Drivers of MERS-CoV Emergence in Qatar

Abstract

MERS-CoV (Middle East respiratory syndrome corona virus) antibodies were detected in camels since 1983, but the first human case was only detected in 2012. This study sought to identify and quantify possible drivers for the MERS-CoV emergence and spillover to humans. A list of potential human, animal and environmental drivers for disease emergence were identified from literature. Trends in possible drivers were analyzed from national and international databases, and through structured interviews with experts in Qatar. The discovery and exploitation of oil and gas led to a 5-fold increase in Qatar GDP coupled with a 7-fold population growth in the past 30 years. The lifestyle gradually transformed from Bedouin life to urban sedentary life, along with a sharp increase in obesity and other comorbidities. Owing to substantial governmental support, camel husbandry and competitions flourished, exacerbating the already rapidly occurring desertification that forced banning of free grazing in 2005. Consequently, camels were housed in compact barns alongside their workers. The transition in husbandry leading to high density camel farming along with increased exposure to humans, combined with the increase of camel movement for the racing and breeding industry, have led to a convergence of factors driving spillover of MERS-CoV from camels to humans.

Keywords: Drivers; MERS-CoV; Qatar.

Figure 1

Developments in economy, camel demography, production, and trade. (A). Development over time of the gross domestic product per capita; (B) Development over time of the camel population; (C) Development over time of camel import and export; (D) Development over time of camel importation per country of origin. *Other Arab countries: Algeria, Comoros, Djibouti, Egypt, Iraq, Jordan, Lebanon, Libya, Mauritania, Morocco, Palestine, Somalia, Sudan, Syria, Tunisia, and Yemen. **Other GCC countries: Bahrain, Kuwait, Oman, Qatar.

Figure 1

Developments in economy, camel demography, production, and trade. (A). Development over time of the gross domestic product per capita; (B) Development over time of the camel population; (C) Development over time of camel import and export; (D) Development over time of camel importation per country of origin. *Other Arab countries: Algeria, Comoros, Djibouti, Egypt, Iraq, Jordan, Lebanon, Libya, Mauritania, Morocco, Palestine, Somalia, Sudan, Syria, Tunisia, and Yemen. **Other GCC countries: Bahrain, Kuwait, Oman, Qatar.

Figure 2

Developments in human demography in Qatar; (A) Development over time of the age structure of the population; (B) Development over time of the human sex ratio; (C) Development over time of the ration Qatari vs. non Qatari; (D) Development over time of tourism per country of origin *Other Arab countries: Algeria, Comoros, Djibouti, Egypt, Iraq, Jordan, Lebanon, Libya, Mauritania, Morocco, Palestine, Somalia, Sudan, Syria, Tunisia, and Yemen. **GCC countries: Bahrain, Kuwait, Oman, Qatar, KSA, and the United Arab Emirates.

Figure 2

Developments in human demography in Qatar; (A) Development over time of the age structure of the population; (B) Development over time of the human sex ratio; (C) Development over time of the ration Qatari vs. non Qatari; (D) Development over time of tourism per country of origin *Other Arab countries: Algeria, Comoros, Djibouti, Egypt, Iraq, Jordan, Lebanon, Libya, Mauritania, Morocco, Palestine, Somalia, Sudan, Syria, Tunisia, and Yemen. **GCC countries: Bahrain, Kuwait, Oman, Qatar, KSA, and the United Arab Emirates.

Figure 3

Human and camel density map of Qatar (adapted from Ministry of Development Planning and Statistics, Population Concentration map, 2015). The density map shows the density of camels (source: Ministry of Municipality and Environment) and humans in Qatar. Most people live in and around Doha, where the Doha animal market and slaughterhouse are also located. The highest camel density can be found in the Al-Rayyan area, where the Al-Shehaniya racing tracks are also located. A small, but growing, part of the Qatar population also lives in the Al-Rayyan area.

Figure 4

Seasonality and movements of camels and camel activities. (A) Dark green locations and periods of time indicate a high concentration of camels. The arrows show the direction of camel movements. It is shown that many camels gather and mix at the animal market, racing track, and breeding farms in Qatar in August, September and October. Moreover, there is constant movement to and from grazing grounds and racing tracks outside of Qatar. In March and April, most camels travel back to their barns. (B) shows the seasonality of camel related activities. Most activities take place in the “cold season” from September to April.

Figure 4

Seasonality and movements of camels and camel activities. (A) Dark green locations and periods of time indicate a high concentration of camels. The arrows show the direction of camel movements. It is shown that many camels gather and mix at the animal market, racing track, and breeding farms in Qatar in August, September and October. Moreover, there is constant movement to and from grazing grounds and racing tracks outside of Qatar. In March and April, most camels travel back to their barns. (B) shows the seasonality of camel related activities. Most activities take place in the “cold season” from September to April.

Figure 5

Visual summary/timeline of relevant events.