article · PeerJ
Middle East Respiratory Syndrome Coronavirus represents a significant challenge for healthcare systems, particularly within the Arabian Peninsula. The virus provides a clear demonstration of the One Health framework, linking animal reservoirs, environmental spread, and human infection. Dromedary camels are currently the only confirmed animal reservoir, shedding the virus in nasal and rectal discharges capable of infecting human airway tissue. Evidence demonstrates direct transmission from camels to humans, while human-to-human spread occurs through close contact with active or asymptomatic cases. Specific risk factors include sharing rooms, handling patient waste, and direct contact with respiratory fluids. Family cluster patterns suggest potential genetic predispositions or comorbidities influencing susceptibility. Identifying the exact pathways of transmission between camels and humans, alongside finding potential alternate reservoirs, remains critical to curbing environmental shedding and protecting human populations.
Understanding how respiratory viruses cross from animals to people is vital for preventing major outbreaks. Because camels shed the virus into the environment and human-to-human spread readily occurs in domestic settings, clarifying these transmission routes directly informs public health strategies, hospital infection control protocols, and livestock management practices needed to protect vulnerable communities.
The abstract outlines epidemiological dynamics and transmission risks but does not indicate an application pathway.
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Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is one of the major threats to the healthcare systems in some countries, especially in the Arabian Peninsula. MERS-CoV is considered an ideal example of the One Health concept. This is due to the animals, especially dromedary camels, play important roles in the transmission and sustainability of the virus, and the virus can be transmitted through aerosols of infected patients into the environment. However, there is some debate regarding the origin of MERS-CoV either from bats or other unknown reservoirs. The dromedary camel is the only identified animal reservoir to date. These animals play important roles in sustaining the virus in certain communities and may act as an amplifier of the virus by secreting it in their body fluids, especially in nasal and rectal discharges. MERS-CoV has been detected in the nasal and rectal secretions of infected camels, and MERS-CoV of this origin has full capacity to infect human airway epithelium in both in vitro and in vivo models. Other evidence confirms the direct transmission of MERS-CoV from camels to humans, though the role of camel meat and milk products has yet to be well studied. Human-to-human transmission is well documented through contact with an active infected patient or some silently infected persons. Furthermore, there are some significant risk factors of individuals in close contact with a positive MERS-CoV patient, including sleeping in the same patient room, removing patient waste (urine, stool, and sputum), and touching respiratory secretions from the index case. Outbreaks within family clusters have been reported, whereby some blood relative patients were infected through their wives in the same house were not infected. Some predisposing genetic factors favor MERS-CoV infection in some patients, which is worth investigating in the near future. The presence of other comorbidities may be another factor. Overall, there are many unknown/confirmed aspects of the virus/human/animal network. Here, the most recent advances in this context are discussed, and the possible reasons behind the emergence and sustainability of MERS-CoV in certain regions are presented. Identification of the exact mechanism of transmission of MERS-CoV from camels to humans and searching for new reservoir/s are of high priority. This will reduce the shedding of the virus into the environment, and thus the risk of human infection can be mitigated.
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DOI: 10.7717/peerj.7556
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