BOX 6-1Coronaviruses

  • First identified in the 1960s
  • Named for the crown-like spike proteins (S proteins) on the surface, which are the target of current vaccination efforts
  • Found in many animals, including bats
  • Six human coronaviruses have been identified: four cause mild, seasonal disease (“common cold”), two cause severe disease (severe acute respiratory syndrome, or SARS, and Middle East respiratory syndrome, or MERS)

SARS Epidemic (2002-2003)

  • 8,098 probable cases and 774 deaths (10 percent fatality rate)
  • Estimated economic losses of more than $30 billion
  • Association of cases with “superspreading events” (e.g., from one hotel guest to many others and their contacts)
  • Experts concerned that transmissibility increased over the course of the epidemic, associated with changes to the S protein
  • Control strategies: surveillance to identify cases, isolation of ill persons, quarantine of exposed persons, good infection control to prevent onward transmission

MERS Outbreak (2012-present)

  • 1,075 total cases confirmed by World Health Organization, 404 deaths (38 percent fatality rate)
    • Most cases in Saudi Arabia (951 cases, 372 deaths), cases exported to 19 countries
    • 221 cases since August 2014, primarily Middle East, with some recent cases in Europe, Asia
    • Two U.S. cases (Florida, Indiana) were health care workers who worked in Saudi Arabia and traveled home; no secondary cases among contacts
  • Demographics: 66 percent male, median age 50, most with underlying health conditions
  • Transmission likely respiratory: human to human (not sustained), health care associated outbreaks, animal sources (bats, camels)
  • No established treatment or vaccines (investigational products in development)
  • Epidemiological and laboratory activities in the United States included developing and broadly disseminating case definitions, infection control guidance, travelers health recommendations, epidemiology toolkits, serology, and polymerase chain reaction diagnostics.

SOURCE: Swerdlow presentation, March 27, 2015.

From: 6, Developing MCMs for Coronaviruses

Cover of Rapid Medical Countermeasure Response to Infectious Diseases
Rapid Medical Countermeasure Response to Infectious Diseases: Enabling Sustainable Capabilities Through Ongoing Public- and Private-Sector Partnerships: Workshop Summary.
Forum on Medical and Public Health Preparedness for Catastrophic Events; Forum on Drug Discovery, Development, and Translation; Forum on Microbial Threats; Board on Health Sciences Policy; Board on Global Health; Institute of Medicine; National Academies of Sciences, Engineering, and Medicine.
Washington (DC): National Academies Press (US); 2016 Feb 12.
Copyright 2016 by the National Academy of Sciences. All rights reserved.

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