NIV on the lookout for 'novel' virus

Even as the World Health Organisation (WHO) has sounded an alert on the novel MERS-CoV (Middle East Respiratory Syndrome Coronavirus) stating this newest viral threat has the potential to become a pandemic, Pune’s National Institute of Virology (NIV) has already started collecting samples from hospitals across India looking for presence of any ‘novel’ virus in case of an unexplained severe respiratory illness.

WHO has asked countries to be alert and watch travellers to and fro from Middle Eastern countries especially those suffering from severe acute respiratory infections (SARI) with any unusual patterns.

NIV director said that specimens of severe pneumonia cases reported across the country are being collected to screen for the novel MERS-CoV, but all have tested negative.

“Screening for the novel coronavirus is now part of our influenza surveillance programme. While coronavirus is not something new, the MERS-CoV strain had not been identified in humans earlier. The reason it is being feared is because of its severity as more than 60% infected persons have died. Also, little is known about it so far like transmission and clinical impact,” said Dr D T Mourya, director, NIV.

Coronaviruses are a large family of viruses that includes viruses that may cause a range of illnesses in humans, from the common cold to SARS. According to WHO, 58 laboratory-confirmed cases of MERS-CoV have been reported till June 2013, of which 33 people have died. Mourya added that Indian hospitals and clinicians have been alerted to look out for any severe pneumonia cases, especially in cases of people returning from the Middle East.

Dr Manju Chaddha, deputy director at NIV who heads the influenza research division, explained that scientists and clinicians have been told to look out for any viruses that cannot be sub-typed or which are novel.

“Currently we perform standard tests to determine patient’s specimen tests for any of known influenza virus sub-types. However, after the tests if it is found that the specimen is negative for all of them, then the alert should be sounded. Since what we are looking for is something unique, we have asked hospitals to refer us cases where the cause is unknown or unexplained,” she said.

Ask her about the difference between MERS-CoV and other respiratory tract illnesses and she replies, “This infection is more severe.”
While the WHO has not yet asked member states to start screening at airports but keep a watch on ‘guest workers’ and travellers from the Middle East, NIV scientists say the real challenge could be in the post-Haj pilgrim and Ramzan period.

“Thousands of our pilgrims would travel to Middle East and there is increased risk especially given the crowds. Not only will we have to educate our travellers but also work out a surveillance strategy for the post-Haj pilgrim period,” said Mourya.

What is MERS-CoV

This particular strain of coronavirus has not been previously identified in humans. There is very limited information on transmission, severity and clinical impact with only a small number of cases reported thus far.

The symptoms

MERS-CoV infection generally presents as pneumonia but has also caused kidney failure. The most common symptoms observed are fever, cough, and breathing difficulties, while atypical symptoms such as diarrhoea have also been recorded in patients with immunosuppression.—(Source WHO)