2 Health Care Workers Made Ill by SARS-Like Virus

An emerging, SARS-like virus that has sickened 40 people in the Middle East and Europe since September has now caused illness in two health care workers who were caring for infected patients, health officials report.

Two health care staffers caring for a patient in Saudi Arabia have been sickened with the coronavirus, the first such recorded case of transmission from patient to health care worker, the Associated Press reported. Person-to-person transmission has been suspected before, the news agency said.

Coronaviruses include SARS, the infection that caused a widespread global outbreak in 2003. The new coronavirus appears to have a high fatality rate, with 20 deaths recorded among the 40 known cases.

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Secrets of New SARS-Like Virus Uncovered

Finding shows how it enters cells, could lead to vaccine, researchers report

By Barbara Bronson Gray

HealthDay Reporter

WEDNESDAY, March 13 (HealthDay News) -- A discovery that shows how a novel -- and often fatal -- virus infects cells may help fight a health threat that has recently emerged on the world stage, researchers report.

A unique coronavirus was identified as the cause of severe respiratory illness in 14 people from Jordan, Qatar, Saudi Arabia and the United Kingdom between April 2012 and February 2013, according to the U.S. Centers for Disease Control and Prevention. Eight people have died after contracting the virus.

Coronaviruses -- named for their crown-like projections visible under a microscope -- are causes of the common cold but also are associated with more severe illness, such as SARS (Severe Acute Respiratory Syndrome), which killed hundreds of people worldwide in 2003.

Although no deaths have been reported in the United States, the fact that there were clusters of people infected in the United Kingdom shows the new virus can be transmitted between humans, according to the CDC.

Now there's a possible clue on how to stop the virus, which was first identified last September. Dutch researchers said they've identified the receptor that is used by the coronavirus to invade cells.

Approaches to preventing the virus from binding to the receptor and gaining entry to cells may help combat infection, said study author Bart Haagmans, a virologist at the Erasmus Medical Center, in Rotterdam. "These findings provide further insight into how the virus causes severe pneumonia, as the receptor is present in the lower respiratory tract [trachea, airways or lungs]," he explained.

The research was published in the March 14 issue of the journal Nature.

The severity of the disease appears to vary, mirroring minor flu-like infections in some people and becoming life-threatening in others. Those with the most serious infections seem to have had other viral or bacterial infections at the same time, which may help explain the more severe cases, experts said.

The virus doesn't seem as contagious as seasonal flu, and Haagmans said this appears to confirm the role of the receptor he identified. "This may be due to the fact that the receptor is minimally expressed in cells of the upper respiratory tract," he said. "Therefore, it is also unlikely that the virus can become much more capable of spreading more universally."

The discovery of the receptor could potentially help researchers inhibit the spread of the virus, said Haagmans. One approach would be to develop a vaccine that securely locked the cell door to the coronavirus receptor, preventing the virus from being able to storm the cell.

Haagmans said he doesn't know why the virus seems to be deadly. He said it's possible that scores of people with a less harmful form of the disease have not been identified, due to limited testing in the Arabian Peninsula, where the disease seems to have originated.

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Emerging SARS-Like Virus Well-Suited to Attack Humans: Study

By Mary Elizabeth Dallas

HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- The new SARS-like "coronavirus" that first emerged in the Middle East can invade the lungs and immune system as easily as the common cold, according to a new study.

But in the event of a large-scale outbreak, researchers in Switzerland found the virus -- known as HCoV-EMC -- may be treatable with components of the immune system, known as interferons. This immunotherapy has shown promise in the treatment of the respiratory disease SARS and hepatitis C, the study authors said.

"Surprisingly, this coronavirus grows very efficiently on human epithelial cells," said study co-author Volker Thiel of the Institute of Immunobiology at Kantonal Hospital in St. Gallen, in a news release from the American Society for Microbiology. Epithelial cells line hollow organs and glands.

"The other thing we found is that the viruses [HCoV-EMC, SARS, and the common cold virus] are all similar in terms of host responses: they don't provoke a huge innate immune response," he said.

The study was published online Feb. 19 in mBio.

HCoV-EMC, which may have jumped from animal to human very recently, was first isolated in June after a man in Saudi Arabia died from a severe respiratory infection and kidney failure. Following his death, health officials identified 11 more people infected with the virus, the latest in Great Britain. So far, six of the 12 people with known infections have died. Nearly all patients have lived or traveled in the Middle East.

Concerns have been raised that the new strain could trigger a pandemic similar to the SARS outbreak of 2002-03, which infected more than 8,000 people and killed 774.

"We don't know whether the cases we observed are the tip of the iceberg, or whether many more people are infected without showing severe symptoms," noted Thiel.

The World Health Organization on Saturday said that doctors should test patients for the new coronavirus if they have unexplained pneumonia or unexplained complicated respiratory illness not responding to treatment.

So far, no cases of the coronavirus have been reported in the United States, according to the U.S. Centers for Disease Control and Prevention.

To test the new virus, the researchers used cultured bronchial cells to mimic the lining of the human airway. Although this lining is a key barrier against respiratory viruses, the study revealed these cells didn't mount a big defense against HCoV-EMC. Instead, they found human lungs are highly susceptible to the virus, which can multiply at a faster initial rate than SARS.

The study authors noted, however, that pre-treating the airway with proteins that play a critical role in immune response to infections -- known as lambda-type interferons -- significantly reduced the number of infected cells.

Although their findings suggest there is promise for an effective treatment against HCoV-EMC, the researchers added ongoing cooperation between scientists and health agencies around the world is needed to prevent outbreaks of this virus and other diseases.

More information

The World Health Organization provides more information on coronavirus infections.

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New SARS-Like Virus May Have Spread Between People

Title: New SARS-Like Virus May Have Spread Between People
Category: Health News
Created: 2/14/2013 11:00:00 AM
Last Editorial Review: 2/14/2013 12:00:00 AM

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New SARS-Like Virus May Have Spread Between People

Feb. 13, 2013 -- A new illness similar to the deadly SARS virus has probably spread from person to person in the U.K.

Previous cases of this new virus, a coronavirus, have been seen in people who've returned from visits abroad. The latest case is in a person who hasn’t been abroad recently and is thought to have caught it from a relative, British officials say.

However, officials say the threat of the infection spreading remains very low.

Many coronaviruses are not a cause for concern. Some strains cause the common cold but also include SARS, or severe acute respiratory syndrome.

The new coronavirus was identified in September 2012 in a person who died from a severe infection of the lungs. The virus caused fever, cough, shortness of breath, and breathing problems.

British officials  say 11 confirmed cases have been seen worldwide, including three deaths in Saudi Arabia and two deaths in Jordan. None have been reported in the U.S., according to the CDC.

Previous U.K. cases have been seen in people who travelled to Qatar, Pakistan, and Saudi Arabia.

Officials say two new cases were found in a U.K. resident who had recently been to the Middle East and Pakistan and a family member who had not traveled recently. They are in intensive care at the Queen Elizabeth Hospital in Birmingham. The family member has an existing medical condition that makes them more susceptible to infections of the lungs, officials say.

In a statement, Professor John Watson, head of the respiratory diseases department at Britain’s Health Protection Agency (HPA),  says, "Confirmed novel coronavirus infection in a person without travel history to the Middle East suggests that person-to-person transmission has occurred, and that it occurred in the U.K.

"Although this case provides strong evidence for person-to-person transmission, the risk of infection in most circumstances is still considered to be very low. If novel coronavirus were more infectious, we would have expected to have seen a larger number of cases than we have seen since the first case was reported three months ago."

The HPA says special measures have been put in place to stop the infection from spreading.

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