on MERS-CoV and Other Emerging Zoonotic Coronaviruses from 27 to 29 November 2023, in Riyadh, KSA. The meeting brought together more than 200 experts, researchers, government representatives of affected and at-risk countries, representatives of funding agencies, industrial partners and representatives from FAO, UNEP, WOAH and WHO at headquarters, regional and national levels, to share the latest findings from accelerated efforts to implement the MERS-CoV public health research agenda and R&D road map.
• FAO brought together technical experts from countries implementing the Emerging Pandemic Threats Programme (EPT2) MERS-CoV Project (Egypt, Kenya, Ethiopia, and Jordan) to share experiences and discuss future options for MERS-CoV surveillance at the Inter-Regional Consultative Workshop on Mers-Cov Surveillance, that took place in Nairobi, Kenya, from 19 to 21 September 2023. The final communiqué regarding the outcomes of the workshop has been shared with meeting participants.
• FAO participated in the WHO EPI-WIN webinar: MERS-CoV, a circulating coronavirus with epidemic and pandemic potential - Pandemic preparedness, prevention and response with a One Health approach, on 24 May 2023. The discussion can be found on the WHO EPI-WIN webinar website [reference]. A EPI-WIN update on MERS-CoV following the webinar discussion is available [reference].
• FAO participated in the 3rd scientific conference of the Eastern Mediterranean Acute Respiratory Infection Surveillance (EMARIS) Network held from 13-15 March 2023 [reference].
• The report on the FAO-WOAH-WHO organized “Global tripartite technical meeting on MERS-CoV and other emerging zoonotic coronaviruses”, on 15-16 November 2021, has been published [reference].
• The Quadripartite has published the One Health Joint Plan of Action (OH-JPA). It provides a framework for action and proposes a set of activities that the four organizations can offer together to enable countries to advance and scale up One Health in managing human, animal, plant and environment health threats [reference].
• FAO organized a technical workshop on “Qualitative Risk Assessment of MERS-CoV foreign clade introduction to Africa” from July 5 – 6, 2022, hosted by the FAO Egypt office in Cairo. Participants included camel movement experts from different African, Near East, and European countries, as well as FAO MERS-CoV country focal points from Egypt, Ethiopia, Jordan, and Kenya. The final report is underway.
• FAO publishes a quarterly situation updates on SARS-CoV-2 in animals [reference].
• FAO published recommendations for the epidemiological investigation of SARS-CoV-2 in exposed animals [reference], including a supplement on investigating potential recombination of MERS-CoV and SARS-CoV-2 or other coronaviruses in camels. [reference]
• The Joint Risk Assessment Operational Tool is available in Arabic, Chinese, and Russian. [reference]
• A peer-reviewed article was published by the Hong Kong University (HKU) [reference] on genetic and phenotypic characteristics of MERS-CoV isolates sampled from camels in Burkina Faso, Egypt, Ethiopia, Kenya, Morocco, and Nigeria, and compared to viruses isolated in the Arabian Peninsula. FAO, under the EPT-2 project contributed samples taken in Ethiopia and Kenya. The findings highlight the need for enhanced MERS-CoV surveillance in dromedaries and humans in Africa and for measures to avoid introduction of clade B viruses from the Arabian Peninsula to Africa.
• FAO has published a SARS-CoV-2 qualitative exposure assessment [reference] which provides a comprehensive review of available scientific evidence and assessment of exposure risk from different wild or domestic animal species. Results can inform country-level risk assessments and provide the evidence base for targeted SARS-CoV-2 investigations in animals and mitigation options. The e-book version can be found here: [reference], and the summary is now available in all UN languages. [reference]
• FAO published an illustrative guideline describing optimized procedures to facilitate swab sampling from the deeper part of the upper respiratory tract inside the camel’s nasal cavity and to collect good quality specimens from slaughtered camels. [ reference]
• The Tripartite Zoonoses Guide is now available in all UN languages. [reference]
• In close collaboration with WOAH and WHO, monitoring the situation / inter-agency teleconferences.
• Analysing available data, including results from surveillance in camels and advanced characterization of the virus.
• Providing technical assistance and guidance to countries to improve understanding of the disease situation and help fill existing gaps in epidemiological knowledge.
• Supporting national laboratories to develop capacity in serology and PCR diagnostic for MERS-CoV, quality assurance and quality control and biosafety, and establish national sample banks;
• Keeping a dialogue between the scientific community and the field to ensure needs and gaps are addressed.
• Assist in developing communication strategies to ensure appropriate information reaches the public on MERS-CoV and avoid possible negative impacts of the crisis on the livestock industry.

Important links

• Africa Centres for Disease Control and Prevention
• Recommendations for the investigating potential recombination of MERS-CoV and SARS-CoV-2 or other coronaviruses in camels
• Good emergency management practices - the essentials
• Tripartite Joint Risk Assessment (JRA) Operational Tool for multi-sectoral risk assessment at the animal-human-environment interface
• FAO illustrative guideline: Swab and tissue sample collection procedures enhancing MERS-CoV detection in camels
• Tripartite Zoonoses Guide
• FAO meeting report "Understanding MERS-CoV at the Animal-Human Interface", 2016
• US Centers for Disease Control and Prevention (CDC) MERS-CoV page
• CIDRAP University Of Minnesota
• Doha Declaration FAO, 29 April 2015
• European CDC webpages on MERS-CoV
• Ministry of Health of Saudi Arabia
• MERS-CoV case definition for reporting to WOAH
• Muscat Declaration FAO, 21 May 2014
• WOAH Questions and Answers on MERS-CoV
• WHO disease outbreak news and WHO’s MERS-CoV information page
• WHO roadmap for research and product development against MERS-CoV
• WHO MERS-CoV Global Summary and risk assessment
• Human exposure to Middle East Respiratory Syndrome Coronavirus from livestock or wildlife species FAO, 2017
• WHO MERS-CoV Investigations and studies

Disclaimer

Information provided herein is current as of the date of issue. Information added or changed since the last MERS-CoV situation update appears in orange. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisation for Animal Health [WOAH]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The boundaries and names shown and the designations used on these map(s) do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers and boundaries. Dashed lines on maps represent approximate border lines for which there may not yet be full agreement.