Spatial association between primary Middle East respiratory syndrome coronavirus infection and exposure to dromedary camels in Saudi Arabia

Middle East respiratory syndrome coronavirus (MERS‐CoV) is an emerging zoonotic disease. Exposure to dromedary camels (Camelus dromedaries) has been consistently considered the main source of primary human infection. Although Saudi Arabia reports the highest rate of human MERS‐CoV infection and has one of the largest populations of dromedary camels worldwide, their spatial association has not yet been investigated. Thus, this study aimed to examine the correlation between the spatial distribution of primary MERS‐CoV cases with or without a history of camel exposure reported between 2012 and 2019 and dromedary camels at the provincial level in Saudi Arabia. In most provinces, a high proportion of older men develop infections after exposure to camels. Primary human infections during spring and winter were highest in provinces characterized by seasonal breeding and calving, increased camel mobilization and camel–human interactions. A strong and significant association was found between the total number of dromedary camels and the numbers of primary camel‐exposed and non‐exposed MERS‐CoV cases. Furthermore, spatial correlations between MERS‐CoV cases and camel sex, age and dairy status were significant. Via a cluster analysis, we identified Riyadh, Makkah and Eastern provinces as having the most primary MERS‐CoV cases and the highest number of camels. Transmission of MERS‐CoV from camels to humans occurs in most primary cases, but there is still a high proportion of primary infections with an ambiguous link to camels. The results from this study include significant correlations between primary MERS‐CoV cases and camel populations in all provinces, regardless of camel exposure history. This supports the hypothesis of the role of an asymptomatic human carrier or, less likely, an unknown animal host that has direct contact with both infected camels and humans. In this study, we performed a preliminary risk assessment of prioritization measures to control the transmission of infection from camels to humans.     

The prevalence of Middle East respiratory syndrome coronavirus (MERS‐CoV) antibodies in dromedary camels in Israel

Middle East respiratory syndrome coronavirus, MERS‐CoV, was identified in Saudi Arabia in 2012, and as of January 29, 2018, there were 2,123 laboratory‐confirmed MERS‐CoV cases reported to WHO (WHO, 2018, https://www.who.int/emergencies/mers-cov/en/ ). Multiple studies suggest that dromedary camels are a source for human MERS‐CoV infection. MERS‐CoV‐specific antibodies have been detected in the serum of dromedary camels across Northern Africa and across the Arabian Peninsula. Israel's geographic location places Israel at risk for MERS‐CoV infection. To date, MERS‐CoV‐related illness has not been reported and the burden of MERS‐CoV infection in the Israeli population is unknown. The seroprevalence of MERS‐CoV‐specific antibodies in Israeli dromedary camels is unknown. The objective of this study was to determine the prevalence of MERS‐CoV seropositivity in dromedary camels in Israel. The prevalence of MERS‐CoV antibodies in Israeli camels was examined in 71 camel sera collected from four farms across Israel by MERS‐CoV‐specific microneutralization (Mnt) assay and confirmed by MERS‐CoV‐specific immunofluorescence assay (IFA). Although this study cannot rule out potential antibody cross‐reactivity by IFA, the presence of bovine coronavirus‐specific antibodies do not appear to impact detection of MERS‐CoV antibodies by Mnt. MERS‐CoV neutralizing antibodies were detectable in 51 (71.8%) camel sera, and no association was observed between the presence of neutralizing antibodies and camel age or gender. These findings extend the known range of MERS‐CoV circulation in Middle Eastern camels. The high rate of MERS‐CoV‐specific antibody seropositivity in dromedary camels in the absence of any reported human MERS cases suggests that there is still much to be learned about the dynamics of camel‐to‐human transmission of MERS‐CoV.     

Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE

Since the emergence of Middle East respiratory syndrome coronavirus (MERS‐CoV) in 2012, there have been a number of clusters of human‐to‐human transmission. These cases of human‐to‐human transmission involve close contact and have occurred primarily in healthcare settings, and they are suspected to result from repeated zoonotic introductions. In this study, we sequenced whole MERS‐CoV genomes directly from respiratory samples collected from 23 confirmed MERS cases in the United Arab Emirates (UAE). These samples included cases from three nosocomial and three household clusters. The sequences were analysed for changes and relatedness with regard to the collected epidemiological data and other available MERS‐CoV genomic data. Sequence analysis supports the epidemiological data within the clusters, and further, suggests that these clusters emerged independently. To understand how and when these clusters emerged, respiratory samples were taken from dromedary camels, a known host of MERS‐CoV, in the same geographic regions as the human clusters. Middle East respiratory syndrome coronavirus genomes from six virus‐positive animals were sequenced, and these genomes were nearly identical to those found in human patients from corresponding regions. These data demonstrate a genetic link for each of these clusters to a camel and support the hypothesis that human MERS‐CoV diversity results from multiple zoonotic introductions.     

