MERS-CoV spillover at the camel-human interface

  1. Gytis Dudas  Is a corresponding author
  2. Luiz Max Carvalho
  3. Andrew Rambaut
  4. Trevor Bedford
  1. Fred Hutchinson Cancer Research Center, United States
  2. University of Edinburgh, United Kingdom

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic virus from camels causing significant mortality and morbidity in humans in the Arabian Peninsula. The epidemiology of the virus remains poorly understood, and while case-based and seroepidemiological studies have been employed extensively throughout the epidemic, viral sequence data have not been utilised to their full potential. Here we use existing MERS-CoV sequence data to explore its phylodynamics in two of its known major hosts, humans and camels. We employ structured coalescent models to show that long-term MERS-CoV evolution occurs exclusively in camels, whereas humans act as a transient, and ultimately terminal host. By analysing the distribution of human outbreak cluster sizes and zoonotic introduction times we show that human outbreaks in the Arabian peninsula are driven by seasonally varying zoonotic transfer of viruses from camels. Without heretofore unseen evolution of host tropism, MERS-CoV is unlikely to become endemic in humans.

Article and author information

Author details

  1. Gytis Dudas

    Vaccines and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, United States
    For correspondence
    gdudas@fredhutch.org
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-0227-4158
  2. Luiz Max Carvalho

    Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  3. Andrew Rambaut

    Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  4. Trevor Bedford

    Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, United States
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-4039-5794

Funding

National Institutes of Health (R35 GM119774-01)

  • Trevor Bedford

Pew Charitable Trusts (Pew Biomedical Scholar)

  • Trevor Bedford

European Commission (278433-PREDEMICS)

  • Andrew Rambaut

Wellcome (206298/Z/17/Z)

  • Andrew Rambaut

Fred Hutchinson Cancer Research Center (Mahan Postdoctoral Fellowship)

  • Gytis Dudas

European Commission (725422-RESERVOIRDOCS)

  • Andrew Rambaut

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Neil M Ferguson, Imperial College London, United Kingdom

Publication history

  1. Received: August 14, 2017
  2. Accepted: December 19, 2017
  3. Accepted Manuscript published: January 16, 2018 (version 1)
  4. Version of Record published: January 22, 2018 (version 2)
  5. Version of Record updated: April 19, 2018 (version 3)

Copyright

© 2018, Dudas et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Gytis Dudas
  2. Luiz Max Carvalho
  3. Andrew Rambaut
  4. Trevor Bedford
(2018)
MERS-CoV spillover at the camel-human interface
eLife 7:e31257.
https://doi.org/10.7554/eLife.31257

Further reading

    1. Epidemiology and Global Health
    Tina Bech Olesen, Henry Jensen ... Morten Rasmussen
    Research Article

    Background: Worldwide, most colorectal cancer screening programmes were paused at the start of the COVID-19 pandemic, whilst the Danish faecal immunochemical test (FIT)-based programme continued without pausing. We examined colorectal cancer screening participation and compliance with subsequent colonoscopy in Denmark throughout the pandemic.

    Methods: We used data from the Danish Colorectal Cancer Screening Database among individuals aged 50-74 years old invited to participate in colorectal cancer screening from 2018-2021 combined with population-wide registries. Using a generalised linear model, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) of colorectal cancer screening participation within 90 days since invitation and compliance with colonoscopy within 60 days since a positive FIT test during the pandemic in comparison with the previous years adjusting for age, month and year of invitation.

    Results: Altogether, 3,133,947 invitations were sent out to 1,928,725 individuals and there were 94,373 positive FIT tests (in 92,848 individuals) during the study period. Before the pandemic, 60.7% participated in screening within 90 days. A minor reduction in participation was observed at the start of the pandemic (PR=0.95; 95% CI: 0.94-0.96 in pre-lockdown and PR=0.85; 95% CI: 0.85-0.86 in 1st lockdown) corresponding to a participation rate of 54.9% during pre-lockdown and 53.0% during 1st lockdown. This was followed by a 5-10% increased participation in screening corresponding to a participation rate of up to 64.9%. The largest increase in participation was observed among 55-59 year olds and among immigrants. The compliance with colonoscopy within 60 days was 89.9% before the pandemic. A slight reduction was observed during 1st lockdown (PR=0.96; 95% CI: 0.93-0.98), where after it resumed to normal levels.

    Conclusions: Participation in the Danish FIT-based colorectal cancer screening programme and subsequent compliance to colonoscopy after a positive FIT result was only slightly affected by the COVID-19 pandemic.

    Funding: The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.