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Zoonoses Public Health. 2018 May;65(3):322-333. doi: 10.1111/zph.12435. Epub 2017 Dec 13.

Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE.

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Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Oak Ridge Institute for Science Education, Oak Ridge, TN, USA.
Abu Dhabi Food Control Authority, Abu Dhabi, United Arab Emirates.
Health Authority Abu Dhabi, Abu Dhabi, United Arab Emirates.
Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
The University of Sydney, Sydney, NSW, Australia.


Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, there have been a number of clusters of human-to-human transmission. These cases of human-to-human transmission involve close contact and have occurred primarily in healthcare settings, and they are suspected to result from repeated zoonotic introductions. In this study, we sequenced whole MERS-CoV genomes directly from respiratory samples collected from 23 confirmed MERS cases in the United Arab Emirates (UAE). These samples included cases from three nosocomial and three household clusters. The sequences were analysed for changes and relatedness with regard to the collected epidemiological data and other available MERS-CoV genomic data. Sequence analysis supports the epidemiological data within the clusters, and further, suggests that these clusters emerged independently. To understand how and when these clusters emerged, respiratory samples were taken from dromedary camels, a known host of MERS-CoV, in the same geographic regions as the human clusters. Middle East respiratory syndrome coronavirus genomes from six virus-positive animals were sequenced, and these genomes were nearly identical to those found in human patients from corresponding regions. These data demonstrate a genetic link for each of these clusters to a camel and support the hypothesis that human MERS-CoV diversity results from multiple zoonotic introductions.


dromedary camel; epidemiology; genomics; middle east respiratory syndrome; viral pathogens; zoonoses

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