Risk factors and mitigation strategies for spillover of MERS-CoV and other infections at the camel-human-interface: Rapid research needs appraisal

Middle East respiratory syndrome (MERS), caused by MERS coronavirus (MERS-CoV), is a zoonotic disease transmitted from camels-to-humans. We applied a targeted rapid research needs appraisal (RRNA) to review evidence and gaps on spill-over risk, mitigation measures, associated social and behavioural research. We systematically searched PubMed, Ovid, Scopus, Web of Science and WHO Global Index Medicus up to November 2024, studies on MERS and other zoonoses at the camel-to-human interface. The protocol and interpretation were informed by a WHO-coordinated MERS expert reference group and Secretariat. Of 82 records, 92.7% (76/82) were observational and 74.4% (61/82) focused on MERS. Most were set in the Eastern Mediterranean (69.5%, 57/82) region. Most studies explored spillover risk activities (n = 50), and host and occupational risk factors (n = 36). Current evidence overlooks social and cultural contexts of camel-to-human interactions, highlighting the need for multidisciplinary research and engagement with at-risk populations to inform mitigation strategies applicable to diverse contexts.