please let me know what is your question, I think I could help you.

Hi Tamara

Which information you want, I can help, as I have a search published in veterinary parasitology 2013 on camel trypanosomiasis ,welcome anytime

I would like to get some information on public health risks in the camel value chain and also some practical information in mastitis control in a camel herd.

Camel play an important role as a reservoir of some zoonotic diseases of public health importance. please let me help you.in any public health risk from zoonotic point of view.

Dear Dr.Dishon,

We have published few papers related to camel zoonoses (brucellosis, Dermatophytosis) and also on fungal mastitis etc.

1. Pal, M and Lee, C.W. 2000: Trichophyton verrucosum infection in a camel and its handler. Korean Journal of veterinary Clinical Medicine 17: 293 - 294.

2.Hadush, A., Pal, M., Kassa, T. and Zeru, F. 2013: Sero-epidemiology of camel brucellosis in the afar region of Northwest Ethiopia. Journal of Veterinary Medicine and Animal Health 5: 269-275.

3.Pal, M. 2015: First record of camel mastitis due to Candida albicans in Ethiopia. Indian Journal of Comparative Microbiology, Microbiology Immunology and Infectious Diseases 36: 32-34.

4. Pal, M. and Sabir, M. 2015. Major milk-borne microbial diseases of camels. Haryana Veterinarian 54: 93-98.

5.Pal, M. 2016: First mycological investigation of dermatophytosis in camels due to Trichophyton verrucosum in Ethiopia. Journal of Mycopathological Resarch 54: 89-92.

All these publications can be easily downloaded from Research Gate and Academia.

Wishing you good luck in your mission.

Prof.Dr.Mahendra Pal

Following

Dear Dr Dishon Muloi

camels, as small ruminants and cattle, can be a vehicle of zoonosis such as anthrax, rabies, brucellosis, echinococcosis, cisticercosis, TB (rare), sarcoptes (rare), various bacteria and fungal pathogens, Yersinia pestis. Camels can specifically transmit MERS and "uncommon" viruses such as AlKhurma Hemorrhagic Fever, Hepatitis E, Crimean-Congo hemorrhagic fever (blod +ticks) etc. Any additional question you are welcome to contact me: [email protected]

Dear Dr.Dishon,

I have mentioned viral, bacterial, fungal, actinomycetic, rickettsial, and parasitic zoonotic diseases of camels in my book entitled " Zoonoses".

Prof.Dr.Mahendra Pal

Founder Director

Dear Maurizio Dioli ,

Regarding your words herein connecting MERS-CoV transmission to dromedary camels, enclosed please find down here my 2014 letter-to-the-mBio-editor that addressed several concerns about two articles been published by the same Journal, specifically the uncertainties regarding the potential applicability of their epidemiological data, obtained from dromedary camels infected with MERS-CoV, to human public health ..

And surprisingly since then, no study(ies) had satisfied all these concerns, to let us scientifically declare that dromedary camels serve as a reservoir or vector of MERS-CoV in human infection !!

Cordially,

Emad

Article Concerns about Misinterpretation of Recent Scientific Data I...

Dear Emad M. Samara ,

thank you for the your 2014 letter information.

However a 2015 review:

Article Dromedary Camels and the Transmission of Middle East Respira...

pretty much confirm that camels are a "confirmed transmission pathways of MERS to humans"

A later study (2018):

Article A rapid scoping review of Middle East respiratory syndrome c...

again confirmed that "Field studies have provided compelling evidence that dromedary camels act as the reservoir host for MERS‐CoV. Experimental evidence has confirmed the susceptibility of dromedary camels and provided key details regarding the course of infection in camelids"

While still a lot of things are not known about MERS there are many studies that have convincing established that dromedary are a reservoir of MERS and are the most common source of the virus and transmit it to human. MERS virus has been found in milk and therefore is reasonable to assume consumption of raw milk will almost certainly be able to transmit MERS

Kind regards

Maurizio

Dear Maurizio Dioli ,

Despite they are being merely "Reviews" and not experimental studies, I sincerely thank you for mentioning these articles.

