Mystery Virus in Wuhan Identified As Novel Coronavirus; Researchers Still Searching For Animal Host

Chinese authorities have been commended for the speed at which they have identified the genetic make up of a novel coronavirus, 2019-nCoV as the cause of a new pneumonia-like illness in Wuhan, China. The virus has infected 42 people, and is likely transmitted primarily through animals to humans, said a leading infectious disease specialist on Monday.

But while the recent coronarvirus outbreak does not appear to be nearly as deadly as previous ones, such as the 2002-2003 SARS epidemic or the most recent 2015 outbreak of MERS, it is reflective of a new reality that public health officials increasingly face. Deadly infections are leaping the species barrier from animals to human populations with greater frequency, speed or intensity in a globalized world, experts say. And whether the outbreak is in a remote rural area or dense urban landscape such as Wuhan, it can send shockwaves through countries and global economies.

Wholesale seafood and animal market in China.

“The Chinese could be commended for their efforts in containing the outbreak… but now we need to know more about the animal reservoir, so we know to prepare for future outbreaks,“ Michael Osterholm, director of the Minnesota-based Center for Infectious Disease Research and Policy (CIDRAP), told Health Policy Watch.

But “Wuhan shouldn’t have been a surprise, it’s going to happen more and more. The world responded quickly to people flying out of Wuhan [as seen in Thailand]. However, it may have been more complicated if the virus emerged in a more internationally-travelled city such as Beijing or Shanghai,” he said.

“I think that our ability to respond to these emergencies is moving in a more positive response generally… However, worldwide, we still have many areas of social and political unrest; the world is becoming less safe for public health work,” Osterholm added.

On Saturday, WHO’s Director General Dr Tedros Adhanom Gheyebresus also commended the Chinese authorities for “working around the clock” to identify the genetic sequence of the new Wuhan pneumonia virus, dubbed 2019-nCOV. The authorities also transmitted those sequences to WHO. The data will help WHO support global efforts to diagnose and treat other suspected cases of the virus, WHO said.

In a statement on Monday, WHO also confirmed that a “seafood market,” which also also houses an abundance of live animals, some of which are pets while others are slaughtered and eaten, appeared to be the source of the infection.  Further investigations were still underway to identify the actual “animal reservoirs or intermediate hosts“, the agency said.

Cats awaiting sale in a Chinese live animal market.

Dr Tedros was also consulting with WHO Emergency Committee members in terms of the level of health emergency that exists, and WHO said a meeting could be called with the committee on “short notice“.

In his interview, Osterholm added that it is critical for the Chinese to share information about which animals have been investigated already, and the outcomes of such research. Since there is no evidence of human-to-human transmission as no cases have been reported in health care workers attending to confirmed patients, the main route of transmission seems to be from animal-to-human, he explained. So identifying and preventing the animal host from coming into contact with humans is critical for containing the epidemic.

Most of the confirmed infections have come from people who were either business operators or regular shoppers at “Hua Nan Seafood Wholesale Market in Wuhan,” according to the National Health Commission of China. The market has been closed since 1 January for health inspections.

“Although it’s called a ‘seafood’ market, it is in fact a market for general animal species… mostly sold for consumption,” said Osterholm. Many vendors sell bats and birds, as well as other live animals that could be hosts for the novel virus.

However, while public health officials should remain vigilant, there is no need for undue alarm, Osterholm said, emphasizing that the focus should be on learning from this outbreak to prepare for future ones.

“Panic never works period,” he says. “To me it appears that if anything, [the outbreak] is under control… it seems to be over [in Wuhan] as we haven’t seen any secondary transmission.

“Now the question is, if the market opens up again, what will happen. We need an understanding of what, in fact, was the source, and if that source is likely to come back into contact again with humans?”

So far, the outbreak has not been nearly as deadly as previous coronoravirus outbreaks, which have included Middle Eastern Respiratory Syndrome (MERS), emerging out of the Middle East and harbored by camels, as well as SARS, which first infected humans via civet cats infected by bats, both of which are sold in live animal markets to be consumed in parts of China.

As of Monday, the number of confirmed 2019-nCoV cases had actually declined from 59 suspected cases last week to 42 confirmed cases, including just one case in Thailand. One death has been reported, of a 61-year-old who had a pre-existing liver condition. Six patients remain severely ill while seven patients have been discharged from the hospital. So far, no new cases have been reported in Wuhan since 3 January, according to WHO WPRO. Authorities are currently following 763 contacts of confirmed cases, and no related cases have been detected according to an English translation of a press release from Chinese health authorities.

Wuhan, Hubei, China.
Rapid Action To Identify and Contain The Novel Virus

The Chinese National Health Service shared genetic sequences of the novel virus with WHO on 11-12 January; these confirmed the mysterious disease was a new type of coronavirus, according to news updates posted by WHO on Twitter over the weekend.

Genetic sequences obtained have been uploaded to an open-access online gene bank GISAID, which will publish the sequence upon confirming the information. This will enable other countries to rapidly confirm new suspected cases of the disease and institutions to collaborate on researching the disease, as well as prevention and treatment.

On 8 January, a confirmed case of 2019-nCoV was also reported in Thailand. The patient, a traveler from Wuhan, was hospitalized the same day and quarantined. Thai officials reported that the person is now recovering.

WHO said in a statement on Monday that the possibility of cases being identified in other countries was “not unexpected,” and the case in Thailand confirmed the need for “active monitoring” and “preparedness in other countries.”   However, mutations can also occur as a new virus emerges in humans, making them more dangerous and infectious over time.

The episodes underlines the need for emergency preparedness for emerging infectious diseases to remain high on the global health agenda, said Osterholm.

 

Image Credits: Peter Griffin/Public Domain Pictures, lihkg.com, Wikipedia/user: 钉钉.

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