On December 31 2019, China alerted the World Health Organization (WHO) about a mysterious outbreak of pneumonia in Wuhan, the capital of the Hubei province in Central-Eastern China. Wuhan is one of the most populous cities in China, with more than seven million inhabitants. Many of the 41 people who have been hospitalized due to this outbreak were workers or visitors of a live seafood and exotic animal market that has since shut down. As of January 17, two people have died from the infection.
Genetic sequencing quickly revealed that the pathogen responsible for the outbreak is a previously undetected coronavirus, the same family responsible for the Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory (SARS) outbreaks. These viruses originate in bats and can be transmitted between animals and humans. During the 2003 SARS outbreak, thousands of people were infected and hundreds were killed while the virus spread to 37 countries. Chinese authorities have been trying to contain the spread of the new virus and have shared its genetic sequence to enable other countries to quickly identify new cases and respond accordingly. On January 13, the first case outside of China occurred in Thailand, where a tourist travelling from Wuhan was hospitalized with pneumonia. As of January 17, a new case of the virus was reported in Japan. However, to date, neither person-to-person spread of the virus nor cases among healthcare workers have been detected.
No specific treatment options or vaccines are available for coronavirus infections. Prevention is usually limited to an attempt to reduce the risk of infection by frequent hand washing; avoiding touching one’s eyes, nose, or mouth with unwashed hands; and avoiding contact with sick people. According to GlobalData’s proprietary drug database, three MERS vaccine candidates are in early-stage clinical trials. Inovio Pharmaceuticals’ DNA vaccine INO-4301 completed Phase I in 2019 and is recruiting for Phase I/II. Phase I studies include a recombinantly modified vaccinia virus Ankara (MVA) viral vector with
MERS glycoproteins from the Ludwig-Maximilians-University Munich, as well as Vaccitech’s VTP-500, which uses the proprietary chimpanzee adenovirus vector ChAdOx1 to deliver the coronaviral spike proteins. Several antiviral candidates targeting the viral surface spike proteins with the aim of prohibiting viral entry into host cells are in Phase I, including Regeneron’s REGN-3048 and REGN-3051, as well as SAB Biotherapeutics’ SAB-301. Furthermore, Gilead’s RNA polymerase inhibitor remdesivir is being tested for multiple viral indications such as SARS, MERS, Ebola, and Zika.
Rapid identification of pathogens and information sharing are imperative to allow global surveillance to contain the spread of the disease, especially during the ongoing cold and influenza season, as coronavirus infections initially show similar symptoms to respiratory-related hospitalizations due to cold and influenza. However, uncertainty about the transmission of the new Wuhan coronavirus poses a challenge and makes global alertness necessary even though vaccines and treatment options for coronavirus infections are in early clinical development.