KUALA LUMPUR: When SARS (Severe Acute Respiratory Syndrome) gripped the world in fear 17 years ago, the deadly pneumonia-like respiratory disease left 774 people dead and 8,096 infected.
The pandemic was spread by the SARS coronavirus (SARS-CoV), which was traced in China in 2002.
Although the World Health Organisation (WHO) had, in July 2003, declared that the outbreak had been contained, four SARS cases were reported in China in December 2003 and January 2004. No new infections have been reported since.
Almost two decades on, 2019-nCoV (or Wuhan coronavirus) is raising fears whether the SARS virus had mutated and made a comeback.
Universiti Malaya Tropical Infectious Diseases Research and Education Centre director Professor Dr Sazaly Abu Bakar does not rule out the possibility of another SARS-like health emergency.
“The virus could mutate and escape the body’s immune system,” he said when asked if the coronavirus that caused SARS, Middle East Respiratory Syndrome (MERS) and the recent Wuhan outbreak could return despite it having been contained.
Dr Sazaly said health officials stopped human-to-human transmissions of SARS via effective containment approaches but the question remained whether it had been completed wiped out.
“Was it really eliminated? Yes. Because it is no longer infecting humans. Then again, it could be lurking in its original host or reservoir.
“It could return if naive humans (not immuned) come into contact with the virus and if the infected person replicates the virus efficiently and subsequently infects others. Only those who were infected and recovered would have a strong immune defence against the virus. This is because immunity has a long-term memory that could recognise the original SARS virus,” said the virologist, and biosafety and biosecurity expert.
Dr Sazaly, who is director of WHO Collaborating Centre for Arbovirus Reference and Research, said the disease could recur even in those with immunity if the virus changed its genetic code, even slightly, to make it look different to the immune system.
On wild animals being the reason behind the outbreaks, he stressed the importance of protection of endangered wildlife and laws around the world.
In practice, he said, good risk management approaches and biosafety practices would enable one to handle any form of potentially infective material, including wildlife.
SARS-CoV is believed to be an animal virus from an animal reservoir, most likely bats, that has yet to be ascertained and has spread to other animals such as civet cats. MERS is a viral respiratory infection caused by the MERS-coronavirus (MERS-CoV) and reported to have originated from dromedary camels. Meanwhile, 2019-nCoV is suspected to have originated from bats or snakes.
Dr Sazaly advised people to be vigilant and take immediate containment measures.
Active surveillance was needed for early detection to prevent infections, he said.
“It is imperative that a baseline data or inventory of potential emerging viruses be established.
“Investment must be made in research to enable scientists to work on these exotic viruses to assess their human infection potential and to allow for the development of countermeasures.
“Regularised activities, including consistent sharing of information, expertise and resources such as through OneHealth initiatives and WHO platforms, should be in place.”
He said Malaysia needed to improve its capability and capacity in catering to infectious disease events that could take place in places beyond the major cities.
“Democratisation of cutting-edge laboratory diagnostics — that is making it accessible even in the remote localities — is important for the rapid identification and containment of potential emerging infections.
“The ability to produce vaccines against potential emerging pathogens is critical for national health and economic security.”
Dr Sazaly has 35 years of experience working on viruses, including cytomegalovirus, herpes, dengue, chikungunya, Japanese encephalitis, Zika, Nipah and MERS-CoV. He is also the chairman of the Laboratory Biosafety and Biosecurity Malaysia Committee and the Institutional Biosafety and Biosecurity Committee at Universiti Malaya.