2. 2
Severe Acute Respiratory Syndrome, or SARS, was first discovered in Guangdong
province of China in November 2002 (Hui et. al. 2014). The disease was characterized by
persistent fever, dry cough, myalgia, malaise, and shortness of breath. It was described as
atypical pneumonia by clinicians. Eventually, many patients fall into acute respiratory distress,
which necessitates ventilatory support. The most troubling thing about the SARS epidemic in
2002/2003 was that the virus was able to spread to 29 countries and regions, causing 8098 cases
and 774 deaths (Hui et. al. 2014).
More recently, a similar atypical pneumonia-causing coronavirus has been discovered in
the Middle East. Scientists call it Middle East Respiratory Syndrome, or MERS. Since SARS
and MERS are both emerging coronaviruses, a lot of what was learned from the SARS epidemic
in 2003 has been applied since the first reported case or MERS in 2012. Although the viruses are
similar, there are differences between SARS and MERS. MERS seems to be less transmissible
through human-to-human contact than SARS is (Hui et. al. 2014). MERS patients are also more
prone to organ failure, due to the high rate of secondary illnesses associated with the disorder.
Researchers have very recently begun doing research on vaccines for coronaviruses like
SARS and MERS. A live attenuated measles vaccine that expressed the same S spike protein as
SARS CoV (coronavirus) was created and administered to laboratory mice. When exposed to
SARS, the lab mice were fully protected by their immune system against the virus (Escriou et. al.
2014). There has also been recent research done regarding antiviral medication development for
emerging viral infections such as SARS, MERS, ebola, and more. 5000 small molecules were
screened, one of which was able to inhibit the protein needed for such viruses to cleave and
infect healthy cells. This small antiviral molecule could one day be developed into a potent
broad-spectrum anti-viral drug (Elshabrawy et. al. 2014).
3. 3
Another thing that SARS and MERS seem to have in common is bats. Bats are believed
to serve as reservoir hosts for coronaviruses such as SARS and MERS, in addition to Ebola,
Marburg, Nipah, and Hendra viruses (O’Shea et. al. 2014). Researchers believe that the increased
body temperature and higher metabolism of bats during flight boosts their immune system,
allowing them to tolerate a higher viral diversity in their bodies without becoming ill. This makes
them an important, and potentially lethal reservoir for the virus (O’shea et. al. 2014). Camels
have also been found to be carriers of the MERS virus, but whether or not the camels infected
the humans, or vice versa, is yet to be determined (Hui et. al. 2014).
Although science seems to have come a long way from the blind panic that characterized
the beginning of the SARS epidemic, what has been missing from the research done on
coronaviruses is how to eliminate the potential of spread from suspected disease reservoirs. Why
is there a lack of research on preventing transmission from viral reservoirs to humans?
An effective comparison that can be made here is malaria. It is widely known that malaria
is caused by a bite from an infected mosquito, just as bats are the known carrier of SARS and
MERS. However, measures such as creating spermless mosquitos to curb the population of
mosquitos able to transmit the disease have showed promise in the effort to stop malaria
(Carpenter 2011). There is little to no research on curbing bat population, or even reducing the
viral diversity that bats carry. Ultimately, although there is research being done on the reservoir
(answering the “why?” question), not enough testing is being done on the “how?” question (that
is, how are we going to reduce/prevent transmission of the virus from bats to humans?).
This gap in literature is perhaps the missing link between controlling a future
SARS/MERS epidemic and preventing it altogether. This notion of choosing treatment over
prevention can be broadened to a surprising number of diseases that exist in the world today:
4. 4
cardiovascular disease, essentially the whole spectrum of mental health disorders, and type II
diabetes mellitus to name a few. Further research on controlling disease reservoirs and
preventing the spread of CoVs from bat to humans will make the most impact on controlling the
disease, while also saving cost overall by preventing epidemics and cutting back on money spent
on new and experimental antiviral drugs.
5. 5
References
Carpenter, J. (2011, August 8). Spermless mosquitos hold promise to stop malaria. In BBC News.
Retrieved May 20, 2014
Elshabrawy, H. A., Fan, J., Haddad, C. S., Ratia, K., Broder, C. C., & Caffrey, M. (2014, April).
Identification of a Broad-Spectrum Antiviral Small Molecule against Severe Acute
Respiratory Syndrome and Ebola, Hendra, and Nipah Viruses by Using a Novel High-
Throughput Screening Assay. Journal of Virology, 88(8), 4353-4365. Retrieved May 20,
2014
Escriou, N., Callendret, B., Loren, V., Combredet, C., Marianneau, P., Fevrier, M., & Tangy, F.
(2014, March). Protection from SARS coronavirus conferred by live measles vaccine
expressing spike glycoprotein. Virology, 452, 32-41. Retrieved May 20, 2014
Hui, D. S., Memish, Z. A., & Zumla, A. (2014, May). Severe Acute Respiratory Syndrome Vs.
Middle East Respiratory Syndrome. Current Opinion in Pulmonary Medicine, 20(3),
233-241. Retrieved May 20, 2014
O'Shea, T. J., Cryan, P. M., Cunningham, A. A., Fooks, A. R., Hayman, D. T., Luis, A. D., &
Peel, A. J. (2014, May). Bat Flight and Zoonotic Viruses. Emerging Infectious
Diseases, 20(5). Retrieved May 20, 2014
