Thursday, 5 June 2014

1 of these papers is pretty much exactly like the other...[UPDATED #2]

This is a strange one. 

Today, a New England Journal of Medicine (NEJM) paper [2] came out and received a vast amount of media coverage. 

It seems as if all the other recent press, the camel kissing videos, camel advocates decrying the link between MERS-CoV and their beauties and camels being included in risk assessments...have just primed the world for the next scientific paper. 

And then this new paper came out showing MERS-CoV infection of a farmer and of his camels and a likely direction to that infection of camel >> farmer. And, it came out in the highly prestigious NEJM - this folks, is one part of what a high impact factor is all about - wide exposure and broad coverage. You really get your research out there.

Apparently neither of us are actually
Jeddah camels 'cause we're wearing too
much bling.
Twitter and the mainstream media have lit up with lines like "direct evidence that MERS comes from camels", "new report offers strongest evidence yet that MERS virus spreads from camels to people", "1st evidence that a new deadly virus has been transmitted from a camel to people".
There is a problem though. It's not reeeally any of those things.

These are both studies of what looks to be the same infected human (a 43-year or 44-year old man depending on which report), hospitalised at King Abdulaziz University Hospital in Jeddah on 3-November-2013, owner of a herd of 9 camels, some of whom were sick, sampled at around the same time (I presume, otherwise why sampled at all?).

The only major differences (there are smaller differences) between the 2 reports is which camel yielded sequence - it seems to have been Camel G for Drosten's lab and Camel B for Madani's - they even seem to have used the same identification scheme for the camels! The NEJM paper also has some human serology data that were absent from Drosten's study; determined using an immunofluorescence assay, although not confirmed as MERS-CoV specific using the more specific neutralization test.

Oh, one other big difference.

Memish, Drosten and colleagues got their paper out online around 20-March-2014 (2-months 15-days earlier [UPDATED]).

But let's also look at the sequence release/modification date too. This is the date when the researcher's virus sequence data, submitted to the public sequence database GenBank prior to the paper being published, is available. For Azhar and Madani and colleagues, that date was 1-May-2014 (sample taken 5/8-Nov-2013) and for Memish and Drosten and colleagues, 24-March-2014 (could only access 3 fragments; sampled 9-November-2013).

NOTE: This Editor's Note was added (9-June) to the NEJM paper:
The patient and camels discussed in this article are also described in Memish ZA, Cotten M, Meyer B, et al. Human infection with MERS coronavirus after exposure to infected camels, Saudi Arabia, 2013. Emerg Infect Dis 2014;20:1012-5.

I'm sure there are at least 2 very interesting stories behind this little event.

References...

  1. Human Infection with MERS Coronavirus after Exposure to Infected Camels, Saudi Arabia, 2013
    Ziad A. Memish, Matthew Cotten, Benjamin Meyer, Simon J. Watson, Abdullah J. Alsahafi, Abdullah A. Al Rabeeah, Victor Max Corman, Andrea Sieberg, Hatem Q. Makhdoom, Abdullah Assiri, Malaki Al Masri, Souhaib Aldabbagh, Berend-Jan Bosch, Martin Beer, Marcel A. Müller, Paul Kellam, and Christian Drosten
    Emerging Infectious Diseases
    http://wwwnc.cdc.gov/eid/article/20/6/14-0402_article.htm
  2. Evidence for Camel-to-Human Transmission of MERS Coronavirus
    Esam I. Azhar, Ph.D., Sherif A. El-Kafrawy, Ph.D., Suha A. Farraj, M.Sc., Ahmed M. Hassan, M.Sc., Muneera S. Al-Saeed, B.Sc., Anwar M. Hashem, Ph.D., and Tariq A. Madani, M.D.
    New England Journal of Medicine
    http://www.nejm.org/doi/pdf/10.1056/NEJMoa1401505