From SARS to COVID-19: A previously unknown SARS-CoV-2 virus of pandemic potential infecting humans – Call for a One Health approach
Identifieur interne : 000914 ( Pmc/Corpus ); précédent : 000913; suivant : 000915From SARS to COVID-19: A previously unknown SARS-CoV-2 virus of pandemic potential infecting humans – Call for a One Health approach
Auteurs : Mohamed E. El Zowalaty ; Josef D. J RhultSource :
- One Health [ 2352-7714 ] ; 2020.
Abstract
Human coronaviruses continue to pose a threat to human health. The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 which causes coronavirus disease-2019 (COVID-19), an acute respiratory disease marked the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century. This recent ongoing emergence of a previously unknown coronavirus in China leads to huge impacts on humans globally. Here, we discuss the outbreak in a one health context, highlighting the need for the implementation of one health measures and practices to improve human health and reduce the emergence of pandemic viruses.
Url:
DOI: 10.1016/j.onehlt.2020.100124
PubMed: 32195311
PubMed Central: 7075990
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PMC:7075990Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">From SARS to COVID-19: A previously unknown SARS-CoV-2 virus of pandemic potential infecting humans – Call for a One Health approach</title><author><name sortKey="El Zowalaty, Mohamed E" sort="El Zowalaty, Mohamed E" uniqKey="El Zowalaty M" first="Mohamed E." last="El Zowalaty">Mohamed E. El Zowalaty</name><affiliation><nlm:aff id="af0005">Zoonosis Science Center, Dep. of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden</nlm:aff></affiliation><affiliation><nlm:aff id="af0010">Division of Virology, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA</nlm:aff></affiliation><affiliation><nlm:aff id="af0015">Infectious Diseases and Anti-Infective Therapy Research Group, College of Pharmacy, Sharjah University, United Arab Emirates</nlm:aff></affiliation></author><author><name sortKey="J Rhult, Josef D" sort="J Rhult, Josef D" uniqKey="J Rhult J" first="Josef D." last="J Rhult">Josef D. J Rhult</name><affiliation><nlm:aff id="af0020">Zoonosis Science Center, Dep. of Medical Sciences, Uppsala University, Uppsala, Sweden</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32195311</idno><idno type="pmc">7075990</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075990</idno><idno type="RBID">PMC:7075990</idno><idno type="doi">10.1016/j.onehlt.2020.100124</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000914</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000914</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">From SARS to COVID-19: A previously unknown SARS-CoV-2 virus of pandemic potential infecting humans – Call for a One Health approach</title><author><name sortKey="El Zowalaty, Mohamed E" sort="El Zowalaty, Mohamed E" uniqKey="El Zowalaty M" first="Mohamed E." last="El Zowalaty">Mohamed E. El Zowalaty</name><affiliation><nlm:aff id="af0005">Zoonosis Science Center, Dep. of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden</nlm:aff></affiliation><affiliation><nlm:aff id="af0010">Division of Virology, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA</nlm:aff></affiliation><affiliation><nlm:aff id="af0015">Infectious Diseases and Anti-Infective Therapy Research Group, College of Pharmacy, Sharjah University, United Arab Emirates</nlm:aff></affiliation></author><author><name sortKey="J Rhult, Josef D" sort="J Rhult, Josef D" uniqKey="J Rhult J" first="Josef D." last="J Rhult">Josef D. J Rhult</name><affiliation><nlm:aff id="af0020">Zoonosis Science Center, Dep. of Medical Sciences, Uppsala University, Uppsala, Sweden</nlm:aff></affiliation></author></analytic><series><title level="j">One Health</title><idno type="eISSN">2352-7714</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Human coronaviruses continue to pose a threat to human health. The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 which causes coronavirus disease-2019 (COVID-19), an acute respiratory disease marked the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century. This recent ongoing emergence of a previously unknown coronavirus in China leads to huge impacts on humans globally. Here, we discuss the outbreak in a one health context, highlighting the need for the implementation of one health measures and practices to improve human health and reduce the emergence of pandemic viruses.