Meta-analysis of seroprevalence and zoonotic infections of Middle East respiratory syndrome coronavirus (MERS-CoV): A one-health perspective.

The zoonotic Middle East respiratory syndrome (MERS) is caused by an emerging beta-coronavirus (CoV). The majority of MERS studies have included scattered data from sub-Saharan Africa and the Middle East, and these data have not been analyzed collectively. In this work, a meta-analysis of these studies was conducted to coalesce these results, determine the prevalence and seroprevalence of MERS-CoV in camels and humans, and examine how zoonotic infection rates in dromedary camels are related to human infection rates. After extracting the collected data, the prevalence and seroprevalence at a 95% confidence interval (CI) using a fixed-effects inverse-variance meta-analysis was conducted. Thirteen studies were included. Eight studies included 2905 samples from dromedary camels, of which 1108 (38.14%) were positive for the virus. The prevalence was 8.75[-13.47, 30.98] at 95% CI in dromedary camels and 0.03[-35.23, 35.28] at 95% CI in humans. Ten studies included 7176 serum samples, 5788 (80.66%) of which were positive. The seroprevalence was 20.69[-4.60, 45.99] at 95% CI. The prevalence of MERS-CoV was moderate to high, but the seroprevalence was high. Despite the high prevalence of the virus in camel herds, zoonotic transmissions were not widespread. Further longitudinal and cross-sectional follow-up studies are recommended to provide solid control of MERS-CoV transmission.