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

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

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

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

Recent publications

Ogoti, B. M., Riitho, V., Wildemann, J., Mutono, N., Tesch, J., Rodon, J., Harichandran, K., Emanuel, J., Möncke-Buchner, E., Kiambi, S., Oyugi, J., Mureithi, M., Corman, V. M., Drosten, C., Thumbi, S. M., & Müller, M. A. (2024). Biphasic MERS-CoV Incidence in Nomadic Dromedaries with Putative Transmission to Humans, Kenya, 2022-2023. Emerging infectious diseases, 30(3), 581–585. [reference] A year-long study at a Kenyan abattoir revealed two peaks of MERS-CoV incidence in dromedaries: October 2022 and February 2023. Additionally, 7 out of 48 abattoir workers exposed to dromedaries showed serologic evidence of prior MERS-CoV exposure.

Country-level actions

Egypt

• Abattoir and risk-based MERS-CoV surveillance in camels is still under discussion considering the recently developed camel value chain study. 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.
• A joint meeting was organized with public health authorities to explore the opportunity to conduct a joint study between animal and public health sectors in targeted areas (abattoir) to better understand the transmission dynamic of MERS-COV.

Ethiopia

• A Participatory Disease Search (PDS) took place in the Afar and Somali Regional States of Ethiopia, specifically in eight sites/kebeles. The primary objective of the PDS was to enhance knowledge regarding disease patterns in camel populations, detect temporal and spatial trends, and evaluate risk factors. Special attention was given to comprehending and confirming the recurring reports of unidentified camel diseases. Currently, the process of preparing a comprehensive report based on the findings of the Participatory Disease Search (PDS) is underway.
• The terminal report for the MERS-CoV project has been prepared and shared with the project focal points at the FAO Headquarters. This report provides a comprehensive overview of the essential elements, achievements, and impacts of the MERS-CoV surveillance and management project in Ethiopia.
• Contributed to the review of the Regional MERS-CoV surveillance framework, which is currently being developed through expert consultants based in Nairobi. Cost for recruitment of the consultants is jointly covered through project funds from Kenya and Ethiopia.

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 meeting was organized with the veterinary services and Jordan Center for Disease control (JCDC) to overview the support and coordination to enhance early detection and characterization of MERS-CoV in camels.
  • An introductory meeting was held for relevant stakeholders to introduce the GHSP project activities including MERS-CoV.
• Jordan participated in the 2023 Quadripartite Global Technical Meeting, presenting a poster entitled “High Prevalence of Middle East Respiratory Coronavirus in Young Dromedary Camels in Jordan”.

FAO and partners

• 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

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 designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.