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Monto, A S" uniqKey="Monto A">A.S. Monto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Drosten, C" uniqKey="Drosten C">C. Drosten</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peiris, J" uniqKey="Peiris J">J. Peiris</name></author><author><name sortKey="Guan, Y" uniqKey="Guan Y">Y. Guan</name></author><author><name sortKey="Yuen, K" uniqKey="Yuen K">K. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">One Health</journal-id><journal-id journal-id-type="iso-abbrev">One Health</journal-id><journal-title-group><journal-title>One Health</journal-title></journal-title-group><issn pub-type="epub">2352-7714</issn><publisher><publisher-name>Elsevier</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32195311</article-id><article-id pub-id-type="pmc">7075990</article-id><article-id pub-id-type="publisher-id">S2352-7714(20)30013-6</article-id><article-id pub-id-type="doi">10.1016/j.onehlt.2020.100124</article-id><article-id pub-id-type="publisher-id">100124</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>From SARS to COVID-19: A previously unknown SARS-CoV-2 virus of pandemic potential infecting humans – Call for a One Health approach</article-title></title-group><contrib-group><contrib contrib-type="author" id="au0005"><name><surname>El Zowalaty</surname><given-names>Mohamed E.</given-names></name><email>elzow005@gmail.com</email><xref rid="af0005" ref-type="aff">a</xref><xref rid="af0010" ref-type="aff">b</xref><xref rid="af0015" ref-type="aff">c</xref><xref rid="cr0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="au0010"><name><surname>Järhult</surname><given-names>Josef D.</given-names></name><xref rid="af0020" ref-type="aff">d</xref></contrib></contrib-group><aff id="af0005"><label>a</label>Zoonosis Science Center, Dep. of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden</aff><aff id="af0010"><label>b</label>Division of Virology, Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA</aff><aff id="af0015"><label>c</label>Infectious Diseases and Anti-Infective Therapy Research Group, College of Pharmacy, Sharjah University, United Arab Emirates</aff><aff id="af0020"><label>d</label>Zoonosis Science Center, Dep. of Medical Sciences, Uppsala University, Uppsala, Sweden</aff><author-notes><corresp id="cr0005"><label>⁎</label>Corresponding author at: Zoonosis Science Center, Dep. of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden. <email>elzow005@gmail.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>24</day><month>2</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>24</day><month>2</month><year>2020</year></pub-date><elocation-id>100124</elocation-id><history><date date-type="received"><day>4</day><month>2</month><year>2020</year></date><date date-type="rev-recd"><day>20</day><month>2</month><year>2020</year></date><date date-type="accepted"><day>22</day><month>2</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 The Authors. Published by Elsevier B.V.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="ab0005"><p>Human coronaviruses continue to pose a threat to human health. The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 which causes coronavirus disease-2019 (COVID-19), an acute respiratory disease marked the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century. This recent ongoing emergence of a previously unknown coronavirus in China leads to huge impacts on humans globally. Here, we discuss the outbreak in a one health context, highlighting the need for the implementation of one health measures and practices to improve human health and reduce the emergence of pandemic viruses.</p></abstract></article-meta></front><body><p id="p0005">Today, the world faces many complex problems, such as emerging infections, that a single discipline, institution or country cannot respond to alone. The human pulmonary system is vulnerable to infections due to contact-based inoculation of infectious material in droplets through the eyes, nose, or mouth, and airborne transmission is effective as seen e.g. in the plethora of viral respiratory diseases affecting individuals of all age groups [<xref rid="bb0005" ref-type="bibr">1</xref>]. Thus, respiratory viruses pose a continuous pandemic threat, of which coronaviruses and specifically the genus <italic>Betacoronavirus</italic> in the family <italic>Coronaviridae</italic> is a subset. During the past decades, humans have been challenged with a number of emerging viral respiratory infections with pandemic potential including the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) which emerged in China in 2002 [<xref rid="bb0010" ref-type="bibr">2</xref>,<xref rid="bb0015" ref-type="bibr">3</xref>], swine pandemic (pH1N1) influenza A virus which emerged in Mexico in 2009 [<xref rid="bb0020" ref-type="bibr">4</xref>] and the Middle East Respiratory Syndrome coronavirus (MERS-CoV) which emerged in Saudi Arabia in 2012 [<xref rid="bb0025" ref-type="bibr">5</xref>].