But as you've saw in my letter, there are several gaps in our epidemiological understanding of the MERS-CoV transmission between dromedary camels (DCs) and human. In fact, I have summarized these gaps, as you've saw, under four possible routes of transmission: human to human, camel to camel, camel to human, and human to camel.

And as I told you before, I'm following this matter since then. And unfortunately no study(ies) had answered all my questions !!! Everybody is going with the flow i.e. in confirming what the precedential studies had already found !!!

I'm not just being stubborn, my friend. I'm just dealing with this matter with total objectivity and unbiased as I can be. As a matter of fact, I'll declare that DCs serve as a reservoir or vector of MERS-CoV in human infection only when all these gaps or concerns been scientifically resolved.

Pleeeease take a second look down here on what I've wrote in my letter about Human-to-Camel MERS-CoV transmission, and apply that on ALL you can find in the literature findings which confirms that DCs plays a role in MERS-CoV transmission to human. And then, let me know your OPINION.

" There is no doubt that everyone can question whether such form of transmission is actually happening in the case of MERS, but no one can deny it either. Ordinarily, all new pathogens are believed to emerge from animals (i.e., the source or reservoir) when ecological changes increase the pathogen’s opportunities to enter the human population (i.e., the new host) and to generate subsequent human-to-human transmission. However, we might consider the reverse in the following scenario: a new host (i.e., DCs) acquires a new infectious agent (i.e., MERS-CoV) that emerges from an unknown source of infection (humans or any other source). Once infected, DCs will rapidly produce antibodies to MERS-CoV, and if the virus cannot induce a disease (i.e., MERS), DCs will have no clinical signs, viremia, or fatality cases. Now, if we assume that this infectious agent has an evolutionary rescue (e.g., genetic mutations) to enable its adaptation to the new environment, DCs will have an infectious agent with a set of genetic variants (genotypes) that differ from the original one. Therefore, we can clearly see that it is plausible to assume that humans (or any other source) are the ones who infected DCs in the first place. In fact, domestic cats, living in Hong Kong, were reported in 2003 to be infected with severe acute respiratory syndrome coronavirus (SARS-CoV) originating from humans (13). Likewise, Memish (10) detected MERS-CoV sequences in a DC owned by an individual infected by MERS. Therefore, the presence of antibodies, viral nucleic acids, and quasispecies variants of MERS-CoV detected by the authors in their sampled DCs may suggest that dromedaries can be naturally infected with MERS-CoV from infected humans, although how this happens is yet unclear. Nonetheless, we should test archived human samples to demonstrate whether humans can be implicated or whether MERS-CoV truly emerges as a human pathogen prior to 2012 or not. In addition, we should entertain the idea that MERS-CoV in DCs (i.e., the new host) may adapt again and eventually lead to reemergence of the disease in human populations and subsequently to a massive epidemic attack, which, as we previously argued, is the key driver in the current debate"

Yours truly,

Emad

Dear Emad M. Samara

The fact that MERS is casing an asymptomatic/mild condition in camels while a severe disease in human would be a convincing indication that MERS is well adapted to camel while not to new hosts: humans.

This hypothesis seem correct since there is data who clearly indicate that camels give MERS to human and not viceversa. In Saudi Arabia there is higher seroprevalence of MERS-CoV–specific antibodies in camel shepherds, (2.3%) and slaughterhouse workers (3.6%) but almost nothing in the general population (0.2%) (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)70090-3/fulltext)

So this data clearly indicate that your hypothesis that humans are the one who infect camels with MERS is incorrect.

This recent article (February 2020) https://wwwnc.cdc.gov/eid/article/26/2/19-0697_article

state the following :

Current epidemiologic evidence supports a major role in transmission for direct contact with live camels or humans with symptomatic MERS, (Contact with nasal secretions can occur when directly handling live camels, and virus from camel nasal secretions can contaminate fomites in the environment)

The article report that MERS virus was found in raw milk. One hypothesis is that MERS viruus originated from calf saliva/nose excretions because milk is usually obtained using traditional milking methods : using a suckling calf as stimulus for milk letdown;

The article conclusion:

"in areas in which MERS-CoV actively circulates among camels, human cases can result from zoonotic transmission"

There are many zoonotic diseases of public health importance.Which one you are asking about.

