camel diseases GF‐TADs Sub-regional conference on camel diseases, Abu Dhbi – United Arab Emirates 14-16 February 2016

Camels in Egypt, MERS-CoV Dr. Safaa Elfadaly Senior Veterinarian General Organization for Veterinary Services GOVS

Egypt Population: 90,000,000 Located in cross road in the north east corner of Africa. Agricultural production Represents 40% of the national economy Livestock represents 30 % of the agricultural production.

Cont... Egypt animals population by type: Ruminant livestock: (cattle, sheep, goats, buffalo) population is over 8.2 million. About 1 million equines. Huge poultry population estimated at over 1.5 billion camel's population : Estimated total camel population inside villages are 66228 camels in addition 1,76,000 heads are imported /year.

Camels in Egypt The majority (>85%) of camels in Egypt are imported from East African Countries mainly, Ethiopia and Sudan. During the past 5-6 years over 1.2 million heads of camels were imported, nearly 70% from the Sudan and the rest from Eastern Africa (mainly Ethiopia)

Cont... Distribution of camels : Camels' population is concentrated in 19 governorates within average 500 villages distributed in household and farms. There are great variability in camel's density in each village where Number of camels ranged from 1-1200 in each villages; 450 villages out of 500 villages contain 1-100 camel/village represented 38%of camel population in villages while other 50 villages contain number of camels ranged from 101-1200 camel/village represented 62% of camel population in villages .

Cont... Free nomads concentrated in South Sinai with average number of 4600 camels These camels are mainly reared for meat and milk production and agriculture field works or carry goods and some of them for racing purpose.

Cont... Camels' slaughter houses: 61 slaughter houses in 8 governorates with average capacity 460 camels/week. (10) slaughter houses have the Highest capacity, more than 2000 camels / year in each, they are located in four governorates. Cairo (Basatin) Giza Qualiobia Sharkia

Cont... Camels' markets : Out of around 300 farm animals markets, There are 25 camel markets Located in 10 governorates, density ranging from (0-1500/day). Most of them are of small capacity.

Cont... Three major markets ; Giza which is the largest with an average number of 1500 camels daily and it works for 7 days a week Other two markets in Red sea and Aswan and they work 6 days a week.

Cont... Imported camels : Camels are imported mainly from Sudan and Ethiopia. Imported camels are mainly for immediate slaughter or short fattening period (40-90 days) then slaughter.

Cont... There are 5 main quarantine stations. Three public quarantines; Abo simbel, Shalatin and Daraw receive camel from Sudan . Two private quarantines; receive camels from Ethiopia.

Camel pathogen Little is known about the pathogens that circulate in camel populations and how these pathogens interact with the camel. Very few diagnostic tests are validated for use in camels, and it is not fully understood how they respond to vaccines. Role of camels in the human disease ‘Middle East Respiratory Syndrome (MERS)’ and questions about the validity of antibody tests for MERS in camels have highlighted the need to better understand disease dynamics in these creatures

Cont… The main camels pathogens According to public veterinary clinics records Trypanosomes camel pox internal parasites. (usually for native camels) According to public abattoirs records: T.B. not records Brucellosis, negative.

Cont… Camels vaccines Camel pox, live attenuated, locally manufactured, non mandatory programs. Rift Valley Fever (RVF) , killed vaccine, mandatory twice/year for native camels . No regular monitoring programs are currently implemented.

MERS-CoV 1st report of MERS-CoV in Saudi Arabia (Sept. 2012), more than 1550 laboratory confirmed cases and 550 human deaths reported from 26 countries(WHO report). Up to date cases get infection originally in Arabian Pensulla, despite they get illness and diagnosed later and outside the region.

GOVS Response GOVS set a protocol with Animal Health and Research Institute ( AHRI) to examine 10 % of all imported camels since 23/4/2014 . April 23,2014 a summarized scientific bulletin is sent to all Veterinary directorates about MERS-Corona emerging disease to raise awareness of veterinarians at local level. Also a simplified scientific flyer is delivered about the new emerging corona, including definition of the disease for raising public health awareness about the disease prevention and control .

Cont… May 3,2014 ministerial decree No717 was issued to establish the High National Committee for Zoonotic diseases.To safeguard public health and animal health in Egypt with collaboration of all stakeholders: MOHP AHRI NRC Veterinary Medicine College (Cairo University, virology and infectious departments).

