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Brower Sept 2013
Notes: Topics covered this summer at INCDNCM 2013

Image left: This undated electron microscope image shows a novel coronavirus particle, also known as the MERS virus, center. (AP Photo/NIAID - RML)
Read more: http://www.dailystar.com.lb/News/Middle-East/2013/Sep-08/230443-another-3-die-of-mers-virus-in-saudi-arabia.ashx#ixzz2eIbKxYdj 
(The Daily Star :: Lebanon News :: http://www.dailystar.com.lb

Middle East respiratory syndrome (MERS) coronavirus

In 2003 SARS-CoV outbreaks in Hong Kong were described predominantly in the two locations of 1. Amoy Gardens, where there were approximately 300 cases for which diarrhea was the primary presentation and travel through air conduits between high-rise towers was well described, and 2. Hotel Metropole, where approximately 30 cases presented primarily as respiratory disease.  see: SARS: Chronology of the Epidemic. Martin Enserink Science 15 March 2013: Vol. 339 no. 6125 pp. 1266-1271 DOI: 10.1126/science.339.6125.1266

After 2004, for reasons that have remained unclear, the virus appears to have simply gone away (http://www.nytimes.com/2005/05/15/health/15sars.html?_r=0), and no similar human outbreaks have been seen until MERS was identified in 2012. 

Its close resemblance to SARS-CoV was readily identified, and as with SARS, a move from an animal to human host is proposed.  In the case of MERS, suspect reservoirs based on genomic studies include bats and camel. 94 cases of MERS have been described, most in Saudi Arabia, though there have been 3 cases reported from as far away as the UK; most cases have been in middle aged and older males, more often in those with some form of immune compromise, and human to human transmission appears to take place.

Serology testing is not currently reliable because of cross-reaction with other coronaviruses; PCR tests are available.

There are a number of human coronavirus receptors; of greatest interest presently in MERS is the targeted DPP4 (dipeptidyl peptidase 4) cell receptor (aka CD26), present in cells in the respiratory tract and not common to less pathogenic coronaviruses.

While the ferret, mouse, and hamster have DPP4 receptors, they cannot be infected with MERS and thus will not be viable models for in vitro studies. (MERS corona virus Does Not Replicate in Syrian Hamsters. de Wit E, Prescott J, Baseler L, Bushmaker T, Thomas T, et al. (2013). PLoS ONE 8(7): e69127. doi:10.1371/journal.pone.0069127) Studies to understand the difference between MRS and SARS are now being directed here, specifically at a domain change at the DPP4 receptor in these species. A macaque model has also been sought; macaques develop moderate numbers of pulmonary neutrophils and few macrophages after infection and recover after day 3-4.

There is some question about the tissues involved in human MERS infections; pulmonary infection is clear but reports of renal disease are less convincing and no renal pathology is seen in macaques.

April 22, 2013. Editorial by Brower.
Cultural Responses to Stray Dogs - Weighing Risks and Benefits

Across the globe stray dogs force societies to consider what is and is not humane in the face of potential human risk of dog bites and zoonotic diseases, particularly rabies.  Obviously, views about stray dogs differ depending on the culture in question, and numbers of stray dogs in a society generally reflect cultural points of view.   In the U.S. and U.K. you don’t see many stray dogs; they are  ‘controlled’ through collection, and sheltered, euthanized or re-homed in a fairly systematic way.  In some parts of Africa that I’ve visited, and I’m sure in many parts of the world, dogs are kept loosely in villages.  There is no ownership per se, but there is a communal benefit to having them around, mainly in the forms of help with hunting and protection, and thus a communal effort is made to keep their basic needs met.    Then there are the stray dog populations of Russia and ex-soviet republics, which strike me as a little different.  In these societies stray dogs offer nothing in the way of protection or the acquisition of food, in fact just the opposite.

I haven’t been a lot of places, but of the countries I have visited, I’ve never seen organized groups of stray dogs the way I did in Moscow, Kamchatka and parts of Moldova.  It was almost as though society collectively cared for the dogs, felt a level of responsibility for their wellbeing, and received a sense of companionship from them similar to what one might from a dog owned as a pet.  I can’t help but draw a way-to-simple analogy to collective communist vs. private capitalist worldviews.  Whatever the reason stray dogs in Moscow ride subways with daily commuters, and those in US cities occupy cages in shelters, it seems clear that collection and control is the approach that keeps people safe.  It’s just that when you read the following posts and look at these video links, you may still wonder which, if any, approach is really humane.  

http://englishrussia.com/2009/04/07/smartest-dogs-moscow-stray-dogs/

Moscow Subway's Stray Dogs: Commuters take cell phone pictures of the dogs and load them on this web site: http://metrodog.ru/page/2/

RABIES, ANIMAL - RUSSIA: (MOSCOW) DOG CONTROL
*A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Sat, 27 Mar 2010
Source: News agency "oreanda.ru" [in Russian, trans. Rapp. ArS, edited]
<http://www.oreanda.ru/ru/news/20100327/common/events/article462895/>


Rabies, animal (epidemic awareness) - Russia (Moscow)
-
The epidemic situation for rabies has reached the highest levels of 
concern in Moscow. There were 257 animal rabies cases last year 
[2009], more than 10-fold the means of previous years. 
Rosselkhoznadzor [the federal service of phytosanitary and veterinary 
surveillance] considers taking unprecedented measure to control the 
epidemic, like banning movements of pets to suburban cottages, 
canceling a show dog exhibition and mass immunization of wild and 
domestic animals.
The veterinarians say that the situation was worse only during the 
post-WW2 years, when the annual numbers were above 2000 cases. Only 
the mass shooting of stray dogs, foxes and raccoon dogs controlled the 
epidemic, they think.

These measures were so effective that almost nobody remembered about 
rabies until the late 60s. Since then, there were only single rabies 
cases reported. The regional deputy of Rosselkhoznadzor announced 
during a conference that there were from 2 to dozens of rabies cases 
from the 1970s until recently, when the number of cases increased to 
hundreds.

The situation is worst in the North-West of Moscow oblast where, the 
specialists think, the natural conditions are favorable for 
maintaining the rabies epidemic. There are several water bodies and 
nature conservation areas in this territory, which create a 
environment favorable for wild animals to live in. The water restricts 
the movements of the animals, especially if they are already rabid. 
This causes some level of crowding of rabid animals with subsequent 
enhanced transmission. This is why about 42 percent of the rabies 
cases last year occurred exactly in the North West of the Moscow oblast.

The officials say that each weekend, about 30 000 pets are being 
carried to the suburban country cottages [dachas], where these animals 
are at risk to become infected and bring the infection into the Moscow 
region. The stray dogs add their contribution to the epidemic process. 
The people still remember the case of a rabid dog last year [2009], 
which bit 36 people before being neutralized [see ProMED post 
20091230.4392].

The authorities say that they have to control somehow the movement of 
pets to and from Moscow, while understanding that it will cause 
traffic jams. The movements of non-immunized pets will be forbidden 
and the law will be strictly enforced.

The coming international dogshow is under threat of cancellation if 
the rabies situation does not improve.

--
Communicated by:
ProMED-mail <promed@promedmail.org> Published Date: 2010-04-01 11:00:04
Subject: PRO/AH/EDR> Rabies, animal - Russia: (Moscow) dog control 
Archive Number: 20100401.1029
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The annual International Conference on Diseases in Nature Communicable to Man seeks to increase knowledge and awareness of zoonotic disease within the medical and public health communities.
 
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