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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/12559

Title: Response to the letter to the editor: Barasheed et al., ‘No evidence of MERS-CoV in Ghanaian Hajj pilgrims: cautious interpretation is needed’
Authors: Eckerle, Isabella
Sylverken, Augustina Angelina
Drosten, Christian
Issue Date: Aug-2015
Publisher: John Wiley & Sons Ltd
Citation: Isabella Eckerle, Augustina Annan and Christian Drosten. Response to the letter to the editor: Barasheed et al., ‘No evidence of MERS-CoV in Ghanaian Hajj pilgrims: cautious interpretation is needed. doi:10.1111/tmi.12526
Abstract: Barasheed et al. cite two more studies on surveillance of MERS-CoV in returning Hajj pilgrims, both of which were published after the submission of our manuscript, thus highlighting the interest of MERS-CoV surveillance of Hajj pilgrims that is obviously perceived in the scientific community at the moment [1–4]. Reassuringly, in none of the studies MERS-CoV was detected, which is in line with our findings. However, as a recent study found a lower viral load in samples from the upper respiratory tract compared to those from the lower respiratory tract, Barasheed et al. raise the question of decreased sensitivity for MERS-CoV detection in the surveillance studies that were performed up to now [5]. So far, all surveillance studies of Hajj pilgrims relied on testing of upper respiratory tract samples to exclude the presence of a MERS-CoV infection upon return from the Hajj. Therefore, we want to address the following aspects: the findings from Memish et al. were observed in acutely diseased, hospitalised MERS-CoV cases, and therefore, the relevance from this finding for conducting community-based surveillance studies from both an ethical and a practical point of view is low. Clearly, material from the lower respiratory tract that necessitates invasive procedures such as bronchoscopy cannot be obtained from pilgrims that show no or only mild symptoms. Furthermore, as shedding of virus in the upper airways is also a measure of virus transmissibility, a lack of detection of MERS-CoV RNA in the upper respiratory tract is a valid correlate for a likely absence of a MERS-CoV transmission risk in the cohorts described. Furthermore, Barasheed et al. comment on a lack of the prevalence of influenza-like illness (ILI) in our study.
Description: An article published by John Wiley & Sons Ltd and also available at doi:10.1111/tmi.12526
URI: http://hdl.handle.net/123456789/12559
Appears in Collections:College of Science

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