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T-cell responses to MERS coronavirus infection in people with occupational exposure to dromedary camels in Nigeria: an observational cohort study - 25/02/21

Doi : 10.1016/S1473-3099(20)30599-5 
Chris Ka Pun Mok, PhD a, b, c, , Airu Zhu, MPhil a, d, , Jingxian Zhao, PhD a, , Eric H Y Lau, PhD c, Junxiang Wang, BSc a, Zhao Chen, BSc a, Zhen Zhuang, MPhil a, Yanqun Wang, PhD a, Abeer N Alshukairi, MD e, Salim A Baharoon, MD f, Wenling Wang, PhD g, Wenjie Tan, PhD g, Weiwen Liang, MPhil a, c, Jamiu O Oladipo, MPH c, Ranawaka A P M Perera, PhD c, Sulyman A Kuranga, MD h, Malik Peiris, DPhil a, b, c, , Jincun Zhao, PhD a, i,
a State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China 
b HKU-Pasteur Research Pole, The University of Hong Kong, Hong Kong Special Administrative Region, China 
c School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China 
d Nanshan Medicine Innovation Institute of Guangdong Province Guangzhou, Guangdong, China 
e King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia 
f King Saud bin Abdulaziz for Health Sciences University, Riyadh, Saudi Arabia 
g National Health Commission Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China 
h Department of Surgery, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria 
i Guangzhou Eighth People’s Hospital of Guangzhou Medical University, Guangzhou, China 

* Correspondence to: Dr Malik Peiris, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China School of Public Health Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Special Administrative Region China ** Dr Jincun Zhao, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China State Key Laboratory of Respiratory Disease National Clinical Research Center for Respiratory Disease Guangzhou Institute of Respiratory Health First Affiliated Hospital of Guangzhou Medical University Guangzhou China

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Summary

Background

Middle East respiratory syndrome (MERS) remains of global public health concern. Dromedary camels are the source of zoonotic infection. Over 70% of MERS coronavirus (MERS-CoV)-infected dromedaries are found in Africa but no zoonotic disease has been reported in Africa. We aimed to understand whether individuals with exposure to dromedaries in Africa had been infected by MERS-CoV.

Methods

Workers slaughtering dromedaries in an abattoir in Kano, Nigeria, were compared with abattoir workers without direct dromedary contact, non-abattoir workers from Kano, and controls from Guangzhou, China. Exposure to dromedaries was ascertained using a questionnaire. Serum and peripheral blood mononuclear cells (PBMCs) were tested for MERS-CoV specific neutralising antibody and T-cell responses.

Findings

None of the participants from Nigeria or Guangdong were MERS-CoV seropositive. 18 (30%) of 61 abattoir workers with exposure to dromedaries, but none of 20 abattoir workers without exposure (p=0·0042), ten non-abattoir workers or 24 controls from Guangzhou (p=0·0002) had evidence of MERS-CoV-specific CD4+ or CD8+ T cells in PBMC. T-cell responses to other endemic human coronaviruses (229E, OC43, HKU-1, and NL-63) were observed in all groups with no association with dromedary exposure. Drinking both unpasteurised camel milk and camel urine was significantly and negatively associated with T-cell positivity (odds ratio 0·07, 95% CI 0·01–0·54).

Interpretation

Zoonotic infection of dromedary-exposed individuals is taking place in Nigeria and suggests that the extent of MERS-CoV infections in Africa is underestimated. MERS-CoV could therefore adapt to human transmission in Africa rather than the Arabian Peninsula, where attention is currently focused.

Funding

The National Science and Technology Major Project, National Institutes of Health.

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Vol 21 - N° 3

P. 385-395 - mars 2021 Retour au numéro
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