Here we go again, or do we? Currently we are witnessing the emergence of a new SARS-like coronavirus which seems to have been spreading throughout some Middle East Countries over the last year. So far a small number of cases have been identified of which at least half seem to have been contracted in hospitals. Are we seeing a return of the SARS scenario where hospitals and their staff played a major role in the spread of a deadly infection?
It is early days yet and so far we do not know enough about the new infection, particularly how people are getting infected, whether like SARS an intermediary species is involved in the link to humans, or whether close contact with someone previously infected plays an important role. Should we be concerned? Well SARS and Bird Flu showed just how easy it was for 'new' infections to spread around the world, raising fear and hysteria and pushing our response measures to the edge.
Since the virus first came to light last year the number of reported cases has risen to more than 30 and more than half those infected have died. While the numbers are still small, the steady appearance of new cases and the possibility that we are facing a virus that can spread from person to person raises many alarms. Whether or not the virus will trigger a major epidemic remains to be seen, but perhaps what we are currently witnessing is simply the tip of an iceberg with many cases going unreported.
It appears that we are dealing with a 'new' virus and quite possibly like the SARS virus, one that is linked to bats. SARS originated in bats and made the passage to humans via an intermediary species, in this case civet cats. So far we have been unable to discover the intermediary species in the case of the new virus. Given that all the cases so far seem to have originated in Saudi Arabia and possibly Jordon and Qatar, it may be that the virus is currently circulating in farm or domesticated animals there ( and possibly in humans as well).
Possibly it is a virus that has circulated among animals for decades, perhaps hundreds of years, only to be translated into a more virulent and threatening form by some act of human agency in modifying the local environment. In such circumstances it often becomes possible for the virus to jump to an intermediary species (perhaps domesticated animals) and from there to infect humans.
On the other hand, because all these countries are major importers of livestock, it may be that the infection was introduced from further afield, perhaps even from Asia. Are we witnessing the emergence of a 'new' virus that can easily spread from person to person?
A recent report that two hospital medical staff and a patient who shared a ward in a hospital in northern France with a man who had previously contracted the virus while visiting the Gulf had been taken ill, brings back disturbing memories of SARS. The full impact of SARS fell on health care workers in hospitals. Are we beginning to see a repeat of this with the new virus?
When SARS first appeared, slow official reaction, a lack of openness and a reluctance to officially report cases, made the task of controlling the virus much more difficult. So far it appears that we may well be facing the same sort of situation.
It would appear that little is currently being done on the ground to try and investigate the bat-animal-human link. One can only hope that goats, camels, sheep and horses will soon be tested throughout parts of the Middle East in an effort to try and discover how the virus is spreading to humans. There seems little doubt that our protection rests on continual vigilance and surveillance, allied to quick response measures and the mobilisation of global resources.
Overall, we need to fully recognise the significance of the biophysical environment and the role played by wild and domesticated animals in our lives as well as realise that in a highly mobile, interconnected world infections spread at will and that national boundaries, isolation and distance offer no defence.
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