No Serologic Evidence of Middle East Respiratory Syndrome Coronavirus Infection Among Camel Farmers Exposed to Highly Seropositive Camel Herds: A Household Linked Study, Kenya, 2013

Peninah Munyua Global Disease Detection Program, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, Kenya.

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Victor Max Corman Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
German Centre for Infection Research, Partner Site Bonn-Cologne, Bonn, Germany.

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Austine Bitek State Department of Veterinary Services; Ministry of Agriculture Livestock and Fisheries, Nairobi, Kenya.

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Eric Osoro Department of Preventive and Promotive Health, Ministry of Health, Nairobi, Kenya.

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Benjamin Meyer Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.

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Marcel A. Müller Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.

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Erik Lattwein EUROIMMUN AG, Lübeck, Germany.

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S. M. Thumbi Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington.

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Rees Murithi State Department of Veterinary Services; Ministry of Agriculture Livestock and Fisheries, Nairobi, Kenya.

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Marc-Alain Widdowson Global Disease Detection Program, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, Kenya.

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Christian Drosten Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.
German Centre for Infection Research, Partner Site Bonn-Cologne, Bonn, Germany.

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M. Kariuki Njenga Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington.

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High seroprevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) among camels has been reported in Kenya and other countries in Africa. To date, the only report of MERS-CoV seropositivity among humans in Kenya is of two livestock keepers with no known contact with camels. We assessed whether persons exposed to seropositive camels at household level had serological evidence of infection. In 2013, 760 human and 879 camel sera were collected from 275 and 85 households respectively in Marsabit County. Data on human and animal demographics and type of contact with camels were collected. Human and camel sera were tested for anti-MERS-CoV IgG using a commercial enzyme-linked immunosorbent assay (ELISA) test. Human samples were confirmed by plaque reduction neutralization test (PRNT). Logistic regression was used to identify factors associated with seropositivity. The median age of persons sampled was 30 years (range: 5–90) and 50% were males. A quarter (197/760) of the participants reported having had contact with camels defined as milking, feeding, watering, slaughtering, or herding. Of the human sera, 18 (2.4%) were positive on ELISA but negative by PRNT. Of the camel sera, 791 (90%) were positive on ELISA. On univariate analysis, higher prevalence was observed in female and older camels over 4 years of age (P < 0.05). On multivariate analysis, only age remained significantly associated with increased odds of seropositivity. Despite high seroprevalence among camels, there was no serological confirmation of MERS-CoV infection among camel pastoralists in Marsabit County. The high seropositivity suggests that MERS-CoV or other closely related virus continues to circulate in camels and highlights ongoing potential for animal-to-human transmission.

Author Notes

* Address correspondence to Peninah Munyua, Global Disease Detection Program, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, P.O. Box 606-00627, Nairobi, Kenya. E-mail: ikg2@cdc.gov
† These authors contributed equally to this work.

Financial support: Financial support for the field work was provided by the U.S. Department of Defense's Defense Threat Reduction Agency and U.S. Centers for Disease Control and Prevention. All the laboratory testing was supported by the German Research Foundation (DFG grant DR772/12-1 to CD), the European Commission project PREPARE (contract number 602525) and the ZAPI project; IMI grant agreement n°115760, with the assistance and financial support of IMI and the European Commission, in kind contributions from EFPIA partners.

Authors' addresses: Peninah Munyua and Marc-Alain Widdowson, Global Disease Detection Program, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Nairobi, Kenya, E-mails: ikg2@cdc.gov and zux5@cdc.gov. Victor Max Corman and Christian Drosten, Institute of Virology, University of Bonn Medical Centre, Bonn, Germany, and German Centre for Infection Research, Partner Site Bonn-Cologne, Bonn, Germany, E-mails: corman@virology-bonn.de and drosten@virology-bonn.de. Austine Bitek and Rees Murithi, State Department of Veterinary Services, Ministry of Agriculture Livestock and Fisheries, Nairobi, Kenya, E-mails: bitekorinde@gmail.com and murithi.mbabu@gmail.com. Eric Osoro, Department of Preventive and Promotive Health, Ministry of Health, Nairobi, Kenya, E-mail: osoroe@gmail.com. Benjamin Meyer and Marcel A. Müller, Institute of Virology, University of Bonn Medical Centre, Bonn, Germany, E-mails: meyer@virology-bonn.de and muller@virology-bonn.de. Erik Lattwein, EUROIMMUN AG, Lübeck, Germany, E-mail: e.lattwein@euroimmun.de. S. M. Thumbi and M. Kariuki Njenga, Center for Global Health Research, Kenya Medical Research Institute, Nairobi, Kenya, and Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, E-mails: thumbi.mwangi@wsu.edu and knjenga@vetmed.wsu.edu.

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