Knowledge and practices regarding Middle East Respiratory Syndrome Coronavirus among camel handlers in a Slaughterhouse,Kenya, 2015

Dromedary camels are implicated as reservoirs for the zoonotic transmission of Middle East Respiratory Syndrome coronavirus (MERS‐CoV) with the respiratory route thought to be the main mode of transmission. Knowledge and practices regarding MERS among herders, traders and slaughterhouse workers were assessed at Athi‐River slaughterhouse, Kenya. Questionnaires were administered, and a check list was used to collect information on hygiene practices among slaughterhouse workers. Of 22 persons, all washed hands after handling camels, 82% wore gumboots, and 65% wore overalls/dustcoats. None of the workers wore gloves or facemasks during slaughter processes. Fourteen percent reported drinking raw camel milk; 90% were aware of zoonotic diseases with most reporting common ways of transmission as: eating improperly cooked meat (90%), drinking raw milk (68%) and slaughter processes (50%). Sixteen (73%) were unaware of MERS‐CoV. Use of personal protective clothing to prevent direct contact with discharges and aerosols was lacking. Although few people working with camels were interviewed, those met at this centralized slaughterhouse lacked knowledge about MERS‐CoV but were aware of zoonotic diseases and their transmission. These findings highlight need to disseminate information about MERS‐CoV and enhance hygiene and biosafety practices among camel slaughterhouse workers to reduce opportunities for potential virus transmission.     

A rapid scoping review of Middle East respiratory syndrome coronavirus in animal hosts

Middle East respiratory syndrome coronavirus (MERS‐CoV) is an emerging zoonotic pathogen discovered in 2012. The purpose of this scoping review was to summarize the empirical evidence for MERS‐CoV in animals in order to map knowledge gaps and to extract data for modelling disease transmission in dromedary camels. A review protocol was developed a priori, and a systematic search, data extraction and summary were conducted using the Arksey and O'Malley framework. Ninety‐nine publications were identified for full review out of 1,368 unique records. Of these publications, 71 were articles in scientific journals. Ninety of the studies were observational and the remaining nine were experimental. We summarize characteristics of animal studies including study design, study population and outcomes of interest for future transmission modelling in the reservoir population. The majority of field studies reported measures of prevalence, while experimental studies provided estimates of transmission parameters that pertain to the natural course of disease.     

Serosurvey of Coxiella burnetii (Q fever) in Dromedary Camels (Camelus dromedarius) in Laikipia County,Kenya

Dromedary camels (Camelus dromedarius) are an important protein source for people in semi‐arid and arid regions of Africa. In Kenya, camel populations have grown dramatically in the past few decades resulting in the potential for increased disease transmission between humans and camels. An estimated four million Kenyans drink unpasteurized camel milk, which poses a disease risk. We evaluated the seroprevalence of a significant zoonotic pathogen, Coxiella burnetii (Q fever), among 334 camels from nine herds in Laikipia County, Kenya. Serum testing revealed 18.6% positive seroprevalence of Coxiella burnetii (n = 344). Increasing camel age was positively associated with C. burnetii seroprevalence (OR = 5.36). Our study confirmed that camels living in Laikipia County, Kenya, have been exposed to the zoonotic pathogen, C. burnetii. Further research to evaluate the role of camels in disease transmission to other livestock, wildlife and humans in Kenya should be conducted.     

Detection of the Severe Acute Respiratory Syndrome‐Related Coronavirus and Alphacoronavirus in the Bat Population of Taiwan

Bats have been demonstrated to be natural reservoirs of severe acute respiratory syndrome coronavirus (SARS CoV) and Middle East respiratory syndrome (MERS) CoV. Faecal samples from 248 individuals of 20 bat species were tested for partial RNA‐dependent RNA polymerase gene of CoV and 57 faecal samples from eight bat species were tested positive. The highest detection rate of 44% for Scotophilus kuhlii, followed by 30% for Rhinolophus monoceros. Significantly higher detection rates of coronaviral RNA were found in female bats and Scotophilus kuhlii roosting in palm trees. Phylogenetic analysis classified the positive samples into SARS‐related (SARSr) CoV, Scotophilus bat CoV 512 close to those from China and Philippines, and Miniopterus bat CoV 1A‐related lineages. Coronaviral RNA was also detected in bat guano from Scotophilus kuhlii and Myotis formosus flavus on the ground and had potential risk for human exposure. Diverse bat CoV with zoonotic potential could be introduced by migratory bats and maintained in the endemic bat population in Taiwan.     

