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. 2025 Jan 17;17(1):125.
doi: 10.3390/v17010125.

Low-Level Zoonotic Transmission of Clade C MERS-CoV in Africa: Insights from Scoping Review and Cohort Studies in Hospital and Community Settings

Andrew Karani  1   2 , Cynthia Ombok  1 , Silvia Situma  1   2 , Robert Breiman  3 , Marianne Mureithi  2 , Walter Jaoko  2 , M Kariuki Njenga  1   4 , Isaac Ngere  1   4
Affiliations

Low-Level Zoonotic Transmission of Clade C MERS-CoV in Africa: Insights from Scoping Review and Cohort Studies in Hospital and Community Settings

Andrew Karani et al. Viruses. .

Abstract

Human outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) are more common in Middle Eastern and Asian human populations, associated with clades A and B. In Africa, where clade C is dominant in camels, human cases are minimal. We reviewed 16 studies (n = 6198) published across seven African countries between 2012 and 2024 to assess human MERS-CoV cases. We also analyzed data from four cohort studies conducted in camel-keeping communities between 2018 and 2024 involving camel keepers, camel slaughterhouse workers, and hospital patients with acute respiratory illness (ARI). The analysis showed a pooled MERS-CoV prevalence of 2.4% (IQR: 0.6, 11.4) from 16 publications and 1.14% from 4 cohort studies (n = 2353). Symptomatic cases were rarely reported, with most individuals reporting camel contact, and only 12% had travel history to the Middle East. There was one travel-associated reported death, resulting in a mortality rate of 0.013%. The findings suggest a low camel-to-human transmission of clade C MERS-CoV in Africa. Ongoing research focuses on genomic comparisons between clade C and the more virulent clades A and B, alongside the surveillance of viral evolution. This study highlights the need for continuous monitoring but indicates that MERS-CoV clade C currently poses a minimal public health threat in Africa.

Keywords: MERS-CoV; camel; clades; epidemiology; infections; prevalence; serology; symptoms; transmission; zoonotic.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
A flowchart outlining the PRISMA process of identifying, screening, and selecting studies.
Figure 2
Figure 2
Map of Kenya showing human MERS-CoV study sites.
See this image and copyright information in PMC

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