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Saturday, March 30, 2013

Hong Kong prepares for new coronavirus


By Keith Bradsher
New York Times
HONG KONG — 
A decade after severe acute respiratory syndrome swept through Hong Kong and then around the world, the city is among the first to become worried about the emergence and spread of another, genetically related virus in the Middle East.
Medical researchers emphasize that they do not know if the new virus, which has killed 11 of the 17 people infected, will develop the same ability as SARS to spread from person to person. The World Health Organization is taking a cautious stance, stopping short of urging any special measures.
But Hong Kong is already taking preventive measures. Without a single confirmed human case of the new virus in East Asia so far, the government of the autonomous Chinese territory has begun alerting and training employees at hospitals, clinics and the airport to identify possible cases. Wide-ranging medical research is already under way.
Senior government officials held an extensive exercise last week to simulate the oversight of the quarantine and treatment of patients and their associates if a single person infected with the new virus arrived at the Hong Kong airport and began spreading it. The Health Department announced that it would “stay vigilant and continue to work closely with the WHO and other overseas health authorities to monitor the latest development of this novel infectious disease.”
The Hong Kong government’s measures reflect a continued preoccupation with public health — some say an obsession — that came about after nearly 1,800 people in Hong Kong became extremely ill with SARS in a few weeks during spring 2003, with 299 of them dying.
“At the moment, I think Hong Kong is likely to be the one with the strongest border control against this new virus for obvious historical reasons,” said Dr. Yuen Kwok-yung, chairman of the infectious diseases section of the microbiology department at Hong Kong University.
Some health experts in the West have been wary of drawing too much attention to the new virus, which is a coronavirus like SARS. They point out that as researchers have begun looking harder for coronaviruses after the SARS outbreak, they have found more of them.
Much of the research has been done in Hong Kong, which became a leading center for disease research as a British colony before the handover to China in 1997. The World Health Organization has long sent samples from all over Asia to Hong Kong University for testing, and Yuen and his colleagues at the university played a central role in identifying the SARS virus in 2003.
Hong Kong University researchers are now expressing growing concern about the new coronavirus that has emerged in the Middle East, known as novel coronavirus. Dr. Malik Peiris, a co-discoverer of SARS who is the director of the center for influenza research at Hong Kong University, warned that while SARS faded away after a year, with 8,445 cases and 790 deaths worldwide, two other coronaviruses had jumped from animals to people in the past two centuries and become endemic.
One of the concerns about the novel coronavirus is that it seems deadlier, having killed more than half of the people with confirmed cases. A study published last week in The Journal of Infectious Diseases by Yuen and 12 colleagues in Hong Kong and mainland China found that the new virus also infects a wider range of human tissue types than the SARS virus and kills them more quickly.
One big question is whether far more people are being infected without detection, in which case the disease may kill a lower percentage of victims but also be more transmissible. Yuen said that when 2,400 people were screened recently in Saudi Arabia for antibodies to the virus, none had them.
That suggests that the virus is periodically infecting people from an unknown animal host, but has not developed the ability to pass easily from person to person, he said.
The H5N1 avian influenza virus has been periodically jumping from birds to people and causing sporadic deaths for 16 years without developing sustained transmissibility among people. On the other hand, the SARS virus appears to have developed transmissibility after only a few months of sporadic infections of people in southern China in late 2002.
For the new virus, “we may be at the 2002 situation at this time, and that would be very, very bad,” Yuen said.