Dear Maurizio Dioli ,

As I told you before, my friend, everyone are going with the flow unfortunately!! And that is applies as well on the 2020 CDC article, even I honestly telling you that I've never seen it before; thus, thank you for sharing it with me.

Regarding the LANCET article, meanwhile;

Its merely a cross-sectional study from 2012-2014 (where this type of studies can only result in calculating the Prevalence Rate and the Odd ratio, as we all know) !!

However, identification of the reservoir host requires knowledge of the Incidence Rate to measure the transmissibility, which can be achieved by conducting a large-scale follow-up of cohort surveys or at least serial of pro- or retrospective cross-sectional surveys, not just one cross-sectional seroprevalence survey.

As for their conclusion of camel-to-human MERS-CoV transmission, I’m not saying that DCs can’t infect human or vise versa, my friend. OUR DISCUSSION HERE is about if DCs is the RESERVOIR of MERS-CoV or not ?!

Thus, if you take a quick look at their data, as follow ;

6 positive samples out of 87 samples (2.3%) in camel shepherds

6 out of 140 (3.6%) in slaughterhouse workers

152 out of 10'009 (0.2%) in the general population

You will instantly see the unequal sample size they depend on drawing their (BIASED, in my opinion) conclusion for each category. And, I’m not saying its false conclusion. All I’m saying that it is not the TRUTH due to the bias. Biased, because the number should at least reach 50% in group No. 1 and 2 if DCs is the source of this virus. This is one of the classic Rational Fallacy, my friend. And I wonder how their paper was accepted in such top-tier journal !!

Anyhow and beside that, several points can be raised that contradict these authors’ findings as to whether this form of transmission can or cannot happen.

In fact, the reported outcomes by Alagaili et al. (2014) and Briese et al. (2014), together with no more than 14 cases of infection in humans reported over the 2012-2014 period to have been in close proximity to DCs (one case reported by Memish, 2013; another one case reported by Haagmans et al, 2014; and 12 cases reported by this article in 2015), clearly indicate at most that a virus that is “closely related” to MERS-CoV has been circulating in DCs for the last 2 decades in Saudi Arabia.

Additionally, it might be possible that MERS-CoV cannot be transmitted from DCs to humans, as happened previously between cats and humans during the SARS-CoV epidemic (Lun and Qu, 2004).

OF COURSE, we understand that identification of the route of transmission from DCs to human beings (if any) would be of utmost importance and (if confirmed) could lead directly to implementation of prevention and intervention strategies. Unfortunately, however, the transmission capability of MERS-CoV from DCs to humans cannot yet be ascertained, my friend.

Thus, claiming that DCs harbor the infectious form of MERS-CoV does not support the conclusion that they are the source of transmission to humans.

It must be confirmed that this form of transmission can actually occur.

I suggest addressing this conundrum by the viral culture of MERS-CoV, during which it is imperative to first isolate the virus (preferably the three genotypic variants) from DCs, then to infect epithelial cells of human airway tissues derived from nasal or tracheobronchial regions with the isolated virus, and thereafter, to note the cytopathological changes in the infected cells. This will also provide a useful in vitro model of human lung origin to study the characteristics of MERSCoV replication and pathogenesis (such as identifying specific cell surface receptors for MERS-CoV). And I later found some studies saying so.

However, an explicit assessment of the epidemiological role of DCs in the field is very important before making any speculations as well. According to Nishiura et al. (2014), two conditions should be objectively examined to confirm that an animal species constitutes a reservoir: (i) the reservoir is sufficient to maintain the disease by frequently transmitting the virus to another host, and (ii) the presence of the reservoir is essential for the continuous transmission of infection.

Thus, the above-mentioned conditions of reservoir dynamics should be fulfilled beside what I previously told you about Human-to-Camel MERS-CoV transmission.

