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Issue paper

Investigating potential recombination of MERS-CoV and SARS-CoV-2 or other coronaviruses in camels. Supplementary recommendations for the epidemiological investigation of SARS-CoV-2 in exposed animals

Dromedary camels are the main reservoir for Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Genetic analysis of MERS-CoV isolates from humans and dromedaries revealed that direction of transmission is from camels to humans. Furthermore, several studies reported evidence of camel infection by other human CoVs, animal CoVs or unknown coronaviruses. There is evidence of recombination between different betacoronaviruses in camels. Analysis of the Angiotensin converting enzyme 2 receptor (ACE2) binding in dromedaries predicted potential binding affinity to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) receptor binding domain (RBD), however some other studies predicted the contrary. With the pandemic spread of SARS-CoV-2, it is not a matter of if but rather when camels will be exposed to SARS-CoV-2 in these countries.

Co-circulation of both viruses in the same host can favour virus recombination, and may lead to increased virulence in animals and/or humans if the recombinant virus incorporates pathogenicity of MERS-CoV with the transmissibility of SARS-CoV-2. Further investigations into camel susceptibility to SARS-CoV-2, the possibility for recombination between MERS-CoV and SARS-CoV-2 or other coronaviruses in camels, and the associated zoonotic potential are therefore urgently required to ensure early-detection of such events.