Contact Variables for Exposure to Avian Influenza H5N1 Virus at the Human–Animal Interface

Although the highly pathogenic avian influenza H5N1 virus continues to cause infections in both avian and human populations, the specific zoonotic risk factors remain poorly understood. This review summarizes available evidence regarding types of contact associated with transmission of H5N1 virus at the human–animal interface. A systematic search of the published literature revealed five analytical studies and 15 case reports describing avian influenza transmission from animals to humans for further review. Risk factors identified in analytical studies were compared, and World Health Organization‐confirmed cases, identified in case reports, were classified according to type of contact reported using a standardized algorithm. Although cases were primarily associated with direct contact with sick/unexpectedly dead birds, some cases reported only indirect contact with birds or contaminated environments or contact with apparently healthy birds. Specific types of contacts or activities leading to exposure could not be determined from data available in the publications reviewed. These results support previous reports that direct contact with sick birds is not the only means of human exposure to avian influenza H5N1 virus. To target public health measures and disease awareness messaging for reducing the risk of zoonotic infection with avian influenza H5N1 virus, the specific types of contacts and activities leading to transmission need to be further understood. The role of environmental virus persistence, shedding of virus by asymptomatic poultry and disease pathophysiology in different avian species relative to human zoonotic risk, as well as specific modes of zoonotic transmission, should be determined.     

Isolation,identification and associated risk factors of non‐tuberculous mycobacteria infection in humans and dromedary camels in Samburu County,Kenya

Non‐tuberculous mycobacteria are of public health significance, and zoonotic infection is attributed to the sociocultural practice of consumption of raw milk and the close human–livestock contact in pastoral communities. This study aimed at isolation, identification of mycobacteria from human sputum and camel milk and risk factors assessment in Samburu East, Kenya. Six hundred and twelve camels and 48 people presumed to have tuberculosis (TB) from 86 households in Wamba and Waso regions were screened. Camels were categorized into Somali, Turkana and Rendile breeds. Single intradermal comparative tuberculin test (SICTT) was used as a herd‐screening test on lactating camels and a milk sample collected from reactive camels. Sputum samples were collected from eligible members of participating households. A standard questionnaire on possible risk factors for both humans and camels was administered to respective household heads or their representatives. Total camel skin test reactors were 238/612 (38.9%). Milk and sputum samples were analysed at KEMRI/TB research laboratory for microscopy, GeneXpert^®, culture and identification. Isolates were identified using 16S rRNA gene sequencing at Inqaba biotec in South Africa. Sixty‐four isolates were acid‐fast bacilli (AFB) positive of which M. fortuitum (3), M. szulgai (20), M. monacense (5), M. lehmanni (4), M. litorale (4), M. elephantis (3), M. duvalii (3), M. brasiliensis (1), M. arcueilense (1) and M. lentiflavum (1) were from milk; M. fortuitum (1), M. szulgai (2) and M. litorale (1) were from humans. Risk factors included the following: Turkana breed (OR = 3.4; 95% CI: 1.2–9.3), replacements from outside the County (OR = 2.1; 95% CI: 0.3–12.3), presence of other domestic species (small stock; OR = 4.6) and replacement from within the herd (OR = 3.2; 95% CI: 0.7–14.7). Zoonotic risk practices included raw milk consumption, shared housing and handling camels. Monitoring of zoonotic NTM through surveillance and notification systems is required.     