</p><p id="p0010">Coronaviruses represent a continuous pandemic threat; humans have experienced two coronavirus-related health security crises since 2003. In December 2019, a previously unknown coronavirus was discovered in Wuhan city in China [<xref rid="bb0030" ref-type="bibr">6</xref>,<xref rid="bb0035" ref-type="bibr">7</xref>] which initially resulted in a cluster of viral pneumonia cases [<xref rid="bb0040" ref-type="bibr">8</xref>] and later caused an escalating number of reported infections in humans in China and globally [<xref rid="bb0045" ref-type="bibr">[9]</xref>, <xref rid="bb0050" ref-type="bibr">[10]</xref>, <xref rid="bb0055" ref-type="bibr">[11]</xref>]. The mortality of the emerging coronavirus of 2019 seems mainly to be caused by acute respiratory distress syndrome (ARDS) [<xref rid="bb0060" ref-type="bibr">12</xref>] which may be associated with comorbidities and followed by multiple organ failure leading to death [<xref rid="bb0065" ref-type="bibr">13</xref>]. It is probable that this 2019 coronavirus outbreak is not the last one due to a coronavirus, and a provisional name that was initially given to this coronavirus as 2019-novel coronavirus (2019-nCoV) and was recently designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the <italic>Coronaviridae</italic> Study Group of the International Committee on Taxonomy of Viruses (ICTV) [<xref rid="bb0070" ref-type="bibr">14</xref>]. The WHO have announced that the disease caused by the SARS-CoV-2 is referred to as coronavirus disease-2019 (COVID-19) [<xref rid="bb0075" ref-type="bibr">15</xref>].</p><p id="p0015">Despite recent efforts in basic and translational influenza and coronavirus research, there is still no vaccine against coronaviruses for use in humans (this includes SARS and MERS) [<xref rid="bb0080" ref-type="bibr">[16]</xref>, <xref rid="bb0085" ref-type="bibr">[17]</xref>, <xref rid="bb0090" ref-type="bibr">[18]</xref>, <xref rid="bb0095" ref-type="bibr">[19]</xref>]. In addition, there is yet no universal influenza vaccine available against all influenza virus subtypes and hence seasonal influenza vaccines have to be updated annually and that vaccines for pandemic preparedness are a challenge [<xref rid="bb0100" ref-type="bibr">[20]</xref>, <xref rid="bb0105" ref-type="bibr">[21]</xref>, <xref rid="bb0110" ref-type="bibr">[22]</xref>, <xref rid="bb0115" ref-type="bibr">[23]</xref>, <xref rid="bb0120" ref-type="bibr">[24]</xref>, <xref rid="bb0125" ref-type="bibr">[25]</xref>]. The lack of preventive vaccines for clinical use in humans against such viruses makes emerging influenza and coronaviruses a serious global threat.</p><p id="p0020">Since the emergence of SARS-CoV and MERS-CoV, bats have been the suspect of harbouring emerging viruses. Several studies have recently reported the detection of coronaviruses of pandemic potential [<xref rid="bb0130" ref-type="bibr">26</xref>,<xref rid="bb0135" ref-type="bibr">27</xref>]. Genetic evolutionary analysis of SARS-CoV-2 revealed that this virus is genetically related to two bat coronaviruses [<xref rid="bb0035" ref-type="bibr">7</xref>,<xref rid="bb0140" ref-type="bibr">28</xref>]. Contrary to SARS-CoV and MERS-CoV, SARS-CoV-2 cases have been reported to a quite large extent outside the epicentre of the infection. The numbers of infections due to SARS-CoV-2 continued to grow since its emergence till January 31 (<xref rid="f0005" ref-type="fig">Fig. 1</xref>), and as of the date of this publication, the virus has caused more than 74,000 confirmed and reported infections in humans globally [<xref rid="bb0055" ref-type="bibr">11</xref>,<xref rid="bb0145" ref-type="bibr">29</xref>]. Through rapid and frequent international air travel, infections due to SARS-CoV-2 have spread to over 26 countries around the world causing more than 2000 deaths including four deaths outside China in the Japan, Taiwan, the Philippines and France have been reported as of 19 February 2020 [<xref rid="bb0045" ref-type="bibr">9</xref>,<xref rid="bb0145" ref-type="bibr">29</xref>]. The epidemiological data available at the time of this publication are summarized in <xref rid="f0010" ref-type="fig">Fig. 2</xref>[<xref rid="bb0050" ref-type="bibr">10</xref>]. Infections due to SARS-CoV-2 are yet unreported at the time of this publication in South American countries. Except for Egypt