Analysis: Emerging deadly virus demands swift sleuth work

LONDON Wed Feb 27, 2013 8:34am EST

1 of 2. A electron microscope image of a coronavirus is seen in this undated picture provided by the Health Protection Agency in London February 19, 2013.

Credit: Reuters/Health Protection Agency/Handout

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LONDON (Reuters) - The emergence of a deadly virus previously unseen in humans that has already killed half those known to be infected requires speedy scientific detective work to figure out its potential.

Experts in virology and infectious diseases say that while they already have unprecedented detail about the genetics and capabilities of the novel coronavirus, or NCoV, what worries them more is what they don't know.

The virus, which belongs to the same family as viruses that cause the common cold and the one that caused Severe Acute Respiratory Syndrome (SARS), emerged in the Middle East last year and has so far killed seven of the 13 people it is known to have infected worldwide.

Of those, six have been in Saudi Arabia, two in Jordan, and others in Britain and Germany linked to travel in the Middle East or to family clusters.

"What we know really concerns me, but what we don't know really scares me," said Michael Osterholm, director of the U.S.-based Center for Infectious Disease Research and Policy and a professor at the University of Minnesota.

Less than a week after identifying NCoV in September last year in a Qatari patient at a London hospital, scientists at Britain's Health Protection Agency had sequenced part of its genome and mapped out a so-called "phylogenetic tree" - a kind of family tree - of its links.

Swiftly conducted scientific studies by teams in Switzerland, Germany and elsewhere have found that NCoV is well adapted to infecting humans and may be treatable medicines similar to the ones used for SARS, which emerged in China in 2002 and killed a tenth of the 8,000 people it infected.

"Partly because of the way the field has developed post-SARS, we've been able to get onto this virus very early," said Mike Skinner, an expert on coronaviruses from Imperial College London. "We know what it looks like, we know what family it's from and we have its complete gene sequence."

Yet there are many unanswered questions.

SPOTLIGHT ON SAUDI ARABIA, JORDAN

"At the moment we just don't know whether the virus might actually be quite widespread and it's just a tiny proportion of people who get really sick, or whether it's a brand new virus carrying a much greater virulence potential," said Wendy Barclay, a flu virologist, also at Imperial College London.

To have any success in answering those questions, scientists and health officials in affected countries such as Saudi Arabia and Jordan need to conduct swift and robust epidemiological studies to find out whether the virus is circulating more widely in people but causing milder symptoms.

This would help establish whether the 13 cases seen so far are the most severe and represent "the tip the iceberg", said Volker Thiel of the Institute of Immunobiology at Kantonal Hospital in Switzerland, who published research this month showing NCoV grows efficiently in human cells.

Scientists and health officials in the Middle East and Arab Peninsular also need to collaborate with colleagues in Europe, where some NCoV cases have been treated and where samples have gone to specialist labs, to try to pin down the virus' source.

"ONE BIG VIROLOGICAL BLENDER"

Initial scientific analysis by laboratory scientists at Britain's Health Protection Agency (HPA) - which helped identify the virus in a Qatari patient in September last year - found that NCoV's closest relatives are most probably bat viruses.

It is not unusual for viruses to jump from animals to humans and mutate in the process - high profile examples include the human immunodeficiency virus (HIV) that causes AIDS and the H1N1 swine flu which caused a pandemic in 2009 and 2010.

Yet further work by a research team at the Robert Koch Institute at Germany's University of Bonn now suggests it may have come through an intermediary - possibly goats.

In a detailed case study of a patient from Qatar who was infected with NCoV and treated in Germany, researchers said the man reported owning a camel and a goat farm on which several goats had been ill with fevers before he himself got sick.

Osterholm noted this, saying he would "feel more comfortable if we could trace back all the cases to an animal source".

If so, it would mean the infections are just occasional cross-overs from animals, he said - a little like the sporadic cases of bird flu that continue to pop up - and would suggest the virus has not yet established a reservoir in humans.

Yet recent evidence from a cluster of cases in a family in Britain strongly suggests NCoV can be passed from one person to another and may not always come from an animal source.

An infection in a British man who had recently travelled to Saudi Arabia and Pakistan, reported on February 11, was swiftly followed by two more British cases in the same family in people who had no recent travel history in the Middle East.

The World Health Organization says the new cases show the virus is "persistent" and HPA scientists said the cluster provided "strong evidence" that NCoV, which like other coronaviruses probably spreads in airborne droplets, can pass from one human to another "in at least some circumstances".

Despite this, Ian Jones, a professor of virology at Britain's University of Reading, said he believes "the most likely outcome for the current infections is a dead end" - with the virus petering out and becoming extinct.

Others say they fear that is unlikely.

"There's nothing in the virology that tells us this thing is going to stop being transmitted," said Osterholm. "Today the world is one big virological blender. And if it's sustaining itself (in humans) in the Middle East then it will show up around the rest of the world. It's just a matter of time."

(Editing by Anna Willard)

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Comments (11)
tmc wrote:
The biggest threat to 7 billion plus people? Pandemic.

Feb 27, 2013 9:13am EST  --  Report as abuse
Overcast451 wrote:
“The biggest threat to 7 billion plus people? Pandemic.”

It might well be a toss up though… between Pandemic and Governments.

While the Black Plague may have killed 50 – 200 Million, plagues like that don’t happen daily – the wars that the reckless governments of the world create and sustain for years and years do happen almost daily. Never a day goes by when there is not some war somewhere slaughtering innocent citizens.

Sad truth I think – while a virus can be scarey; man is his own worst enemy.

Feb 27, 2013 9:45am EST  --  Report as abuse
AdamSmith wrote:
Globalization, we are told by the wealthy, over and over, is simply a wonderful thing. Globalization, we are told by the oligarch billionaires of Russia, should be allowed to freely happen.

But here, we see that globalization is not such a beneficient force, but can be a deadly force of the very worst kind. Here globalization brings about a new, different type of deadly virus.

NAFTA was America’s giant step towards unfettered globalization. At the behest of America’s wealthy criminal class, NAFTA was signed into law, and America abandoned the American tariff system which had been created by George Washington and Alexander Hamilton, and which had made America into the mightiest industrial nation on earth.

NAFTA, written by America’s wealthy criminal class, enabled them to become far wealthier by outsourcing jobs and driving down wage rates. They did not care if that destroyed the American middle class. Their mantra, their lie, their propaganda, repeated over and over, was “tariffs hurt America” and “globalization helps America”.

Unfettered globalization (abandonment of national border controls) is by far the greatest disaster to happen to America in its history:

1. The destruction of the American protective tariff system.

2. The outsourcing of American manufacturing jobs on a massive scale, destroying the American manufacturing prowess.

3. The unchecked massive immigration into America, unprecedented in size and speed.

4. The abandonment of responsibility for security of the American border with Mexico.

5. The purchase of American homes and real estate by wealthy foreigners on an unprecedented scale. In all the major American coastal cities, e.g., Boston, New York, Miami, Los Angeles, San Francisco, Seattle, the majority of homes purchased this year over $800,000 were bought by foreigners.

6. New strains of deadly viruses, that, as this Reuters article illustrates, are now going global.

But the American wealthy criminal class, and the billionaire Russian oligarchs, Saudia Arabian and Chinese billionaires,quickly buying up the American land, chant their mantra over and over “tariffs hurt America” and “globalization helps America”.

Feb 27, 2013 10:14am EST  --  Report as abuse
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