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

Zhou, Z., Ali, A., Walelign, E., Demissié, G. F., Masry, I. E., Abayneh, T., Getachew, B., Krishnan, P., Ng, D. Y. M., Gardner, E., Makonnen, Y., Miguel, E., Chevalier, V., Chu, D. K., So, R. T. Y., Von Dobschuetz, S., Mamo, G., Poon, L. L. M., & Peiris, M. (2023). Genetic diversity and molecular epidemiology of Middle East Respiratory Syndrome Coronavirus in dromedaries in Ethiopia, 2017 to 2020. Emerging microbes & infections, 2164218. Advance online publication. https://doi.org/10.1080/22221751.2022.2164218. This study investigated the genetic diversity and molecular epidemiology of MERS-CoV in dromedary camels in Ethiopia from samples collected from 2017-2020. Twenty-five whole genome sequences were obtained. Phylogenetically, these Ethiopian camel-originated MERS-CoV belonged to clade C2, clustering with other East African camel strains. In contrast to clade A and B viruses from the Arabian Peninsula, clade C camel-originated MERS-CoV from Ethiopia had various nucleotide insertions and deletions in non-structural gene nsp3, accessory genes ORF3 and ORF5 and structural gene N. This study demonstrates the genetic instability of MERS-CoV in dromedaries in East Africa.

Country-level actions

Egypt

• Abattoir-based sampling continued during December 2022. A total of 240 samples (120 deep nasal swabs, and 120 tissues from lymph node) and epidemiological data were collected from 120 camel carcasses from slaughterhouses at Cairo and Giza Governorates . The sampling team was composed of experts from the General Organization for Veterinary Services (GOVS) and the Animal Health Research Institute (AHRI).
• A research article was prepared and submitted to an international peer review journal on the Longitudinal Study of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Dromedary Camels between December 2019 and March 2020 to characterize the kinetics of MERS-CoV neutralizing antibodies and its relationship with viral shedding.
• A letter of agreement was signed with the Animal Health Research Institute (AHRI) in Egypt to conduct risk-based surveillance of MERS-CoV, including monitoring for genomic changes.

Ethiopia

• Field and slaughterhouse sample collection resumed in December 2022. 153 samples (66 nasal swab and 66 serum from field and 7 nasal swab, 7 serum and 7 lymph node tissue samples from slaughterhouse) were collected from 73 camels through LOA collaboration with the National Veterinary Institute (NVI).
• Epidemiological report for the period 2019 -2020 was completed and shared with FAO Rome for further analysis, review and feedback together with the previously prepared epi report for 2016-2018. Additionally, raw data of the whole surveillance activity and its laboratory results since 2016 were shared.  
• Proficiency Testing (PT) for MERS-CoV PCR is planned for February 2023. The PT panel is expected to arrive at Addis between 21-24 Jan 2023.
• Preparation of questionnaires to conduct KAP study on camel respiratory diseases in area/farming system with high MERS-CoV seroprevalence is underway. Data collection will start in February.
• A research paper on “Genetic diversity and molecular epidemiology of Middle East Respiratory Syndrome Coronavirus in dromedaries in Ethiopia, 2017–2020” was published in Emerging Microbes & Infections (see link under recent publications)
• Abstract on "Epidemiologic and Genetic characterization of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Ethiopia" has been accepted for presentation at the 3rd Scientific Conference on Acute Respiratory Infections in the Eastern Mediterranean Region ( EMARIS Conference 2023).

Kenya

• Manuscript on KAP study on camel respiratory conditions in Isiolo and Garissa in October 2020 was published in Veterinary Frontiers in November 8, 2022 [reference].

Jordan

• Two veterinarians from central veterinary laboratories at the Ministry of Agriculture completed their training on advanced serological diagnostic techniques using pseudo particle neutralization testing (PPNT) at the Erasmus Medical Center from 24 – 28 October in Rotterdam.

FAO and partners

• The report on the FAO-WOAH-WHO organized “Global tripartite technical meeting on MERS-CoV and other emerging zoonotic coronaviruses” 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]
• FAO’s USAID-funded work on MERS-CoV in Jordan, Egypt, Kenya and Ethiopia has been extended to June 2023.
• 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 filling 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.