where one travel-related case was reported on 12 February 2020, COVID-19 infections are not yet reported elsewhere in Africa. As of this report, 99.06% (<italic>n</italic> = 40,216) of infections were reported in China, however this number of infections may not reflect the true situation in China since additional cases may not be reported to health authorities at the time of the outbreak. As of 19 February, COVID-19 has been reported outside of China (519 cases), where there have been 23 infections in North America (15 in USA, 8 in Canada), 45 infections in Europe (16 in Germany, 12 in France, 9 in UK, 3 in Italy, 2 Spain, 1 in each of Belgium, Finland, Sweden), 15 in Australia. Infections in Asia excluding China (221 cases) were reported from Japan (28), 70 on international conveyance Japan, Thailand (32), Singapore (43), Republic of Korea (28), Taiwan (18), Malaysia (18), Vietnam (14), United Arab Emirates (8), India (3), the Philippines (3), Russia (2), Cambodia (1), Nepal (1), and Sri Lanka (1) [<xref rid="bb0050" ref-type="bibr">10</xref>,<xref rid="bb0145" ref-type="bibr">29</xref>].<fig id="f0005"><label>Fig. 1</label><caption><p>Timeline of COVID-19 infections worldwide since 31 December 2019 until 31 January 2020. (The figure was reproduced with permission from Kara Kochek of Duke University's One Health Research Team).</p></caption><alt-text id="al0005">Fig. 1</alt-text><graphic xlink:href="gr1_lrg"></graphic></fig><fig id="f0010"><label>Fig. 2</label><caption><p>Distribution of laboratory confirmed cases due to SARS-CoV-2 by (a) continent (b) worldwide as of 10 February 2020. (Reproduced with permission from [<xref rid="bb0050" ref-type="bibr">10</xref>].</p></caption><alt-text id="al0010">Fig. 2</alt-text><graphic xlink:href="gr2_lrg"></graphic></fig></p><p id="p0025">The case fatality rate is calculated by dividing the number of known deaths by the number of confirmed cases. The resulting number, however, does not represent the true case fatality rate and might be off by orders of magnitude [<xref rid="bb0150" ref-type="bibr">30</xref>]. The true case fatality rate is unknown at this stage of the outbreak, and its precise estimate is impossible at present [<xref rid="bb0150" ref-type="bibr">30</xref>,<xref rid="bb0155" ref-type="bibr">31</xref>]. The current estimates of case fatality rate of SARS-CoV-2 at any time point of analysis should be interpreted with caution since the outcome of the emerging COVID-19 diseases is yet unknown. There are four fatalities reported outside China as of the date of this report. On the contrary, the case fatality rate with SARS was 10% and the US identified eight patients with no fatalities. For MERS, the fatality is 35% and the US identified two patients with no fatalities, and sporadic MERS cases are being reported mainly from the Arabian Peninsula till this day. As a comparison, Influenza A virus infections in the current season (2018–2019) led to an estimated 490,561 hospitalizations and 34,157 deaths in the US [<xref rid="bb0160" ref-type="bibr">32</xref>]. Although the numbers for Influenza A virus infections are not obtained in the same way as for SARS-CoV-2, SARS-CoV, and MERS-CoV are not directly comparable, they still serve as an important reminder of the large numbers of deaths a ‘low-mortality’ infection can cause when widespread in the community.</p><p id="p0030">Globally, the clinical picture in humans infected with SARS-CoV-2 have ranged from mild (no or few signs and symptoms), to severe, including death. It was reported that the first instance of COVID-19 related pneumonia cases, whether linked to the Huanan Seafood market or not, occurred between 6 and 15 December 2019 [<xref rid="bb0165" ref-type="bibr">33</xref>]. Another study reported the onset of pneumonia cases related to COVID-19 occurred between the 1st and 10th of December [<xref rid="bb0040" ref-type="bibr">8</xref>]. It is unclear whether the COVID-19 pneumonia related cases had occurred undetected in Wuhan, China prior to the 1st December 2019, this requires further investigation.