First evidence of zoonotic spillover of MERS-CoV into occupationally exposed populations in Somalia

Abstract Dromedary camels are the main reservoir for Middle East respiratory syndrome coronavirus (MERS-CoV), a re-emerging infectious disease with pandemic potential. Somalia harbours approximately 32% of dromedary camels globally. We investigated current and past MERS-CoV infections among occupationally-exposed workers in slaughterhouses, dairy farms, livestock markets and a quarantine station. Sera and nasopharyngeal/oropharyngeal swabs from 770 workers were analysed for MERS-CoV antibodies by Enzyme-Linked Immunosorbent Assay (ELISA) and virus neutralization and for viral RNA by Real Star® MERS-CoV Reverse Transcription Polymerase Chain Reaction (RT-PCR). One farm worker with no travel history in the Qardo district, Karkar region, Puntland was sero-positive by ELISA and virus neutralization, providing the first-ever evidence of zoonotic spillover of MERS-CoV to humans in Somalia. This finding highlights the need to strengthen MERS-CoV surveillance across Somalia, along with an urgent need to strengthen national laboratory capacity and integrate MERS into diagnostic algorithms to generate accurate and reliable infection data and studies to understand the socio-cultural and potential risk factors for MERS-CoV.