Lessons learned from SARS

Within three weeks of identifying the first case, Chinese officials had reported a new respiratory illness to the World Health Organization. Scientists identified the coronavirus a week later on Jan. 7. The country’s response to the new strain of viral pneumonia reveals the ways China—and the rest of the world—has improved responses to public health threats.

The first documented cases of the new coronavirus appeared in late December. Though the cause is still unknown, Chinese officials traced the virus to the Huanan seafood market in the central Chinese city of Wuhan. The market sold wild animals, suggesting the illness spread from an animal host to people. But it soon began to jump between humans.

On Jan. 30, the World Health Organization declared the new coronavirus, 2019-nCoV, a global health emergency. The disease has infected at least 28,200 people around the world and killed more than 560, virtually all in China. Officials have reported cases in more than two dozen countries, with one death in the Philippines and another in Hong Kong.

The severity of the coronavirus, which causes fever, cough, and shortness of breath, remains unclear and ranges anywhere from mild symptoms to death. According to the U.S. Centers for Disease Control and Prevention, the illness may manifest anywhere from two to 14 days after exposure. People may become contagious before they develop any symptoms, making it more difficult to contain.

China’s public health response has improved dramatically since the outbreak of SARS (severe acute respiratory syndrome), which infected more than 8,000 people and claimed the lives of 774 in 26 countries over nine months in 2002 and 2003. During that outbreak, Chinese officials did not report the disease until months after it first appeared. By then, five people had died and 300 were infected in China’s Guangdong province. It took another five months before American and Canadian scientists could identify the virus’s genome.

This time around, China quickly moved to quarantine millions of residents and alert international health authorities of the threat. Since the SARS outbreak, China has also updated its anachronistic system of reporting infectious diseases on handwritten filing cards and faxing them to a central office. Health officials now use a centralized online system that links clinics and hospitals across the country to report new cases in real time.

WHO Director-General Tedros Adhanom Ghebreyesus said the agency is confident in China’s capacity to control the outbreak. “Our greatest concern is the potential for the virus to spread to countries with weaker health systems and which are ill-prepared to deal with it,” he said.

But some international scientists fear China still may have transparency issues. Following the SARS epidemic, the Chinese government tightened its grip on the flow of information, and many are concerned that more people in the country have contracted the coronavirus than reported. Li Wenliang, a doctor in Wuhan, received a severe reprimand from Chinese officials after warning on social media that doctors had diagnosed seven patients from a local seafood market with a SARS-like illness and quarantined them in his hospital, CNN reported. The same day, the Wuhan Municipal Health Commission warned the city’s medical institutions that “any organizations or individuals are not allowed to release treatment information to the public without authorization.” Li, while helping others, contracted the coronavirus, and the Wuhan Central Hospital announced on Thursday he had died.

Researchers are racing to develop a vaccine for the virus. According to media reports, doctors in Thailand claim to have successfully treated one patient suffering a severe case with a combination of antiviral drugs used to treat HIV and influenza. The 71-year-old patient from China improved and tested negative for the virus within 48 hours.

In addition to China, other countries, including Germany, Japan, Thailand, and the United States, have reported human-to-human transmission of the virus, according to Tedros. So far in the United States, cases are contained to people who were in contact with the seafood market or were close to someone who was. The disease has not yet spread in the general community, and the CDC believes the risk remains low. Across the country, 11 patients have tested positive for the illness: six in California, two in Illinois, and one each in Washington, Arizona, and Massachusetts, according to the CDC.

Coronaviruses are a family of illnesses common in many different species of animals, including camels, cattle, cats, and bats. A genetic study published on Jan. 30 in The Lancet found that 2019-nCoV most closely resembles two SARS-type coronaviruses that infect bats and likely emerged in humans recently. But, according to the scientists, even though bats likely were the original host, one of the wild animals sold at the seafood market probably served as an intermediary that enabled the virus to jump to humans. Officials first reported the outbreak in late December, when most of the bat species in Wuhan hibernate. The seafood market did not sell any bats but did carry many mammals and snakes.

“This again highlights the hidden virus reservoir in wild animals and their potential to spill over into human populations,” the study’s researchers said.

A child gets a polio vaccine in Lahore, Pakistan Associated Press/Photo by K.M. Chaudary (file)

Polio eradication loses ground

Last year proved a difficult one in the global fight against polio. Afghanistan and Pakistan reported 116 cases of the disease in 2019, four times as many as in 2018, Science magazine reported. Even more alarming, 196 children in 12 African countries contracted the disease from a live vaccine containing poliovirus type 2, which has regained its virulence and ability to spread. Experts worry type 2 could jump continents and reseed outbreaks around the world.

For decades, the live oral polio vaccine contained a mix of three weakened polioviruses. Each posed a threat of potentially reverting to a stronger, more dangerous strain. After the type 2 virus last appeared in the wild in 1999, all 155 countries using the oral vaccine dropped it from the mix in 2016. But type 2 outbreaks in Africa tripled between 2018 and 2019. The risk of outbreaks around the globe continues to ramp up among the millions of children born since experts removed type 2 from the vaccine.

A research consortium is developing two experimental vaccines just for type 2. Researchers in Belgium and Panama are conducting Phase II studies, but it remains unclear if the vaccines will work. Some are concerned that vaccine-derived outbreaks will spiral out of control before they become available.

The Global Polio Eradication Initiative is considering making more of the three-virus vaccine that was pulled from use in 2016, but producing enough could take years.

“All options are on the table,” virologist Mark Pallansch of the U.S. Centers for Disease Control and Prevention told Science. —J.B.

A child gets a polio vaccine in Lahore, Pakistan Associated Press/Photo by K.M. Chaudary (file)

Photographing the sun

The National Science Foundation’s Daniel K. Inouye Solar Telescope just snapped the first close-up photo of the sun. The images depict a pattern of cell-like structures covering the surface of the sun. Each “kernel” measures about the size of Texas. When heat from inside the sun rises to the surface, the hot plasma rises in the bright centers of these cells and then cools off and sinks below the surface again in dark lines.

At 13.9 feet in diameter, the telescope’s mirror is the largest for a solar scope, allowing it to capture more detailed images of the sun than ever before. It sits atop the 10,000-foot summit of Haleakalā, a dormant volcano on the Hawaiian island of Maui.

The new technology will provide valuable information about the magnetic eruptions, or solar storms, on the sun’s surface. These storms can affect air travel, disrupt satellite communications, disable technologies like GPS, and bring down power grids, causing long-lasting blackouts. A 2017 solar storm coincided with Hurricane Irma’s landfall in Florida, shutting down radio communications used by first responders, aviation, and maritime channels for eight hours. The telescope will measure and map the sun’s magnetic field so scientists can more accurately predict solar storms and prepare governments and utilities for future space weather events. Notification of potentially dangerous solar flares could take place as early as 48 hours ahead of time instead of the current standard of 48 minutes. —J.B.