</p><p id="p0035">Retrospective serological investigation of pneumonia cases in Wuhan before December 2019 will determine the extent of early unreported cases. It will also help determine whether SARS-CoV-2 circulated in Wuhan before December 2019 and will help track the origin of this outbreak among Chinese populations and humans in other parts of the world who had travel history to the epicentre prior to the known start of the outbreak. It was previously reported that the sensitive and specific serological detection of MERS-CoV in subclinical infection is challenging [<xref rid="bb0170" ref-type="bibr">34</xref>,<xref rid="bb0175" ref-type="bibr">35</xref>]. SARS-CoV-2 can cause asymptomatic to fatal respiratory diseases [<xref rid="bb0180" ref-type="bibr">36</xref>]. Asymptomatic to mild COVID-19 infections can go unnoticed and there may be a lack of seroconversion among nucleic acid PCR-confirmed cases which requires further serosurveillance studies. Evaluation of the serologic response of SARS-CoV- 2 infected patients according to the disease severity will help determine the potential role of serodiagnostic parameters as prognostic markers. The development of accurate and robust serological assay will help determine the accurate SARS-CoV-2 prevalence.</p><p id="p0040">Infections due to SARS-CoV-2 among healthcare workers and family clusters were also reported and human-to-human transmission has been confirmed [<xref rid="bb0185" ref-type="bibr">37</xref>], however further investigations are required to determine and understand the full extent of this mode of transmission. So far, there is no evidence of airborne transmission of the SARS-CoV-2, however precautionary measures are recommended due to the lack of information excluding this mode of transmission. The present COVID-19 outbreak is the third global alert of coronavirus infections. SARS-CoV-2 transmission in humans appears efficient and the virus is of pandemic potential. As of today, public health measures in China are yet unable to halt the spread of human infections. There is great concern that spread of the virus may be devastating and of huge public health concern globally, especially in resource-limited countries.</p><p id="p0045">Based on the general definition of a pandemic as an infection that spreads globally, COVID-19 is already a “pandemic”. On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared COVID-19 outbreak a public health emergency of international concern (PHEIC) [<xref rid="bb0190" ref-type="bibr">38</xref>]. Subsequently, the US declared it a public health emergency on January 31, 2020 [<xref rid="bb0195" ref-type="bibr">39</xref>], and several travel restrictions to the epicentre of the outbreak were imposed by the USA, Canada, UK, many countries in Europe, the Philippines, several other countries have followed similar travel restriction [<xref rid="bb0200" ref-type="bibr">40</xref>,<xref rid="bb0205" ref-type="bibr">41</xref>] to avoid SARS-CoV-2 infection importation by air travel.</p><p id="p0050">COVID-19 is a recent example of the complex threats of emerging infectious diseases. Emerging infections in humans and animals, along with other threats such as antimicrobial resistance, are difficult challenges to humanity, to a large extent driven by increasing food production and other issues related to a growing and more resource-demanding population. The interdisciplinary <italic>One Health</italic> approach represents an attempt to deal with such complex problems engaging professionals from many disciplines such as human, veterinary, and environmental health, as well as social sciences [<xref rid="bb0210" ref-type="bibr">42</xref>]. The One Health approach recognizes the interrelationship between animals, humans and the environment and encourages collaborative efforts to improve the health of people and animals, including pets, livestock, and wildlife [<xref rid="bb0215" ref-type="bibr">43</xref>]. One Health teams can work to identify sources of emerging pathogens and ways to reduce the threat of outbreaks [<xref rid="bb0220" ref-type="bibr">44</xref>]. The implementation and development of One Health collaborations on a global scale are critical to reduce the threats of emerging viruses [<xref rid="bb0210" ref-type="bibr">42</xref>,<xref rid="bb0215" ref-type="bibr">43</xref>].</p><p id="p0055">Regarding SARS-CoV-2 in particular, there are several aspects that needs a One Health approach in order to understand the outbreak, and to mitigate further outbreaks of a similar virus. SARS-CoV-2 is likely a bat-origin coronavirus that was transmitted to humans through a spill over from bats or through an undetermined yet intermediate animal host (avian, swine, phocine, bovine, canine, other species) or wild animals. <xref rid="f0015" ref-type="fig">Fig. 3</xref>depicts a transmission hypothesis of SARS-CoV-2 outbreak, yet the intermediate host is to be determined. The list of animals which were sold range between poultry (turkey, pheasants, geese, roosters, doves, and wild birds (Peacocks swans, and exotic animals, to reptiles and hedgehogs. The animal list included frogs, camels, wild rabbits, reptiles, snakes, deer, crocodiles, Kangaroos, snails, civet cats, goats, centipedes, and cicades [<xref rid="bb0225" ref-type="bibr">45</xref>,<xref rid="bb0230" ref-type="bibr">46</xref>]. There are no data available in scientific literature on the detection and isolation of SARS-CoV-2 from environmental samples. However, it was recently reported that the Chinese Centers for Disease Control and Prevention isolated SARS-CoV-2 from 33 samples out of 585 environmental samples collected from Huanan Seafood Market [<xref rid="bb0235" ref-type="bibr">47</xref>].