Reply to "Concerns about misinterpretation of recent scientific data implicating dromedary camels in epidemiology of Middle East respiratory syndrome (MERS)".

REPLY

We thank Samara and Abdoun for this opportunity to extend the discussion of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in dromedary camels (DCs) (1). Several research groups working with samples from DCs collected in the Middle East have independently reported findings consistent with ours (2, 3), including the detection of specific antibodies to MERS-CoV (4–14), MERS-CoV nucleic acid (8, 11–16), and the isolation of infectious virus (13–15). One of these reports from Azhar and colleagues provides serological evidence of DC-to-human virus transmission (14). Furthermore, recent publications, abstracts from recent meetings, and news articles in prominent scientific journals reporting results of these meetings indicate the presence of MERS-CoV in DC products, including milk and meat, as well as a higher prevalence of antibodies to MERS-CoV in humans who come into contact with DCs or DC products (17–21).

We agree that the most urgent challenge at present is to investigate the epidemiology of human-to-human transmission. We are also actively pursuing studies focused on the analysis of other animal species for evidence of MERS-CoV infection. Nonetheless, the recent decision of the governments of the Kingdom of Saudi Arabia and Qatar to recommend against consumption of raw DC milk and to exert caution when interacting with DCs is prudent and appropriate. A similar recommendation was issued by the World Health Organization (22).

In short, we stand by the data and conclusions that we have reported in mBio and are pleased that they may have contributed to the adoption of public health policies that will help in the containment of MERS-CoV transmission.