May 20, 2014
MERS Arrives In The Netherlands, Researchers Identify Drugs That Could Treat The Deadly Virus
Lawrence LeBlond for redOrbit.com - Your Universe Online
The deadly Middle East respiratory syndrome-coronavirus (MERS-CoV) has been largely confined to the Middle East and surrounding countries since it was first reported two years ago. In fact, prior to 2014 it has only been reported in a handful of Old World countries outside the Middle East, with relatively few cases observed in each.
As of late, however, the dangerous illness has reared its ugly head in the US. The first US case was reported by redOrbit back on May 3; as of last week, a second case had been confirmed in Florida. Both cases were in males who had traveled to Saudi Arabia as healthcare workers, undoubtedly picking the virus up from contact with infected individuals while in the Middle East.
Now, the deadly MERS virus has been confirmed in another country in the Old World – one that neighbors Germany’s western border and lies north of France, two countries that have already seen limited MERS outbreaks.
The National IHR Focal Point for the Netherlands notified the World Health Organization (WHO) on May 14 of the first laboratory confirmed case of MERS-CoV infection in the Netherlands. The patient is a 70-year-old male citizen of the Netherlands, who had recently traveled to Saudi Arabia, returning home on May 10.
The man’s symptoms first appeared on May 1 while in Medina, Saudi Arabia. He was evaluated on May 6 in Mecca, but did not have respiratory symptoms during his time in Saudi Arabia. Upon return to the Netherlands, his condition deteriorated, he developed respiratory symptoms, and was hospitalized; he tested positive for MERS on May 13.
On May 15, the National IHR Focal Point for the Netherlands notified WHO of a second lab-confirmed case of MERS-CoV infection in the Netherlands. This case was discovered during a national contact investigation, performed in relation to the first MERS case reported on May 14.
The second patient is a 73-year-old female citizen of the Netherlands and a close family member of the first case. Both patients were on the same trip to Saudi Arabia and shared the same hotel room throughout their journey. The second patient had developed symptoms first, which included breathing difficulties, on May 5 while in Mecca. Upon return to the Netherlands on May 10, the patient’s symptoms worsened, but still not severe enough to seek medical help.
During the contact investigation, the woman’s clinical condition was re-evaluated by a general practitioner and sampling for MERS was initiated. While the samples taken needed to be tested, other initial findings made it clear she had the MERS-CoV. As of May 15, both patients were in stable condition with fever and mild respiratory symptoms and were both put into isolation.
Together with nine additional cases reported to WHO from the IHR National Focal Point of the United Arab Emirates as of May 15, total cases of infection from MERS-CoV now stands at 614 lab-confirmed cases, including 181 deaths.
With MERS continuing its wrath across the Middle East and now around the world, the race is on to find a treatment that can stop the virus dead in its tracks. Several new research articles published ahead of print in the journal Antimicrobial Agents and Chemotherapy may be approaching the finish line.
The research papers offer new hope in finding an effective treatment, as they have uncovered a number of drugs that may offer an effective treatment approach in fighting the MERS-CoV.
In the first study, US researchers screened 290 drugs, either FDA-approved or in advanced clinical development, looking for antiviral activity against the MERS coronavirus and SARS coronavirus in cell culture. They found 27 compounds that were active against both viruses. These compounds included some cancer drugs and antipsychotics.
"Repurposing of approved pharmaceutical drugs for new indications presents an attractive alternative to the normal paradigm of huge library screening against a specific viral enzyme," author Matthew Frieman, of the University of Maryland Medical School, said in a statement. "Given development times and manufacturing requirements for new products, repurposing of existing drugs is likely the best solution to rapidly identify therapeutics for outbreaks due to emerging viruses."
In the second study, researchers collaborating in the European antiviral research program SILVER screened 348 FDA-approved drugs for anti-MERS-CoV activity in cell culture. They identified four compounds that inhibited MERS-CoV, SARS, and Human Coronavirus 229E at relatively low concentrations. Two of the compounds identified in the SILVER study were also identified in the US study: the antimalarial drug chloroquine and the antipsychotic chlorpromazine.
"Although their therapeutic potential (alone or in combination) remains to be assessed in animal models, our findings may offer a starting point for treatment of patients infected with zoonotic coronaviruses like MERS-CoV," says corresponding author Eric Snijder of Leiden University Medical Center, the Netherlands.
In the third study, researchers found that an experimental compound that had been previously shown to block SARS-CoV replication, can inhibit replication of MERS-CoV and mouse hepatitis virus.
"This study shows that it is possible to target multiple coronaviruses through broad-spectrum inhibitors," says corresponding author Stefan Sarafianos of the Bond Life Sciences Center at the University of Missouri, an author on the study. "This compound could serve as a lead for the development of effective broad-spectrum anti-coronavirus drugs."