<fig id="f0015"><label>Fig. 3</label><caption><p>The emergence of SARS-CoV-2 and outbreak of COVID-19. The figure depicts a hypothesized origin and transmission of the virus and a generalised route of the epidemic zoonotic coronavirus.</p></caption><alt-text id="al0015">Fig. 3</alt-text><graphic xlink:href="gr3_lrg"></graphic></fig></p><p id="p0060">A broad surveillance for SARS-CoV-2 among different animals is warranted within Huanan seafood market and the vicinities, and should include potential reservoir hosts such as bats (both in the wild and if found in live animal markets) as well as potential intermediate hosts such as pigs, live poultry, fish, reptiles, and wild animals in close proximity to humans, which not only allows virus transmission among them but also leads to the generation of new viral strains. As a previous example, in 2018, an HKU-2 bat origin, swine acute diarrhoea (SADS-coronavirus emerged in swine population in Guangdong in China [<xref rid="bb0135" ref-type="bibr">27</xref>]. Surveillance for SARS-CoV-2 in nonhuman hosts including swine and wild animals and further genetic analysis of SARS-CoV-2, SADS-CoV, and other SARS-like CoVs may reveal the possible intermediate host of the recently emerged human SARS-CoV-2 responsible for the current outbreak and is a very important One Health measure. When the transmission chains and ecology of SARS-CoV-2 are clearer, the next step is to identify potential interventions to mitigate transmission. The unavailability of information on the possible intermediate host of SARS-CoV-2 and leaving the intermediate host undetermined are of high risk to humans and may result in inevitable infections with SARS-CoV-2 and future epidemics. In addition, exploring the intermediate host(s) of SARS-CoV-2 will help conduct further investigations to evaluate the host-pathogen relationship, disease dynamics and the possibility of reverse zoonosis. These interventions will likely include measures of several different types including several different disciplines [<xref rid="bb0210" ref-type="bibr">42</xref>,<xref rid="bb0215" ref-type="bibr">43</xref>,<xref rid="bb0240" ref-type="bibr">48</xref>]. Hypothesizing that bats will be proven as SARS-CoV-2 reservoirs and that adaptation to humans took place in an intermediate host in a live animal market, the following measures would be important:</p><p id="p0065">i) Decreasing the risk of transmission from the natural host. This includes more knowledge of the natural ecology of the virus, so that high-risk transmission situations can be avoided. Also, it is important to consider transmission risks when new interfaces between bats and humans are created, e.g. when human habitations extend into bat habitats. Finally, there are important social science/behavioural measures conveying the message to the public which interactions with bats should be avoided (based on disease ecology knowledge).</p><p id="p0070">ii) Decreasing the risk of transmission from the intermediate host. In principle, this risk could be avoided by completely separating bats from the intermediate host. Depending on which animal(s) is proven to constitute the intermediate hosts(s) for SARS-CoV-2, this may however be more or less difficult in practice. Likely, live animal markets play an important role in this process, and they need to be addressed in any true One Health approach [<xref rid="bb0240" ref-type="bibr">48</xref>]. However, it is crucial to consider the cultural context of these markets meaning that again, social sciences are important in this process. Also, this means that the most viable solution may not be to close down live animal markets but perhaps to ‘sector’ them so that fewer different species mingle in one specific market and that the specific intermediate host(s) for SARS-CoV-2 may be removed from the markets, or rigorously tested for the virus.