First report of Chlamydophila abortus infection in the dromedary camel (Camelus dromedarius) population in eastern Algeria

Chlamydiosis is caused by an obligate intracellular gram-negative bacterium of the genus Chlamydophila which is a zoonotic pathogen. The objectives of the study were to identify the seroprevalence of antibodies against Chlamydophila abortus in dromedary camel herds from four districts in eastern Algeria, as well as to estimate the association between seroprevalence and certain factors present at the animal and herd levels. Blood samples were collected from a random sample of animals within each of 82 camel herds. Serum samples were subjected to a C. abortus ELISA test, and association between the presence of antibodies and potential risk factors was estimated. Animal and herd seroprevalence were 2.5 % and 15.8 %, respectively, indicating substantial exposure of camels to C. abortus in the four districts studied. Age, breed, and sex did not influence seroprevalence in tested animals. Based on the univariate analysis, contact with sheep and goats, contact with other camel herds, and histories of abortion were major risk factors for infection. By using multivariate analysis, contact of camels with sheep and goats and with others camel herds, through shared grazing or watering points, were important factors for transmission of chlamydiosis with an odds ratio of 3.3 and 9.4, respectively. At the herd level the introduction of purchased animals was the major risk factor. This baseline information will be highly useful for launching C. abortus control programs in the region and potentially elsewhere.     

Discussion of the Compendium of Veterinary Standard Precautions: preventing zoonotic disease transmission in veterinary personnel

Veterinary practices are unique environments that bring humans into close contact with many different species of animals; therefore, the risk of exposure to infectious pathogens is inherently different in veterinary medicine than in human medicine. In contrast to the risk of exposure to blood in human medicine, infections from zoonotic diseases in veterinary personnel are primarily related to exposure to animal faeces, infected skin, wounds, droplets and puncture wounds. Infection-control measures in veterinary practices are often insufficient to prevent zoonotic disease transmission. The Veterinary Standard Precautions (VSP) Compendium is designed to help prevent transmission of zoonotic pathogens from animal patients to veterinary personnel in private practice.     

Hepatitis E virus and related viruses in wild,domestic and zoo animals: A review

Hepatitis E is a human disease mainly characterized by acute liver illness, which is caused by infection with the hepatitis E virus (HEV). Large hepatitis E outbreaks have been described in developing countries; however, the disease is also increasingly recognized in industrialized countries. Mortality rates up to 25% have been described for pregnant women during outbreaks in developing countries. In addition, chronic disease courses could be observed in immunocompromised transplant patients. Whereas the HEV genotypes 1 and 2 are mainly confined to humans, genotypes 3 and 4 are also found in animals and can be zoonotically transmitted to humans. Domestic pig and wild boar represent the most important reservoirs for these genotypes. A distinct subtype of genotype 3 has been repeatedly detected in rabbits and a few human patients. Recently, HEV genotype 7 has been identified in dromedary camels and in an immunocompromised transplant patient. The reservoir animals get infected with HEV without showing any clinical symptoms. Besides these well‐known animal reservoirs, HEV‐specific antibodies and/or the genome of HEV or HEV‐related viruses have also been detected in many other animal species, including primates, other mammals and birds. In particular, genotypes 3 and 4 infections are documented in many domestic, wildlife and zoo animal species. In most cases, the presence of HEV in these animals can be explained by spillover infections, but a risk of virus transmission through contact with humans cannot be excluded. This review gives a general overview on the transmission pathways of HEV to humans. It particularly focuses on reported serological and molecular evidence of infections in wild, domestic and zoo animals with HEV or HEV‐related viruses. The role of these animals for transmission of HEV to humans and other animals is discussed.     

Pathology and molecular diagnosis of paratuberculosis of camels

Camels are the prime source of meat and milk in many desert regions of the world including Saudi Arabia. Paratuberculosis of camels, locally called Silag, is a serious and invariably fatal disease in the Arabian camel. Six camels were used in this study. Five camels with clinical paratuberculosis were used to study the pathology of the disease and confirm its aetiology. The sixth camel was clinically healthy and used as a control. The camels were examined clinically and bled for haematological and blood chemistry analysis. They were then humanely killed with a high intravenous dose of thiopental sodium (10 mg/kg) for pathological studies as well as obtaining tissues for microbiological and molecular studies. The clinical signs of the disease were emaciation, diarrhoea, alopecia, wry neck and pale mucous membranes. Laboratory diagnosis showed reduced haemoglobin concentration, low haematocrit and high activity of the serum enzyme alanine aminotransferase. Serum creatinine concentration was normal. These results indicated the infected camels were anaemic and the function of their livers was affected. Postmortem examination showed thickened and corrugated intestinal mucosa, enlarged granulomatous mesenteric lymph nodes, miliary and diffuse granulomas in the liver (in four camels), generalized lymph node granulomas (in one camel), splenic granuloma (in one camel) and mediastinal lymph node granuloma (in two camels). Histopathological examination showed diffuse infiltration of macrophages in all organs showing lesions. Ziehl–Neelsen staining of tissue scraping and tissue sections showed masses of acid fast bacilli, except for the spleen. Infection with Mycobacterium avium subsp. paratuberculosis was confirmed by PCR by targeting the IS900 gene.     

