Stopping a Scourge
No one knows if SARS will strike again. But researchers' speedy work halting the epidemic makes a compelling case study of how to combat a deadly virus
- By David Brown
- Smithsonian magazine, September 2003, Subscribe
(Page 2 of 3)
What scientists do know about coronaviruses in general, and SARS-CoV in particular, suggests that infection may differ considerably from victim to victim, persist over time and be difficult to vaccinate against. SARS-CoV stores genetic information in single-stranded RNA, a less stable and more mutable molecule than the double-stranded DNA used by fungi, human beings and everything in between. Coronaviruses have a larger genome, or collection of hereditary material, than any RNA virus studied so far. In addition, they carry an unusual enzyme that permits two sister viruses to swap genes if they happen to find themselves infecting the same cell. That capacity to form "recombinants," or hybrids, as well as the virus’s large genome, enable the genus to easily gain or lose traits. Such traits may include the ability to infect new species, elude the immune system and change residence in the body over time.
The story of transmissible gastroenteritis virus in pigs demonstrates how coronaviruses acquire new powers. The disease, known since the 1940s, causes severe diarrhea in piglets. Periodic outbreaks have killed whole generations of animals on some farms. In 1989, farmers in Europe began noticing a new respiratory infection in pigs. The cause turned out to be a genetically altered form of the gastroenteritis virus that had evolved the capacity to invade the lungs. Coronaviruses are changelings, multitaskers, rule breakers. Bovine coronavirus causes several different diseases in cattle. In calves, it causes severe diarrhea; in yearlings, a pneumonia called shipping fever; in adult cows, a dysentery-like illness.
Coronaviruses are versatile in other ways too, with some strains able to infect more than one species. A study two years ago showed that a coronavirus isolated from cattle could also infect baby turkeys, though not, curiously, baby chickens. "Coronaviruses may be much more promiscuous than we originally thought," says Linda Saif, a veterinary scientist and virologist at Ohio State University.
Scientists have only begun to learn the rules of engagement the SARS coronavirus follows. Like many of its kin, it appears to be a lung-and-gut bug; people die from lung damage; about one-fifth of its victims also have vomiting and diarrhea. But SARS-CoV behaves unlike many respiratory viruses. For one thing, the disease it causes develops slowly. Also, there’s an almost miraculous sparing of children. In the recent SARS outbreak, few children became ill and none under age 16 died. Scientists don’t yet know why.
If SARS-CoV entered the human population from animals, it is by no means the first virus to make the jump between species. Measles, which has afflicted human beings for at least 2,000 years and still kills more than 700,000 people annually (mostly children), is caused by a virus whose closest relative causes rinderpest, a disease of cattle. The domestication of animals brought human beings and bovids together in large numbers, and some of the herd’s pathogens adapted to life in the herders. A similar leap ages ago may have introduced human populations to the smallpox virus, which has since been eradicated.
Perhaps the most important question about SARS—is it with us forever?—can’t yet be answered. According to preliminary reports, some exotic mammals in southern China that are caught and sold for food (including the masked palm civet) harbor a coronavirus identical to SARS-CoV with an important exception: the animal virus’s RNA has an additional 29 nucleotides, or chemical subunits. The similarity suggests that the SARS virus arose from the animal virus. If those 29 missing nucleotides hold the key to the emergence of SARS-CoV, its future may depend on how frequently that particular genetic deletion occurs. It may not happen again for decades, or centuries. Or it could happen next year. But even if the virus’s genetic material changes frequently, future epidemics may possibly be prevented merely by keeping people away from palm civets and other infected species.
Alternatively, SARS may behave like Ebola hemorrhagic fever, which appears periodically. Ebola emerged in 1976 in simultaneous outbreaks in Zaire and Sudan. The virus strikes in Africa every few years, killing 50 to 90 percent of the people it infects, and then vanishes. Despite great effort, scientists still haven’t found the natural animal host or reservoir for Ebola virus, and that makes it harder to prevent periodic outbreaks.
By early July, the W.H.O. declared that the outbreak was over. At last count, 8,399 people in 30 nations had been identified as "probable" SARS cases and 813 of them had died.
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