SARS HAS VIRUS HUNTER VERY BUSY
03 Jun 2003
Source: Contra Costa Times (CA), June 3, 2003
SARS has virus hunter very busy
By Patricia Anstett, KNIGHT RIDDER NEWSPAPERS
ANN ARBOR, Mich. - When it comes to the coronavirus, the little bug that causes SARS, Dr. Arnold Monto is THE MAN.
For years, Monto has fielded calls about the coronavirus. But the past few months, he has been in even greater demand from world health authorities and the media, with the emergence of the world's newest disease, severe acute respiratory syndrome (SARS).
They come to him because he is one of the most recognized experts on the two best-known human strains of the coronavirus.
The SARS coronavirus is a cousin to those two strains, but widely different. It is one heck of an unpredictable bug.
"With this virus, all bets are off," says Monto, professor of epidemiology at the University of Michigan School of Public Health, and president-elect of the American Epidemological Society. "It doesn't behave like the other coronaviruses."
He didn't write the book, as they say. But he wrote the key chapter on coronaviruses in the leading medical textbook, "Viral Infections of Human, Epidemiology and Control."
He is so well known as a virus hunter that every year he helps pick the strain of virus that makes up the flu vaccine used in the United States. He is a consultant to many international health programs and travels frequently to lend his advice. When he's not doing that, he teaches epidemiology at University of Michigan's nationally regarded School of Public Health. He has no plans to retire. He's 70, a fact that he whispers, given the age-phobic U.S. culture.
"I'm healthy and I'm having fun," he says. "And my wife wouldn't want me to go shopping with her," he says of Ellyne Monto, his spouse of 45 years. They have four children and 10 grandchildren and live here in Ann Arbor.
Before anyone heard about the coronavirus, Monto and a team from the School of Public Health studied it in the 1970s. Over an 11-year span, the team charted the causes of respiratory and other infectious diseases in Tecumseh, Mich.
The team took hundreds of throat swabs and blood tests of Tecumseh residents who got sick and then did follow-up phone calls to check the duration of symptoms. It was a huge task unlikely to be taken on today because of costs and other issues -- even the problem of reaching people by phone in these days of answering machines, Monto says.
Monto and the team identified two human coronavirus strains that play a role in the common cold. Each has a name of alphabet letters and numbers, and a shorter nickname: 22E and the more common OC43. But the germs weren't thought to be lethal. When Monto last revised his coronavirus chapter, in 1997, he wrote: "There is no documented report yet on record of human coronaviruses being involved in a lethal respiratory infection."
Most likely, the strain of coronavirus that causes SARS has undergone some genetic change, he says.
Experts call this change drift.
The SARS virus is different enough that there are many unanswered questions, including why some people get sick when exposed to someone with SARS and some don't.
What is known is that simple measures like quarantine, isolation of sick patients and aggressive measures to protect hospital staffers are effective.
A study published May 23 on the Web page of Science magazine -- www.sciencemag.org -- found that a person with SARS is likely to infect three others.
That's fewer than other, common diseases such as measles, where a single case might generate 15 to 17 other cases, or a case of chicken pox, which would result in six to eight secondary cases, the Harvard School of Public Health team says.
"The bad news is, people are dying from SARS," Monto says. "The good news is, it doesn't spread that well."
The first coronavirus was identified in 1937. It was a strain found in birds that caused a disease called infectious bronchitis. But the coronavirus was hard to keep alive in a laboratory culture, making research difficult, Monto says.
Eight other studies over the years have shed some additional insight into the coronavirus.
One theory about SARS is that a strain of animal coronavirus changed when it transferred from animals to humans. In fact, the World Health Organization has traced the virus to a civet cat, a badger and a raccoon-like dog in China, officials reported.
Civet cats look like raccoons or weasels. The animals may have picked up the virus from contaminated feed, and passed it along to the food handlers who slaughtered them, authorities speculate.
Last week, WHO scientists found SARS antibodies in workers who handled these exotic animals at a market in southern China, lending further support to the theory that the disease jumped from animals to humans, a WHO scientist said last week.
Up to now, it was thought that the coronavirus didn't jump from one animal species to another.
The strains also were considered seasonal, dying off in spring and re-emerging in the fall, he says.
Monto, who also serves on the advisory board to the National Institute of Allergy and Infectious Diseases, worries more about the United States being unprepared for the next flu pandemic -- the health term for a global epidemic -- than he is about SARS.
"We're trying to prepare for pandemics," he adds. "We've only now begun to get the attention of the World Health Organization."
After soaring interest in virology 40 years ago, the field went out of favor in the '70s when new antibiotics caused some experts to proclaim prematurely that infectious diseases had been conquered.
Monto hopes the SARS epidemic will persuade others that much more serious study, better tests and new drugs are needed.
He wants the United States and other nations to stockpile vaccines and drugs to protect people from flu. That's not happening. "Most world health authorities are scrambling to understand SARS," he says.
"SARS has told us we are not ready for a bioterrorism incident," says Monto, who directs the Michigan Bioterrorism and Health Preparedness Research and Training Center at University of Michigan.
"This will make us more prepared for any eventuality. It tells us this exercise in biopreparedness is really health preparedness, whether the disaster is man-made or natural.
"The other thing is: We need to realize we face an influenza pandemic. We know it takes eight months to make a vaccine.
"If we have imported SARS so easily to so many parts of the world, we're going to import a new influenza virus in many parts of the world," he says.