Investigation of MERS-CoV seropositivity among Umrah visitors from the Çorum Region of Turkey

Year 2021, Volume: 38 Issue: 4, 608 - 612, 09.10.2021

Ayşe Güreser Derya Yapar , Özlem Akdoğan , Ayşegül Taylan Özkan , Nurcan Baykam

Abstract

Background/aim: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) causes Middle East Respiratory Syndrome (MERS). Due to the fact that the vast majority of cases (more than 85%) are reported from Saudi Arabia, there is a pandemic potential for pilgrimage due to Hajj or Umrah. It is reported from Turkey that more than 400 thousand people went to Saudi Arabia for umrah and 61 thousand people for Hajj in 2014.
Materials and methods: In this study it is aimed to investigate the patients who had just returned from Makkah for Umrah and who also applied to the Infectious Disease Clinics at the XXXX Training and Research Hospital for having respiratory tract symptoms. Their serologic situations have been determined by ELISA whether there is any risk in terms of performing the Hajj and Umrah, and contracting MERS-CoV. Between January 1st to the 31st of October 2015, 40 people were included in this study, which were admitted to our hospital with upper respiratory tract complaints and had previously been in Saudi Arabia for Umrah within the last 15 days. As a control group, 40 healthy people without any complaints and travel histories to risky areas were selected. Their serum samples were taken and searched by MERS-CoV IgG ELISA (Euroimmun AG, Lübeck, Germany). The results ≤0.8 were considered as negative, ≥1.1 were as positive, 0.8-1.1 were suspected. All suspected and positive results have been revaluated and confirmed.
Results: Only two (5%) individuals from the patients’ group were found as positive for the MERS-CoV IgG antibodies, but individuals from the remaining patients’ group and also all control group members were determined as negative.

Conclusion: Travels to Saudi Arabia could be a risk for exposure to MERS-CoV. Although there is no evidence, contamination could be realized by anthroponotically due to crowds.

Keywords

Corona virus, MERS-CoV, respiratory syndrome

Supporting Institution

There was no funding for this study.

Thanks

We are thankful for Bio. Esra BAKIR for her assistance; Özmen Ltd. Comp. and Dr. Yavuz UYAR for their supports, and for Stacy Taylor from HITITSEM for proofreading of the manuscript.

