Coronavirus: is this the next pandemic?

By Ian Sample  15th March 2013.    Find Full Article Here:-

Last September a doctor in a Saudi hospital was fired for reporting a new, deadly strain of the coronavirus. Now, with half of all confirmed cases ending in death, the World Health Organisation has issued a global alert and scientists are preparing for the worst.

Professor Ali Mohamed Zaki, who diagnosed the first patient with a strain of the coronavirus in Saudi Arabia, stands in his office in Cairo. Photograph: David Degner/Getty Images

In mid-June last year, Ali Mohamed Zaki, a virologist at the Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia, took a call from a doctor who was worried about a patient. The 60-year-old man had been admitted to the hospital with severe viral pneumonia and the doctor wanted Zaki to identify the virus. Zaki obtained sputum from the patient and set to work. He ran the usual lab tests. One after another they came back negative.

Puzzled by the results, Zaki sent a sample to a leading virology lab at Erasmus Medical Centre in Rotterdam. While he waited for the Dutch team to examine the virus, Zaki tried one more test of his own. This time he got a positive result. It showed the infectious agent belonged to a family of pathogens called coronaviruses. The common cold is caused by a coronavirus. So is the far more deadly infection Sars. Zaki quickly emailed the Dutch lab to raise the alarm. Their tests confirmed his fears, but went further: this was a coronavirus no one had seen before.

To alert other scientists, Zaki posted a note on proMED, an internet reporting system designed to rapidly share details of infectious diseases and outbreaks with researchers and public health agencies. The move cost him dearly. A week later, Zaki was back in his native Egypt, his contract at the hospital severed, he says, under pressure from the Saudi Arabian Ministry of Health. “They didn’t like that this appeared on proMED. They forced the hospital to terminate my contract,” Zaki told the Guardian from Cairo. “I was obliged to leave my work because of this, but it was my duty. This is a serious virus.”

Just how serious was clear by then. While Zaki had worked to identify the virus, the patient’s health had declined. His pneumonia worsened; his breath got shorter. His kidneys and other organs began to falter and fail. Despite all the drugs and dialysis, and mechanical ventilation to help him breathe, the man was dead 11 days after he arrived at the hospital.

On its own, the Jeddah case was more intriguing than terrifying. Though much was made of the virus being related to the one that causes Sars, which spread to more than 30 countries and killed 800 people in 2003, the two are genetically very different. Sars was scary because it spread so easily and killed so often. It circulated in families, and tore through hospitals. The Jeddah patient was but a single case.

Or so it seemed. Since the virus came to light in September last year, the number of cases has risen to 15. More than half have died. The latest death was a 39-year-old man, reported by Saudi Arabia this week. The numbers are not yet alarming, but the steady appearance of fresh cases, and the fact that the infection has now spread from person to person, has sparked an intensive effort to understand the virus, and quietly prepare for the worst.

“We don’t know whether this virus has the capability to trigger a full epidemic. We are completely in the dark about it,” says Ron Fouchier, a molecular virologist at Erasmus Medical Centre whose lab identified Zaki’s virus. “We think what we are seeing is just the tip of the iceberg, but we don’t know how big the iceberg is, or where the iceberg is.”

Across from the Houses of Parliament on the bank of the river Thames is St Thomas’s Hospital, London. In September last year, doctors at the intensive care unit were struggling to diagnose a 49-year-old man from Doha, Qatar, who had arrived by air ambulance with a serious respiratory infection. He was being treated in strict isolation. The man had a virus, that much was clear, but the nature of the infection was a mystery. He had recently visited Saudi Arabia.

Stumped by the case, doctors at the hospital alerted the Health Protection Agency‘s Imported Fever Service which began its own investigation. Scientists ran tests on the Qatari man to exclude common infections. They then had a stroke of luck. The night they completed the first round of tests, two scientists on the HPA team logged on to proMED at home. There on the screen was a note published earlier that day from a Professor Zaki at a hospital in Saudi Arabia. It announced the discovery of a new and deadly coronavirus. The patient had almost identical symptoms to the Qatari man.