Final Report Summary - EPISARS (Prevention of future SARS epidemics through the control of animal and human infection)
In November 2002, a previously unrecognized animal coronavirus (CoV) emerged from the 'wet markets' of China to become a worldwide threat to public health systems. Eight months later, more than 8 000 people had been infected in 25 countries spread over five continents, and 774 had died from the disease. Although the number of fatalities was small compared to deaths related to HIV or malaria, the short-term impact of SARS was much wider. Researchers and public health specialists around the world were mobilised to develop drugs and vaccines, to contribute to surveillance of emerging diseases, and to propose ways of preventing future SARS pandemics. At the time this project proposal was submitted (September 2003), it was very difficult to predict what the future of this new emerging disease would be:
- Would a new pandemic restart during the 2003 / 2004 winter season?
- Would the elimination from the markets of masked palm civets, the animals which most likely infected men during the first epidemic, prevent future epidemics?
- Was there another animal source for the virus?
- Were there other 'human' CoV able to induce respiratory diseases?
- Would we have the appropriate diagnostic tools to differentiate SARS from the flu, during acute respiratory infections?
- Would neutralising antibodies play a role in protecting against re-infection; if yes, would such immunity be long-term, knowing the rapid decline in protective immunity associated with other human CoVs?
The SARS epidemic has been exemplary in that it gave the scientific and the public health community the opportunity to study the emergence of a virus in human populations at a time both epidemiological and virological tools were available for in-depth studies. The results were remarkable, with the control of the epidemic within six months. EPISARS has markedly contributed to this outcome, notably with the identification of the horseshoe bats as reservoirs for SARS-like coronaviruses, and with the documentation of the crucial role played by the masked palm civets in the spread of the disease to humans. Needless to say, our contribution, although very significant, is one piece of a gigantic effort putting together international organisations such as the World Health Organisation (WHO), national sentinel surveillance systems, and first-class laboratories. Our work had direct impact on public health policies, with the control of farming and selling of masked palm civets in China. It also showed the value of multidisciplinary approaches to emerging viruses, combining, among others, zoologists, veterinarians, virologists, epidemiologists, clinicians and public health specialists. Our findings have been disseminated through participation in international conferences and more than thirty scientific publications in peer-reviewed journals, including five editorial papers. More details are available on our website: http://www.pasteur.fr/recherche/episars/accueil/
- Would a new pandemic restart during the 2003 / 2004 winter season?
- Would the elimination from the markets of masked palm civets, the animals which most likely infected men during the first epidemic, prevent future epidemics?
- Was there another animal source for the virus?
- Were there other 'human' CoV able to induce respiratory diseases?
- Would we have the appropriate diagnostic tools to differentiate SARS from the flu, during acute respiratory infections?
- Would neutralising antibodies play a role in protecting against re-infection; if yes, would such immunity be long-term, knowing the rapid decline in protective immunity associated with other human CoVs?
The SARS epidemic has been exemplary in that it gave the scientific and the public health community the opportunity to study the emergence of a virus in human populations at a time both epidemiological and virological tools were available for in-depth studies. The results were remarkable, with the control of the epidemic within six months. EPISARS has markedly contributed to this outcome, notably with the identification of the horseshoe bats as reservoirs for SARS-like coronaviruses, and with the documentation of the crucial role played by the masked palm civets in the spread of the disease to humans. Needless to say, our contribution, although very significant, is one piece of a gigantic effort putting together international organisations such as the World Health Organisation (WHO), national sentinel surveillance systems, and first-class laboratories. Our work had direct impact on public health policies, with the control of farming and selling of masked palm civets in China. It also showed the value of multidisciplinary approaches to emerging viruses, combining, among others, zoologists, veterinarians, virologists, epidemiologists, clinicians and public health specialists. Our findings have been disseminated through participation in international conferences and more than thirty scientific publications in peer-reviewed journals, including five editorial papers. More details are available on our website: http://www.pasteur.fr/recherche/episars/accueil/