Cont.. First Meeting: May12,2014 It was agreed to start the 1st stage of surveillance about new corona disease in cooperation with the NRC and AHRI . Second meeting: December3,2014 - Discussed the results in the 1st stage -prepared the 2nd stage of surveillance According the Recommendation of the main stakeholders : the Action Plan had been implemented in June 2014 General organization For Veterinary Services (GOVS) hosted the meeting of the High National committee for Zoontic diseases

Surveillance At June 2014 A National surveillance started (Samples collected from 5 governorates in two stages through multisectoral collaboration, GOVS, AHRI, MoHP and NRC First stage : In 5 governorates (Cairo-Giza-Sharkia- Qaliobia-Matroh) Start with the camel markets,slaughter houses, farms,small house holders ,and wild camels at desert. The samples were : 283 serum samples 158 nasal swaps 18 rectal swaps 18 milk samples 1 ocular swap 1 mouth swap )

Samples Human side: Blood samples (serum) : from human in contacts with camels Animal side(Camels): blood samples (for serum) ,Nasal swabs, Rectal swabs Milk Ocular Buccal Lungs- intestine- spleen

Cont... Camels veterinary quarantines: Aswan Governorate : Abo Simbel Second Stage: Camels veterinary quarantines: Aswan Governorate : Abo Simbel Red Sea Governorate :Halaib and Shlateen 100 serum samples 164 nasal swaps

Surveillance Type of test Laboratory work is done in NRC by using Serology -Micronutrlization test (MNT) RT-PCR

Cont... No record of any clinical signs neither in camels nor in human in contact.

Cont… 2014 surveillance: (summary) It’s implemented in two stages with (743 )total samples from 5 governorates (Cairo-Giza-Qlubia- Matrouh-Sharkia-Aswan. Resuts : 400 samples was (+ve) PCR test. 271samples were (+ve)MNT. And the rest were (-ve)

Surveillance 2015 In collaboration with FAO & NRC The surveillance plan is updated. It is a cross-sectional study to be followed by a longitudinal one, including value chain study to: Determine the prevalence of MERS-CoV and closely related Corona viruses in camels at different nodes along the value chain. Explore the presence of MERS-CoV and closely related corona viruses in other domestic animals (cattle, buffalo, sheep, goat, equines) and in bats. Determine if factors like seasonality pattern, age, sex and main production purpose of camels has effect on the distribution of MERS-CoV and closely related CoVs in animals.

Cont... August ,23,2015 the Updated surveillance plan (cross sectional study) implementation started targeting: total of 1294 camels (2588 samples )432 camels per month) over the three months surveillance period. A minimum of 108 animals from each species From other species with a total of 648 animals be sampled . Total 400 bat samples Five bat congregation areas selected based (easy to capture) Samples are collected from 6 governorates (Cairo-Giza-Qalubia – Sharkia - Behera-Aswan)

Cont.. Samples : Serum samples + nasal swap from each camel + milk from females and also add urine &fecal samples. Serum sample + nasal swap from each animal (other species). Blood + throat swap + rectal swap or fecal pellet from bats.

Cont... From camels 404 NS 22 milk samples 13 rectal swaps Samples had been collected & at the med of October 2015 a primary report was elaborated, showing results 586 samples : From camels 404 NS 22 milk samples 13 rectal swaps From other species 38 NS From bats 109 NS

Lab result two positive samples in camel NS: 1- in berkash market - Giza 2- in basatin abattoir - Cairo One positive sample in bats NS : but its for another type of corona virus The draft report for (C.S.) surveillance plan not finalized yet.

Cont... The longitudinal surveillance is planed to start at March,2016. The present surveillance plan in Egypt is part and parcel of the FAO/USAID/PREDICT global/regional efforts GOVS work will be closely coordinated and jointly implemented with all partners ( FAO, NRC &The USAID PREDICT-2 Project through Eco Health Alliance

Strengths: 2 public labs Animal Health Research Institute (AHRI) National Research Center (NRC) Dedicated MERS-CoV team at central level (Early detection, Awareness and response) Good experience multisectorial collaboration.

Expectation Our interest and expectation: Sustained support for collaborative regional risk based surveillance, including African camels exporter counties. Sustained communication and awareness targeting communities in general (not only those linked with camels) Further studies are needed!

References' 2009 National Conference of development of life stock, Organized by Agriculture Research Centre. Animal production sector of Ministry of Agriculture and land Reclamation. Documents of Central Administration of Preventive Medicine at GOVS

Thank you