Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Seropositivity Rate among Human in Diyala Province-Iraq

Abstract

Background: Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) is a novel coronavirus discovered in 2012 and is responsible for acute respiratory syndrome in humans. The disease is heavily endemic in dromedary camel populations of East Africa and the Middle East.Objectives: The aims of this cross-sectional study are to figure out the MERS-CoV infection rate and to explore its risk factors. Subjects and method: This study was conducted in Diyala province -Iraq for the period from August 2016 to February 2017 to figure out the infection rate of MERS-CoV infection through the detection of serum anti-MERS-CoV IgG. A total of 90 participants were enrolled and subdivided into 3 groups; 40 were close contact with camels, 20 were normal healthy individuals and 30 individuals who visit Saudi Arabia for Hajj pilgrims or Umrah. 34 (37.8%) were female and 56 (62.2%) were male. The age range was 22-72 years. Serum samples from participants were collected and tested for the presence of anti-MERS-CoV IgG using the recombivirus human anti-MERS-CoV spike protein S1 domain (MERS-S1) IgG ELISA kit (Alpha Diagnostic International, USA). Human privacy was respected by taken participant's consent. However, 8 individuals were refused participation. Statistical analysis was done using Statistical Package of Social Science (SPSS), Version 18, and P values less than 0.05 were considered significant. Results: The results revealed that 46(51.1%) of human subjects were positive for anti-MERSCoV IgG, with 95% confidence interval for the prevalence rate (40.9-61.3) with a mean titer of anti-MERSCoV IgG Ab of 99.8. U/ml. the highest positivity rate was found among those 40-49 years. However, the difference was failed to reach the levels of statistically significant (P= 0.08). Similarly, the anti-MERS-CoV IgG Ab titer was insignificantly higher in the 40-49 years age group (P= 0.11). The anti- MERS-CoV IgG positivity rate was insignificantly higher among females compared to males (61.8% vs 44.6%, P = 0.12 ). While the mean, median and Inter-quartile range of anti-MERSCoV- IgG titer was significantly higher among female compared to male (P< 0.004). The results also found that the anti-MERS-CoV IgG positivity rate and Ab titer were significantly higher among those people who visited KSA as Hajj pilgrims or Umrah (P < 0.001 and P< 0.001) respectively. The flu-like syndrome is the most significant symptom reported (P= 0.001).Conclusion: Based on anti-MERS-Cov Ab detection, considerable infection rate by MERS-Cov was found particularly among those who had previous visit to KAS. Further confirmatory and surveillance studies are required for future setup of control measures.