Tuesday, 3 September 2013

Got a spare $6.3-billion? Experts could use it to discover the missing 320,000+ mammalian viruses we don't yet know about

...or just $1.4-billion for 85% of those. And that's not including the non-mammalian ones. This is according to a new paper in mBio today by Andrew and colleagues from a collaborative team including Prof Ian Lipkin, from Columbia University's Mailman School of Public Health. 

The study advocates for a much more structured, systematic approach to discovery and notes that existing studies, such as the U.S. Agency for International Development's (USAID) Emerging Pandemic Threats (EPT) program including the PREDICT project (more detail in Lancet article here), have made headway into the list already. Each adding valuable assets to our virology intelligence archive.

Finding these viruses, and the animals they reside in, is key to limiting zoonoses. Sure, discovery does not equal simultaneous cure, but ignorance does equal surprise outbreak and death. Most emerging human infectious are caused by animal viruses infecting us. This is well defined by the One Health concept which promotes investigation of all aspects of the network of links between humans and their hairier, more leggy or winged co-habitants.

If we ever want to get ahead of the curve, investing in this sort of research is essential to allow us to know our enemy. It let's us be ready to meet them at the door instead of scrambling to action when they kick our door in! And it is a scramble; just look through the literature and media surrounding any virus that has spilt over from animals to humans in recent decades....a degree of controlled panic over the many things we don't yet know in the early stages of an unexpected emergence. For example: 

  • We'd have no laboratory testing methods (culture, PCR or serology) nor the procedures to confirm weird results.
  • Which country would "own" the virus, what would we call it (mock you may, but a lot of electrons and ink have been wasted on that story for the MERS-CoV for instance) and how long would it take before commercial detection kits were available (for MERS-CoV - its been nearly 15-months since the first cases in Jordan and still nothing well validated and widely available for use by non-reference laboratories)?
  • When would we have enough of the virus to make positive controls for those tests or to kick off research into how the virus does what it does?
  • We don't yet know what it does! What is the clinical spectrum of disease, how big is the iceberg let alone it's tip; what are the signs and symptoms; what does it do in different patient groups - those with and without comorbidities, different ages and sex?
  • What is the proportion of fatal cases?
  • Where did the invader came from?
  • How best to handle the pathogen in hospital settings
  • How fast and to how many does each case transmit (it will be a while until we can calculate the R0)?
  • What drugs do we already have that can moderate disease?
  • How long will it take for an antiviral or vaccine, if they can be prepared, to be available and how long thereafter will antiviral resistance become an issue?
  • How many that the virus infects will die?
  • Does the virus interact with other viruses, bacteria, fungi or parasites?
  • Does it have a peak season and is that affected by the environment?
Pretty much ALL of these things can be addressed if we invest in finding the culprits, their host and begin to unravel how they tick sooner rather than (too) later. Sure, they may never spillover, but when just 1 does, the impact is felt around the world, be it from loss of life, financial instability, healthcare burden, travel and tourism decline, animal culling or just a global feeling of insecurity. Any 1 virus outbreak can wield a lot of power in today's highly interconnected world. 

Count VDU in the cheer squad for this sort of proactive research. Money well invested.