Responding to the challenge of MERS-CoV: Development and testing of interventions to reduce risk among Bedouin populations in Southern Jordan

应对中东呼吸综合征冠状病毒的挑战：制定和测试干预措施以降低约旦南部贝都因人的风险

• 批准号: MR/T02996X/1
• 负责人: Javier Guitian
• 金额: $ 272.71万
• 依托单位: Royal Veterinary College
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT02996X%2F1
• 关键词: Responding; challenge; MERS; CoV; Development

Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) is a recently identified 'emerging infectious disease' first seen in Jordan and Saudi Arabia in 2012. Clinical cases can present as a sudden acute respiratory infection, with rapid onset pneumonia and death, although milder infections also occur (in some cases without any symptoms at all). Since the initial outbreaks in 2012, there have been almost 2500 confirmed cases, with over a third of those infected subsequently dying from the disease (848 people to date).Confirmed cases have been reported across 27 countries, although the majority have been in the Arabian Peninsula, with Saudi Arabia the disease epicentre (over 80% of all confirmed cases). Primary infection in humans occurs through contact with infected dromedary camels (or camel products) and camel populations act as the host reservoir for the virus, however infection in camels causes only mild symptoms, similar to a common cold (and may cause no symptoms at all). Once someone becomes infected in this way secondary human-to-human transmission of the virus can then occur (often in a hospital setting) with the potential to cause large scale outbreaks such as those seen in South Korea and Saudi Arabia in recent years. Jordan's strategic location at the centre of current Middle Eastern crises means that its stability within the region is of global significance. Enormous influxes of displaced peoples into Jordan from the conflicts in Syria, Iraq and Yemen among others (accounting for over 30% of the population) have placed unprecedented demands on Jordan's national disease surveillance, response and health-care services and increased the risk of catastrophic disease outbreaks occurring in the future, including MERS-CoV. Jordan's long, porous border with Saudi Arabia, across which frequent movements of people and livestock occur (particularly among rural Bedouin populations in the south of the country) and large camel populations, mean that the risks posed by MERS-CoV remain high.The World Health Organization (WHO) have designated MERS-CoV to be a Blueprint Priority Disease for Research and Development, alongside other 'emerging infectious diseases' that represent a potential global threat, including Ebola, Lassa and Nipah viruses. The development of vaccines against MERS-CoV, for use in both camels and humans, is already at an advanced stage, however knowledge regarding the diseases epidemiology and cultural context (which are essential for effective vaccine deployment) is currently lacking. A similar lack of knowledge has delayed the deployment of other vaccines in the past (e.g. recently the Lassa virus vaccine in West Africa) and so it is important that deployment of future MERS-CoV vaccines is not delayed for the same reasons. It is crucial therefore that appropriate research be conducted among high-risk populations.With this in mind, and building on the findings of successful GRCF Foundation Award research, we aim to conduct state-of-the-art interdisciplinary research to determine the biological and sociocultural contexts of the disease among at-risk Bedouin populations in southern Jordan. In particular, we are seeking to understand which individuals, or camels, should be targeted for future vaccination, the correct seasons for the deployment of such vaccines and the sociocultural issues that are driving the infection, with consideration of these sociocultural issues vital when looking at potential control measures for the disease, including vaccination. Through this project we thus aim to develop appropriate, community based behavioural interventions that will reduce the risk of infection among these communities (as well as considering the potential role of vaccines in the future). We are also aiming to build Jordan's capacity for strategic research, surveillance and control activities to confront the challenge posed by MERS-CoV (as well as by other 'emerging infectious diseases').

中东呼吸道综合征冠状病毒（MERS-COV）是最近在2012年首次在约旦和沙特阿拉伯出现的“新兴感染性疾病”。临床病例可能是突然的急性呼吸道感染，尽管在某些情况下也没有任何症状。自2012年首次爆发以来，已有近2500例确认病例，其中三分之一的被感染者随后死于该疾病（迄今为止有848人）。据报道，在27个国家 /地区确认了案件，尽管大多数人都在阿拉伯半岛，沙特阿拉伯的疾病疾病中心（所有确认的病例的80％）。人类的原发性感染是通过与感染的羊皮骆驼（或骆驼产品）接触而发生的，骆驼种群充当病毒的宿主储层，但是骆驼中的感染只会引起轻度症状，类似于常见的感冒（可能根本不会引起症状）。一旦某人以这种方式感染了该病毒的次要人类到人类传播（通常在医院环境中），并有可能引起大规模爆发，例如近年来在韩国和沙特阿拉伯看到的爆发。约旦在当前中东危机中心的战略位置意味着其在该地区内的稳定性具有全球意义。由于叙利亚，伊拉克和也门等人的冲突（占人口的30％以上），大量流离失所的民族涌入约旦，对约旦的国家疾病监测，反应和卫生保健服务提出了前所未有的要求，并增加了包括Mers-Cov在内的未来发生灾难性疾病暴发的风险。约旦与沙特阿拉伯的漫长，多方面的边界，人们和牲畜的频繁移动（尤其是在该国南部的贝杜因乡村人口中）和大型骆驼人群和众多骆驼人口，这意味着，梅尔斯-COV的风险仍然很高。世界卫生组织（WHO）对MERS-COV的可能性是全球范围的，与其他疾病有关，与其他疾病有关，与其他疾病有关，与其他疾病相同，与其他疾病相同，与其他疾病相同，与其他疾病相同。威胁，包括埃博拉病毒，拉萨和尼帕病毒。针对MERS-COV的疫苗的开发已经在骆驼和人类中都处于高级阶段，但是有关疾病流行病学和文化背景的知识（对于有效的疫苗部署至关重要）。类似的知识缺乏延迟了过去其他疫苗的部署（例如，最近的西非Lassa病毒疫苗）因此，重要的是，由于相同的原因，重要的是，未来MERS-COV疫苗的部署不会被推迟。因此，至关重要的是，在高风险人群中进行适当的研究。考虑到这一点，并在成功的GRCF基金会奖研究的发现上，我们旨在进行最先进的跨学科研究，以确定约旦南部高风险贝都因人种群中这种疾病的生物学和社会文化背景。特别是，我们正在寻求了解哪些人或骆驼应成为未来的疫苗接种，适当的疫苗部署季节以及推动感染感染的社会文化问题，并考虑到这些社会文化问题在寻找疾病的潜在控制措施时至关重要的这些社会文化问题。因此，通过该项目，我们旨在制定适当的基于社区的行为干预措施，以减少这些社区中感染的风险（并考虑将来疫苗的潜在作用）。我们还旨在建立约旦进行战略研究，监视和控制活动的能力，以面对MERS-COV（以及其他“新兴的传染病”）所构成的挑战。

项目成果

Risk Factors for Middle East Respiratory Syndrome Coronavirus Infection among Camel Populations, Southern Jordan, 2014-2018.

• DOI: 10.3201/eid2709.203508
• 发表时间: 2021-09
• 期刊: Emerging infectious diseases
• 影响因子: 11.8
• 作者: Holloway P;Gibson M;van Doremalen N;Nash S;Holloway T;Letko M;Cardwell JM;Al Omari B;Al-Majali A;Abu-Basha E;Mangtani P;Munster VJ;Guitian J
• 通讯作者: Guitian J