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').

中东呼吸综合征冠状病毒(MERS-CoV)是最近发现的一种新出现的传染病，于2012年在约旦和沙特阿拉伯首次发现。临床病例可表现为突然的急性呼吸道感染，迅速发病的肺炎和死亡，尽管也会发生较轻微的感染(在某些情况下根本没有任何症状)。自2012年首次暴发以来，已有近2500例确诊病例，超过三分之一的感染者随后死于该疾病(迄今有848人死亡)。27个国家报告了确诊病例，尽管大多数病例发生在阿拉伯半岛，沙特阿拉伯是疾病中心(占所有确诊病例的80%以上)。人类的主要感染是通过接触受感染的单峰骆驼(或骆驼产品)发生的，骆驼种群是病毒的宿主宿主，但骆驼感染只会引起轻微的症状，类似于普通感冒(可能根本不会引起症状)。一旦有人以这种方式感染，病毒就可能发生二次人与人之间的传播(通常是在医院环境中)，有可能导致大规模疫情，如近年来在韩国和沙特阿拉伯看到的那样。约旦处于当前中东危机中心的战略位置意味着它在该区域内的稳定具有全球意义。叙利亚、伊拉克和也门等国冲突中涌入约旦的大量流离失所者(占约旦人口的30%以上)对约旦的国家疾病监测、反应和医疗保健服务提出了前所未有的要求，并增加了未来发生灾难性疾病爆发的风险，包括MERS-CoV。约旦与沙特阿拉伯漫长、漏洞百出的边界上，人员和牲畜频繁流动(特别是在该国南部的贝都因农村人口中)和大量骆驼种群，这意味着MERS冠状病毒构成的风险仍然很高。世界卫生组织(WHO)已将MERS冠状病毒与埃博拉、拉萨和尼帕病毒等其他代表潜在全球威胁的新出现的传染病一起列为研发蓝图优先疾病。用于骆驼和人类的MERS-CoV疫苗的开发已处于后期阶段，但目前缺乏有关疾病流行病学和文化背景的知识(这是有效部署疫苗所必需的)。由于同样缺乏知识，过去推迟了其他疫苗的部署(例如最近西非的拉萨病毒疫苗)，因此，重要的是不要因为同样的原因而推迟未来MERS-CoV疫苗的部署。因此，在高危人群中进行适当的研究是至关重要的。考虑到这一点，并以成功的GRCF基金会奖研究结果为基础，我们的目标是进行最先进的跨学科研究，以确定约旦南部高危贝都因人中疾病的生物学和社会文化背景。特别是，我们正在努力了解哪些人或骆驼应该成为未来疫苗接种的目标，正确的疫苗接种季节以及导致感染的社会文化问题，并在研究包括疫苗接种在内的疾病潜在控制措施时考虑这些至关重要的社会文化问题。因此，通过这个项目，我们的目标是开发适当的、以社区为基础的行为干预措施，以降低这些社区的感染风险(并考虑疫苗在未来的潜在作用)。我们还致力于建设约旦的战略研究、监测和控制活动的能力，以应对MERS冠状病毒(以及其他“新出现的传染病”)带来的挑战。

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