Another Decade, Another Coronavirus (2020/01/24)+中文摘要轉譯

1月20日新英格蘭臨床期刊報導指出, 繼SARS, MERS之後, 2019-nCoV為新興的人畜共通傳染病; 2019-nCoV感染後, 通常會導致嚴重呼吸道症狀, 因此, 了解如何從動物身上傳播給人之傳播途徑, 對有效防疫十分重要. 目前研究結果指出2019-nCoV與幾種蝙蝠冠狀病毒之genome, 有75-80%相似度, 因此推測蝙蝠是2019-nCoV的可能來源. 武漢肺炎疫情爆發至今, 已造成一定程度的社會和經濟之衝擊, 在公共衛生防疫方面, 如何有效隔離防疫, 提高警覺, 及時診斷, 對降低武漢肺炎傳播非常重要。(國衛院蔡慧如博士整理)

For the third time in as many decades, a zoonotic coronavirus has crossed species to infect human populations. This virus, provisionally called 2019-nCoV, was first identified in Wuhan, China, in persons exposed to a seafood or wet market. The rapid response of the Chinese public health, clinical, and scientific communities facilitated recognition of the clinical disease and initial understanding of the epidemiology of the infection. First reports indicated that human-to-human transmission was limited or nonexistent, but we now know that such transmission occurs, although to what extent remains unknown. Like outbreaks caused by two other pathogenic human respiratory coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and Middle East respiratory syndrome coronavirus [MERS-CoV]), 2019-nCoV causes respiratory disease that is often severe.1 As of January 24, 2020, there were more than 800 reported cases, with a mortality rate of 3% (https://promedmail.org/. opens in new tab).

As now reported in the Journal, Zhu et al.2 have identified and characterized 2019-nCoV. The viral genome has been sequenced, and these results in conjunction with other reports show that it is 75 to 80% identical to the SARS-CoV and even more closely related to several bat coronaviruses.3 It can be propagated in the same cells that are useful for growing SARS-CoV and MERS-CoV, but notably, 2019-nCoV grows better in primary human airway epithelial cells than in standard tissue-culture cells, unlike SARS-CoV or MERS-CoV. Identification of the virus will allow the development of reagents to address key unknowns about this new coronavirus infection and guide the development of antiviral therapies. First, knowing the sequence of the genome facilitates the development of sensitive quantitative reverse-transcriptase–polymerase-chain-reaction assays to rapidly detect the virus. Second, the development of serologic assays will allow assessment of the prevalence of the infection in humans and in potential zoonotic sources of the virus in wet markets and other settings. These reagents will also be useful for assessing whether the human infection is more widespread than originally thought, since wet markets are present throughout China. Third, having the virus in hand will spur efforts to develop antiviral therapies and vaccines, as well as experimental animal models.

Author: Stanley Perlman

Link: https://www.nejm.org/doi/full/10.1056/NEJMe2001126?query=RP