References

• 1. Zaki AM, Boheemen VS, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 2012;367(19):1814–20. DOI: 10.1056/NEJMoa1211721. PMID: 23075143
• 2. Al-Hameed F, Wahla AS, Siddiqui S, Ghabashi A, Al-Shomrani M, Al-Thaqafi A, et al.Characteristics and outcomes of Middle East Respiratory Syndrome Coronavirus patients admitted to an intensive care unit in Jeddah, Saudi Arabia. J Intensive Care Med 2016;31(5):344-8. DOI: 10.1177/0885066615579858. PMID: 25862629
• 3. World Health Organization. Middle East respiratory syndrome coronavirus (MERS-CoV) Summary of Current Situation, Literature Update and Risk Assessment. WHO/MERS/RA/15.1 2015;(July):1–7.
• 4. Al-Mohrej OA, Al-Shirian SD, Al-Otaibi SK, Tamim HM, Masuadi EM, Fakhoury HM. Is the Saudi public aware of Middle East respiratory syndrome? J Infect Public Health 2016;9(3):259-66. DOI: 10.1016/j.jiph.2015.10.003. PMID: 26589657
• 5. Hemida MG, Al-Naeem A, Perera RA, Chin AW, Poon LL, Peiris M. Lack of Middle East Respiratory Syndrome Coronavirus transmission from infected camels. Emerg Infect Dis 2015;21(4):699–701. DOI: 10.3201/eid2104.141949. PMID: 25811546
• 6. Omrani AS, Matin MA, Haddad Q, Al-Nakhli D, Memish ZA, Albarrak AM. A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case. Int J Infect Dis 2013;17(9):e668–72. DOI: 10.1016/j.ijid.2013.07.001. PMID: 23916548
• 7. Türkiye Seyahat Acentaları Birliği TURSAB İnanç Tur 2014 raporu https//www.tursab.org.tr/dosya/11333/tursabinancturizmi_11333_5059687.doc (April,06,2016).
• 8. World Health Organization. Changing epidemiology of pneumococcal serotypes after introduction of conjugate vaccine. Wkly Epidemiol Rec 2010;85(43):434-6. PMID: 21038716
• 9. Assiri A, McGeer A, Perl TM, Price CS, Al Rabeeah AA, Cummings DA, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med. 2013;369(5):407–16. doi:10.1056/NEJMoa1306742. PMID: 23782161
• 10. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East Respiratory Syndrome Coronavirus Disease from Saudi Arabia: a descriptive study. Lancet Infect Dis 2013;13(9):752–61. doi: 10.1016/S1473-3099(13)70204-4. PMID: 23891402
• 11. Ki M. 2015 MERS outbreak in Korea: hospital-to-hospital transmission. Epidemiol Health 2015;37(1):4–7. DOI: 10.4178/epih/e2015033. PMID: 26212508
• 12. Kraaij-Dirkzwager M, Timen A, Dirksen K, Gelinck L, Leyten E, Groeneveld P, et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in two returning travellers in the Netherlands, May 2014. Euro Surveill 2014;19(21): pii: 20817. PMID: 24906375
• 13. Mailles A, Blanckaert K, Chaud P, van der Werf S, Lina B, Caro V, et al. First cases of Middle East Respiratory Syndrome Coronavirus (MERS-COV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013. Euro Surveill. 2013;18(24): pii: 20502. PMID: 23787161
• 14. Drosten C, Muth D, Corman VM, Hussain R, Al Masri M, HajOmar W, et al. An observational, laboratory-based study of outbreaks of Middle East Respiratory Syndrome Coronavirus in Jeddah and Riyadh, Kingdom of Saudi Arabia, 2014. Clin Infect Dis 2015;60(3):369–77. DOI: 10.1093/cid/ciu812. PMID: 25323704
• 15. Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet 2015;386(9997):995–1007. DOI: 10.1016/S0140-6736(15)60454-8. PMID: 26049252
• 16. Memish ZA, Assiri A, Almasri M, Alhakeem RF, Turkestani A, Al Rabeeah AA, et al. Prevalence of MERS-CoV nasal carriage and compliance with the Saudi Health Recommendations among pilgrims attending the 2013 Hajj. J Infect Dis 2014;210(7):1067–72. DOI: 10.1093/infdis/jiu150. PMID: 24620019
• 17. Annan A, Owusu M, Marfo KS, Larbi R, Sarpong FN, Adu-Sarkodie Y, et al. High prevalence of common respiratory viruses and no evidence of Middle East Respiratory Syndrome Coronavirus in Hajj pilgrims returning to Ghana, 2013. Trop Med Int Health 2015;20(6):807–12. doi: 10.1111/tmi.12482. PMID: 25688471
• 18. Gautret P, Charrel R, Benkouiten S, Belhouchat K, Nougairede A, Drali T, et al. Lack of MERS Coronavirus but prevalence of influenza virus in French pilgrims after 2013 Hajj. Emerg Infect Dis 2014;20(4):728–30. DOI:10.3201/eid2004.131708. PMID: 24656283
• 19. Karagöz E, Hatipoǧlu M, Turhan V. Letter to the editor: Middle east respiratory syndrome coronavirus (Mers-CoV) in dromedary camels: Are dromedary camels a reservoir for Mers-CoV? Eurosurveillance 2014;19(20): pii: 20810. PMID: 24871759
• 20. Barasheed O, Rashid H, Alfelali M, Tashani M, Azeem M, Bokhary H, et al. Viral respiratory infections among Hajj pilgrims in 2013. Virol Sin 2014;29(6):364–71. DOI: 10.1007/s12250-014-3507-x. PMID: 25413828
• 21. Memish ZA, Al-tawfiq JA, Makhdoom HQ, Assiri A, Alhakeem RF, Albarrak A, et al. Respiratory tract samples, viral load and genome fraction yield in patients with Middle East Respiratory Syndrome. J Infect Dis 2014;210(10):1590–4. DOI: 10.1093/infdis/jiu292. PMID: 24837403
• 22. Corman VM, Eckerle I, Bleicker T, Zaki A, Landt O, Eschbach-Bludau M, et al. Detection of a novel human coronavirus by real-time reverse-transcription polymerase chain reaction. Euro Surveill. 2012;17(39):1–6. pii: 20285. PMID: 23041020
• 23. Corman VM, Müller MA, Costabel U, Timm J, Binger T, Meyer B, et al. Assays for laboratory confirmation of novel human coronavirus (HCOV-EMC) infections. Euro Surveill 2012;17(49): pii: 20334. PMID: 23231891
• 24. Corless CE, Guiver M, Borrow R, Edwards-Jones V, Fox AJ, Kaczmarski EB, et al. Development and evaluation of a “real-time” RT-PCR for the detection of enterovirus and parechovirus RNA in CSF and throat swab samples. J Med Virol 2002;67(4):555–62. PMID: 12116004
• 25. Mackay IM, Arden KE. MERS coronavirus: diagnostics, epidemiology and transmission. Virol J 2015;12:222. doi: 10.1186/s12985-015-0439-5. PMID: 26695637
• 26. Meyer B, Drosten C, Müller MA. Serological assays for emerging coronaviruses: Challenges and pitfalls. Virus Res 2014;194:175–83. DOI: 10.1016/j.virusres.2014.03.018. PMID: 24670324
• 27. Spanakis N, Tsiodras S, Haagmans BL, Raj VS, Pontikis K, Koutsoukou A, et al. Virological and serological analysis of a recent Middle East respiratory syndrome coronavirus infection case on a triple combination antiviral regimen. Int J Antimicrob Agents 2014;44(6):528–32. DOI: 10.1016/j.ijantimicag.2014.07.026. PMID: 25288266
• 28. Park SW, Perera RA, Choe PG, Lau EH, Choi SJ, Chun JY, et al. Comparison of serological assays in human middle east respiratory syndrome (MERS)-coronavirus infection. Euro Surveill 2015;20(41):1–5. doi: 10.2807/1560-7917.ES.2015.20.41.30042. PMID: 26538277
• 29. Müller MA, Meyer B, Corman VM, Al-Masri M, Turkestani A, Ritz D, et al. Presence of Middle East respiratory syndrome coronavirus antibodies in Saudi Arabia: a nationwide, cross-sectional, serological study. Lancet Infect Dis 2015;15(5):559–64. DOI: 10.1016/S1473-3099(15)70090-3. PMID: 25863564
• 30. Bayrakdar F, Altaş AB, Korukoğlu G, Topal S. Molecular diagnosis and phylogenetic analysis of the first MERS case in Turkey. Mikrobiyol Bul. 2015;49(3):414–22. PMID: 26313282