Is There a Two‐Humped Stage in the Embryonic Development of the Dromedary?

It has been postulated that the one‐humped (Arabian) dromedary and the two‐humped (Bactrian) camel originated from a single ancestor. Consequently, the dromedary was considered a breed of the two‐humped camel, based on an anatomical study by Lombardini L, 1879: Ann. Del. Universita Toscane, 259 , 147, who described a reduced second hump like structure in foetal and adult dromedaries. To resolve this lingering issue, we analysed dromedary foetuses and calves. In contrast to the situation in two‐humped camels, we never observed any rudimentary second hump in the dromedary foetuses or calves.     

Seroprevalence of brucellosis and its contribution to abortion in cattle,camel, and goat kept under pastoral management in Borana,Ethiopia

The involvement of Brucella infection in causing abortion was investigated in a breeding female subpopulation of 283 cattle, 756 camels, and 757 goats. Serum samples were serially tested using the Rose Bengal test and complement fixation test. The study showed that anti-Brucella antibodies were prevalent in 10.6% (95% confidence interval (CI), 7.4, 14.9), 2.2% (95%CI, 1.4, 3.7), and 1.9% (95%CI, 1.1, 3.2) of cattle, camel, and goats, respectively. Abortion was more commonly reported in camels (23.4%) than cattle (13.8%) and goats (12.4%). The results of this study suggested that Brucella infections contribute significantly to abortion in cattle (odds ratio (OR), = 4.7; 95%CI, 2.0, 10.8) and goats (OR = 6.9; 95%CI, 2.2, 21.7) but not in camels. The number of young animals produced by breeding females seems to be apparently reduced in seropositive groups. Keeping more than two animal species at household level was found to be the risk factor for cattle (OR = 3.1; 95%CI, 1.2, 7.9) and camel (OR = 5.3; 95%CI, 1.2–23.5) seropositivity to Brucella infection when compared to those animals from households that keep only two animal species. This may suggest a possibility of cross species transmission of Brucella infection under such mixed herding. Wet season (OR = 4.8; 95%CI, 1.3, 18.1) was found to be associated with seropositivity in goats, linked to a coincidence of increased deliveries in flocks with possible excretion of Brucella organisms. The study results suggest that Brucella infection is the likely cause of abortion in cattle and goats while other causes largely outweigh brucellosis as a cause of abortion in camels in Borana, hence, contributing to reproductive loss.     

Zoonotic cases of camelpox infection in India

This study reports the first conclusive evidence of zoonotic camelpox virus (CMLV) infection in humans associated with outbreaks in dromedarian camels (Camelus dromedaries) in northwest region of India during 2009. CMLV infection is usually restricted to camels and causes localised skin lesions but occasionally leads to generalised form of disease. However, the present outbreak involved camel handlers and attendants with clinical manifestations such as papules, vesicles, ulceration and finally scabs over fingers and hands. In camels, the pock-like lesions were distributed over the hairless parts of the body. On the basis of clinical and epidemiological features coupled with serological tests and molecular characterization of the causative agent, CMLV zoonosis was confirmed in three human cases. Clinical samples such as skin scabs/swabs and blood collected from affected animals and humans were analysed initially, for the presence of CMLV-specific antigen and antibodies by counter immunoelectrophoresis (CIE); serum neutralization test (SNT); plaque-reduction neutralization test (PRNT) and indirect immunoperoxidase test which was later confirmed by amplification of CMLV-specific ankyrin repeat protein (C18L) gene. Virus isolation was successful only from samples collected from camels. Further, sequence analyses based on three full-length envelope protein genes (A27L, H3L and D8L) revealed 95.2-99.8% and 93.1-99.3% homology with other Orthopoxviruses at nucleotide and amino acid levels, respectively. Phylogram of the three genes revealed a close relationship of CMLV with Variola virus (VARV). Considering the emerging and re-emerging nature of the virus, its genetic relatedness to VARV, zoonotic potential and productivity losses in camels; the control measures are imperative in curtailing economic and public health impact of the disease. This is the first instance of laboratory confirmed camelpox zoonosis in India.     

