People: Javier Guitian, Jackie Cardwell, Imadidden Musallam, Peter Holloway

Middle Eastern Respiratory Syndrome coronavirus (MERS-CoV) was 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. 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. 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 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.

In this interdisciplinary research, we study 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. We 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'.

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