And I will repeat this part to you, if you may :

”The presence of antibodies, viral nucleic acids, and quasispecies variants of MERS-CoV detected by the authors in their sampled DCs may suggest that dromedaries can be naturally infected with MERS-CoV from infected humans, although how this happens is yet unclear. Nonetheless, we should test archived human samples to demonstrate whether humans can be implicated or whether MERS-CoV truly emerges as a human pathogen prior to 2012 or not. In addition, we should entertain the idea that MERS-CoV in DCs (i.e., the new host) may adapt again and eventually lead to reemergence of the disease in human populations and subsequently to a massive epidemic attack, which, as we previously argued, is the key driver in the current debate"

AND AGAIN, I'm not just being stubborn, my friend. In fact, I'll be the first person who declares that DCs (and not Bats or Rodent or any other animal) is the actual reservoir of MERS-CoV in human infection only when all these gaps or concerns been scientifically resolved.

But the mystery seem to continue, my friend.

Yours truly ;)

The aforementioned references;

Alagaili AN, Briese T, Mishra N, Kapoor V, Sameroff SC, de Wit E, Munster VJ, Hensley LE, Zalmout IS, Kapoor A, Epstein JH, Karesh WB, Daszak P, Mohammed OB, Lipkin WI. 2014. Middle East respiratory syndrome coronavirus infection in dromedary camels in Saudi Arabia. mBio 5(2):e00884-14. http://dx.doi.org/10.1128/mBio.00884-14.

Briese T, Mishra N, Jain K, Zalmout IS, Jabado OJ, Karesh WB, Daszak P, Mohammed OB, Alagaili AN, Lipkin WI. 2014. Middle East respiratory syndrome coronavirus quasispecies that include homologues of human isolates revealed through whole-genome analysis and virus cultured from dromedary camels in Saudi Arabia. mBio 5(3):e01146-14. http:// dx.doi.org/10.1128/mBio.01146-14.

Haagmans BL, Al Dhahiry SH, Reusken CB, Raj VS, Galiano M, Myers R, Godeke GJ, Jonges M, Farag E, Diab A, Ghobashy H, Alhajri F, Al-Thani M, Al-Marri SA, Al Romaihi HE, Al Khal A, Bermingham A, Osterhaus AD, Alhajri MM, Koopmans MP. 2014. Middle East respiratory syndrome coronavirus in dromedary camels: an outbreak investigation. Lancet Infect. Dis. 14:140 –145. http://dx.doi.org/10.1016/S1473 -3099(13)70690-X.

Lun ZR, Qu LH. 2004. Animal-to-human SARS-associated coronavirus transmission? Emerg. Infect. Dis. 10:959. http://dx.doi.org/10.3201/ eid1005.040022.

Memish ZA. 2013. MERS-CoV—eastern Mediterranean (85): animal reservoir, camel, suspected, official. ProMED-mail archive no. 20131112.2051424. http://www.promedmail.org/direct.php?id

2013112.2051424.

Nishiura H, Ejima K, Mizumoto K. 2014. Missing information in animal surveillance of MERS-CoV. Lancet Infect. Dis. 14:100. http://dx.doi.org/ 10.1016/S1473-3099(13)70696-0.

Dear Emad M. Samara,

thank you for the exhaustive reply. It is highly unlikely that MERS-CoV outbreak is driven by infected humans who infect dromedaries. It is obvious that still a lot of unknowns remain about MERS-CoV.

While the ultimate MERS-CoV reservoir is still debatable the following has been proven beyond doubt:

1) MERS-CoV can infect dromedaries and humans and cause clinical symptoms

2) MERS-CoV infected dromedaries can excrete the virus and therefore may be a source of infection to humans

3) MERS-CoV is therefore a zoonotic virus

Dear Maurizio Dioli , I share these POINTS with you, as well. Have a nice day, Emad

Dear Dr. Dishon Muloi

Hope you're doing well and wish you all the best in your academic endeavors...

In regards to your question, there are many zoonoses associated with camel or camel milk and meat.

The best review article that can summarize that for you is this:

Article A Review of Zoonotic Pathogens of Dromedary Camels

Hope you'll find it useful for your quest...