</p><p id="p0075">iii) Decreasing the human-to-human transmission. This is obviously a crucial measure to stop the current outbreak, and rightfully attracts the most attention at the present time. This review does not aspire to cover the large subject of human-to-human transmission control, but also here a mixture of measures is important from strictly medical (transmission routes, efficiency of PPE, vaccines, antivirals and so on) to more social science-oriented (How do people behave when they suspect they could be infected? How do they behave when they are sick? How to potentially change these behaviours?).</p><p id="p0080">To successfully decrease the risk for a new SARS-CoV-2 outbreak or an outbreak of a similar virus, a One Health approach is crucial.</p><p id="p0085">In conclusion, SARS-CoV-2 which causes COVID-19 is continuing to cause global fears, psychological distress, economic losses and negative impacts on several human activities including industry and mobility. To date, SARS-CoV-2 does not represent a pandemic threat with the same severity as e.g. the 1918 Spanish influenza, but could still cause a high number of deaths and put enormous strain on healthcare systems if widespread globally. Likely, resource-limited countries will be hit hardest due to smaller healthcare budgets and less possibilities of diagnostics and infection control.</p><p id="p0090">There is an urgent need for the implementation of multidisciplinary One Health to address the current complex health challenges at the human-animal-environment interface [<xref rid="bb0210" ref-type="bibr">42</xref>,<xref rid="bb0215" ref-type="bibr">43</xref>].</p><p id="p0095">One Health approaches in China have recently been described [<xref rid="bb0245" ref-type="bibr">[49]</xref>, <xref rid="bb0250" ref-type="bibr">[50]</xref>, <xref rid="bb0255" ref-type="bibr">[51]</xref>, <xref rid="bb0260" ref-type="bibr">[52]</xref>]. However, the implementation of One Health policies in China is challenged by several barriers [<xref rid="bb0240" ref-type="bibr">48</xref>,<xref rid="bb0255" ref-type="bibr">51</xref>]. Should strict implementation of One Health measures in China have been implemented, the emergence of two coronaviruses (SARS in 2002–3 and SARS-CoV-2 in 2019) may have been prevented.</p><p id="p0100">The implementation of One Health measures in live animal markets in China (where SARS-CoV-2 is suspected to have emerged), will likely reduce the risk of emerging zoonotic viruses of pandemic potential in the future. These measures may include implementation of legislations but collaborative interdisciplinary control measures between agricultural and public health sectors are also crucial. Such measures include biosurveillance of live animal markets, improved biosecurity in livestock farms, live animal markets and during animal transportation, public education on zoonotic diseases, and the importance of adopting a cooperative approach between agencies.</p><p id="p0105">The success in the containment of the current COVID-19 outbreak in China and the sporadic travel related cases worldwide will depend much on conventional public health measures, rapid clinical case identification, contact investigation, strict infection control in healthcare facilities, patient isolation, public education and community containment (quarantine) [<xref rid="bb0265" ref-type="bibr">53</xref>].</p><sec id="s0005"><title>Author statement</title><p id="p0110">MEZ conceived the idea of the manuscript. MEZ wrote the initial draft, compiled data, and generated fig. 4. JDJ revised the manuscript and contributed to writing and revisions. All authors revised the final version of the manuscript.</p></sec><sec sec-type="COI-statement"><title>Declaration of Competing Interest</title><p id="p0115">We are declare we do not have any conflict of interest associated with this manuscript.</p></sec></body><back><ref-list id="bi0005"><title>References</title><ref id="bb0005"><label>1</label><element-citation publication-type="journal" id="rf0005"><person-group person-group-type="author"><name><surname>Monto</surname><given-names>A.S.</given-names></name></person-group><article-title>Epidemiology of viral respiratory infections</article-title><source>Am. J. 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The authors would like to thank Dr. James M Wilson from <funding-source id="gts0005">M2 Medical Intelligence, Inc.</funding-source>, Nevada, USA, and Dr. Sagar Goyal from the <funding-source id="gts0010">department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota</funding-source>, St. Paul, Minnesota, USA for reading the manuscript and their comments.</p></ack></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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