As part of its mission to monitor influenza and respiratory viruses in France, the Institut Pasteur has mobilized its teams at the French National Research Center for Influenza viruses (CNR) and the Laboratory for Urgent Response to Biological Threats (CIBU) to identify and confirm suspicious cases of acute respiratory infections linked to the new coronavirus (MERS-CoV). The combined work of these two laboratories enables the Institut Pasteur to respond 24/7 to health authorities faced with an until now unknown virus. Deputy director of the French National Reference Center for Influenza viruses, Vincent Enouf, sheds some light on the situation.
There are currently two cases of acute respiratory infection linked to this new coronavirus (MERS-CoV) in France. The French National Institute for Health Monitoring (InVS) called on the Institut Pasteur to identify and confirm the presence of MERS-CoV in these patients. Why choose the Institut Pasteur?
As the French National Reference Center for Influenza viruses (CNR), we have the expertise and the tools necessary for the detection and epidemiological surveillance of respiratory viruses in France. This includes viruses such as influenza as well as other less common or emerging respiratory viruses, such as this new coronavirus.
The CNR took an interest in MERS-CoV as soon as the first cases were reported in the Middle East in April 2012. At the time a Dutch team specializing in coronaviruses was able to determine that it was a new type of virus and characterize the specific sequences of its genome. By September 2012, using these specific DNA sequences, we were able to synthesize genetic tools enabling us to detect the virus if any suspicious cases were reported in France.
How do you communicate with health authorities? Do hospitals systematically send you all suspected cases of MERS-CoV?
The CNR works closely with health authorities and hospitals according to a well established protocol to avoid false alerts and being overwhelmed with cases. The samples we receive at the CNR have in fact already been sorted out by the InVS during a preliminary epidemiological survey. The hospital practitioner in charge of the patient contacts the InVS. If the patient’s condition is consistent with a specific combination of symptoms the InVS gives the physician its go-ahead to take respiratory, blood, and stool samples to send to the CNR.
Why is good coordination so essential for this project?
The major advantage of working with the Institut Pasteur on this type of mission is the efficiency. Day or night, if the CNR cannot handle identification of a case the CIBU takes over – this is the foundation for the quick and efficient coordination between our teams. In order to supply a result as quickly as possible, while ensuring both human and environmental safety, the teams of scientists, at least three to a team, must be operational as soon as samples arrive. For this to happen we are in contact with all parties involved, before samples are sent, during transport, upon arrival, and of course, after testing is completed. Once the sample has been received we can get the result in a matter of hours.
But your work doesn't end there, does it?
You’re right, it does not. So little is known about this virus (see inset below) and many further studies need to be conducted in order to close the gaps of our misunderstanding. We are striving to develop techniques and tests that, in particular, will enable us to better understand how the virus spreads, to know how contagious the virus is, and also to determine the profile of those people most susceptible to infection. Our end goal is to always provide authorities with the maximum amount of information so that they can be in the best position to make the necessary healthcare decisions.
Photo: Coronavirus, the causal agent of SARS (Severe Acute Respiratory Syndrome). MERS-CoV belongs to the same family of viruses as SARS.
© Institut Pasteur
In an interview for the website MyScienceNews Jean-Claude Manuguerra, Director of the Laboratory for Urgent Response to Biological Threats (CIBU) at the Institut Pasteur, talks about what the CIBU does when an unknown agent emerges.
In an episode from our Ils font avancer la recherche [Moving science forward] series produced in partnership with Sup’Biotech, Vincent Enouf gives us an insight into a day’s work at the French National Reference Center for Influenza viruses (this video is only available in French).
What is the new coronavirus?
The new coronavirus (MERS-CoV) is a respiratory virus of the Coronaviridae family. Because of this, for awhile it was mistaken for SARS (Severe Acute Respiratory Syndrome) which struck in 2003.
Infection by MERS-CoV can lead to benign cold-like symptoms or much more serious symptoms such as acute and potentially fatal respiratory infections. The victims affected by this disease tend to suffer from pre-existing chronic diseases or are immunodeficient.
Never before seen in humans, today MERS-CoV is seen as an emerging virus.
The first confirmed case of infection was in April 2012 in Jordan. Since then 44 cases of MERS-CoV infection have been documented, including 22 fatalities. All of the victims either spent time in the Middle East or were in contact with people having travelled in this geographical area.
The animal reservoir for MERS-CoV has yet to be identified but was most probably derived from an animal coronavirus found in bats that successfully crossed the species barrier. A second animal species having greater contact with humans almost certainly played an intermediate role in transmitting the virus before the infection spread to humans.
The way the infection spreads is still not clear, however, as it is a respiratory and enteric virus, pathways for respiratory and fecal-oral transmission are being closely monitored.