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Duke One Health Team Members Propose New Approach to Mitigating Future Pandemics

April 28, 2021

By: Anfal Abdelgadir, MSc

Last month, Duke One Health team members Professor Gregory Gray, Emily Robie, Caleb Studstill, and Professor Charles Nunn, published a paper titled “Mitigating Future Respiratory Virus Pandemics: New Threats and Approaches to Consider” in the journal Viruses. The paper discusses the impact of respiratory viruses, reviews current efforts for pathogen discovery and prevention, and proposes new approaches for predicting and mitigating the next emerging respiratory virus threats.

The authors review several respiratory virus threats from across five different viral families that have been and continue to be responsible for considerable global morbidity and mortality. These viruses include Human Metapneumovirus (hMPV), Rhinovirus Group C, Enterovirus A71, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Human Adenovirus 14, 2009 H1N1 Influenza A Pandemic Virus, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Enterovirus D68, and finally Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). While these viruses come from five different viral families, most of them are RNA viruses and many are zoonotic in origin.

The authors suggest that while virus spill-over is very common, it is a process that happens over a long period of time during which the virus continues to replicate in the animal host as it develops an affinity for cellular attachment, invasion, and replication in the new human host. This process is illustrated in the below graphic.

A model for zoonotic pathogen genesis, depicting the passage of time from viral spillover events to effective human-to-human transmission of emerging pathogens.

An effective strategy to detect pre-pandemic viruses before they fully adapt to humans is to conduct surveillance for novel viruses at the animal–human interface. Selecting the right reservoir animals depends on the prevalence of the pathogen in the reservoir, the reservoir-to-human contact rate, and the probability of human infection with the animal pathogen. These factors point toward domestic livestock, modern industrialized farms, and live animal markets as key targets for novel virus surveillance. Alternatively, densely populated hospital sites with high rates of pneumonia admissions can be studied for detection of novel respiratory virus pathogens as they first appear in human hosts. The authors provide 39 pages of very detailed laboratory instructions of how to sample for novel viruses in the five viral families they argue are the most important threats to humans.

The full manuscript and supplemental file are available here. To read the National Public Radio news article and listen to Prof. Gray’s interview regarding this important work, click here.

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