No Serologic Evidence for Zoonotic Canine Respiratory Coronavirus Infections among Immunocompetent Adults

Zoonotic diseases continue to emerge and threaten both human and animal health. Overcrowded shelters and breeding kennels create the perfect environment for amplified infectious disease transmission among dogs and present a critical opportunity for zoonotic pathogens to emerge and infect people who work in close contact with dogs. Coronaviruses’ widespread prevalence, extensive host range, various disease manifestations and increased frequency of recombination events all underline their potential for interspecies transmission (Methods Mol. Biol. 2008, 454, 43). The objectives of this study were to determine whether people with occupational contact with dogs were more likely to have antibodies against canine respiratory coronavirus (CRCoV) compared to persons with no dog exposure. A seroepidemiological cohort study was completed, for which 302 canine‐exposed and 99 non‐canine‐exposed study subjects enrolled in the study by providing a serum sample and completing a self‐administered questionnaire. A competitive enzyme‐linked immunosorbent assay (ELISA) was developed to detect human antibodies against CRCoV while controlling for cross‐reacting antibodies against the human coronavirus OC43. All study subjects were negative for antibodies against CRCoV by this competitive ELISA. This study supports the premise that humans are not at risk for CRCoV infections; however, infrequent cross‐species transmission of CRCoV cannot be ruled out.     

Transmission ecology of rodent‐borne diseases: New frontiers

Rodents are recognized reservoir hosts for many human zoonotic pathogens. The current trends resulting from anthropocene defaunation suggest that in the future they, along with other small mammals, are likely to become the dominant mammals in almost all human‐modified environments. Recent intricate studies on bat‐borne emerging diseases have highlighted that many gaps exist in our understanding of the zoonotic transmission of rodent‐borne pathogens. This has emphasized the need for scientists interested in rodent‐borne diseases to integrate rodent ecology into their analysis of rodent‐borne pathogen transmission in order to identify in more detail the mechanisms of spillover and chains of transmission. Further studies are required to better understand the true impact of rodent abundance and the importance of pathogen sharing and circulation in multi‐host– multi‐pathogen communities. We also need to explore in more depth the roles of generalist and abundant species as the potential links between pathogen‐sharing, co‐infections and disease transmission.     

Foot-and-mouth disease in camelids: a review

Foot-and-mouth disease (FMD) in South American camelids, in dromedaries and Bactrians is reviewed. Recent well-executed experimental studies in New World camels indicate that, although the llama and alpaca can be infected with FMD virus (FMDV) by direct contact, they are not very susceptible and do not pose a risk in transmitting FMD to susceptible animal species. They do not become FMDV carriers. Reports on FMD in dromedaries are, however, conflicting. Serological investigations in Africa and the United Arab Emirates (UAE) on thousands of camel sera were negative and experimental infections have been conducted on only a few dromedaries with one serotype and in one country. The design and execution of most of these experiments were poor and therefore the conclusions are questionable. From these investigations, it seems that dromedaries can contract the disease after experimental infection and through close contact with FMD diseased livestock, but do not present a risk in transmitting FMD to susceptible animals. They do not become FMDV carriers. Recent reports from Mongolia describe similar FMD lesions in Bactrian camels. However, so far no samples have tested positive for FMD. To clarify the situation in Bactrians, samples from suspected clinical cases should be tested because other viral vesicular diseases cannot be distinguished from FMD. Thus, further research on the epidemiology of FMD in camelids is necessary. This would include large-scale serological investigations and experimental infections with different FMD serotypes in connection with susceptible contact animals. The Office International des Epizooties (OIE) Code chapter on FMD includes camelids as being susceptible species to FMD, giving the impression that they are similar to cattle, sheep, goats and pigs in their potential involvement in the epidemiology of FMD. This is clearly not the case, and this issue should be re-addressed by the relevant authorities.     

Marine Mammal Zoonoses: A Review of Disease Manifestations

Marine mammals evoke strong public affection as well as considerable scientific interest. However, the resultant close contact with marine wildlife poses human health risks, including traumatic injury and zoonotic disease transmission. The majority of zoonotic marine mammal diseases result in localized skin infections in man that resolve spontaneously or with appropriate medical therapy. However, other marine mammal zoonoses, if left untreated, induce life‐threatening systemic diseases that could pose public health risks. As the number of zoonotic diseases rises, the diagnosis of and treatment for these emerging pathogens pose special challenges requiring the expertise of physicians, veterinarians and wildlife biologists. Here, we provide a comprehensive review of the bacterial, viral and fungal marine mammal zoonotic diseases that we hope will be utilized by public health professionals, physicians, veterinarians and wildlife biologists to better understand, diagnose and prevent marine mammal zoonotic diseases.