CDC team’s latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

“Humans are end-of-life hosts, and this (new coronary pneumonia) once again highlights the hidden virus banks in wild animals and their potential to lurk in mammals (humans). Wu Guizhen, chief expert on biosecurity at the CDC, said. In late December 2019, wuhan, China, has a number of patients infected with viral pneumonia due to unidentified microbial progenitor bacteria.

After that, the Cdc of China, through pathogen identification, identified the pathogen of the patients with viral pneumonia as a new type of coronavirus. On January 10, the World Health Organization named the virus found in Wuhan as “2019-nCoV”, or “2019 Wuhan New Coronary Virus”.

The outbreak of new coronary pneumonia is taking place, and the number of confirmed cases, cured cases and deaths is on the rise.

However, the new coronavirus host source exactly where, and how the virus came to Wuhan, but also through what fulcrum across the human, and so on, these important information, the official has not yet announced the results.

Scientists from all over the world are investing a lot of time and energy in scientific research in the hope of finding conclusions.

In the early hours of January 30, Beijing time, the Lancet, the world’s leading medical journal, published two new papers on the new coronavirus online.

One of the authors, Wu Guizhen, Shi Wenfang of Shandong First Medical University, and others, the paper, through the genetic analysis of 9 patients infected with new coronary pneumonia in Wuhan, for the first time concretely came to the conclusion that “the source of the new coronavirus host is the closest to Zhoushan bats”; More emphasis on clinical case analysis. The paper analyzed the early characteristics of the new coronavirus infection based on data from 99 patients diagnosed with new coronary pneumonia.

The Lancet, the two papers, not only the source of the new coronary pneumonia virus, transmission routes and susceptible people and so on for a full range of data analysis, but also integrated the current situation, through big data analysis and scientific research, “sealed city” and other prevention and control means to better explain, the new coronary pneumonia epidemic prevention work has played a guiding role.

CDC team's latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

Compared with the scientific reports on the new coronavirus published in other journals, the paper published in The Lancet is relatively authoritative. The paper was led by Wu Guizhen, chief expert on biosecurity of the China CENTER for Disease Control and Prevention, and jointly studied by a team of scientists from Shandong First Medical University, the First Hospital affiliated with the Chinese Academy of Sciences, the Huada Center for Genetic Pathogens Technology Research Center, the Army General Hospital of Wenzhou Medical University, the Hubei CDC, the Beijing Institute of Life Sciences of the Chinese Academy of Sciences. Fellow Gao Fu, a member of the High-level Expert Group of the National Health and Health Commission, was also involved.

The authors also re-emphasized the potential threat of unknown viruses to humans in wild animals at the end of the article.

The new coronavirus host is associated with Zhoushan bats, with similarity of up to 87.99%

In the first study, scientists isolated samples from broncholicosinal irrigation and cultures from nine patients diagnosed with new coronary pneumonia for genetic sequencing and genetic analysis. From these samples, the scientists stitched together eight complete viral genomes, as well as two partially complete viral genomes, and performed a new genetic analysis of 10 genome sequences of the nine patients’ new coronavirus (2019-nCoV) to determine the origin of the virus and the route of transmission.

CDC team's latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

Basic data for 9 patients

The researchers first compared the genetic sequences between them. The results show that the eight complete viral genomes are as high as 99.98 percent, almost identical. In fact, after being questioned by researchers and doctors, of the nine confirmed cases of new coronary pneumonia, eight patients have been to the South China Seafood Market, and another has never been to the South China Seafood Market, but before the concurrency, in a hotel near the market, it is not clear how to contract the virus.

Based on the data and patient narratives, the comparison results show that the source of the virus is consistent regardless of where the new coronary pneumonia originated. And it can be determined that the new coronavirus originated from a source, which is very short and can be detected relatively quickly.

So where do these viruses come from?

The paper says researchers have compared the genetic sequence of the new coronavirus to existing virus escloses, which also include well-known SARS and MERS viruses. The results showed that two isolated viruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, shared 87.99% of the viral gene sequence.

In other words, the closest thing to the complete genome sequence of the new coronavirus is the two viruses isolated by scientists in bats in Zhoushan City, Zhejiang Province, in 2018, with similarities of about 88.

CDC team's latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

New Coronary Virus Host Comparison Chart (Source: Lancet Papers)

In contrast, the sequence strains of the new coronavirus are less similar to SARS and MERS viruses, with similarities of 79% and 50%, respectively. This also confirmed that although the source of the new coronary pneumonia and SARS virus are bats, and have a similar structure, but from the data, the two coronavirus samples are not consistent, that is, the virus of the Wuhan pneumonia outbreak is an unknown, different from SARS coronavirus and MERS coronavirus new coronavirus.

According to the data analysis in the paper, the new coronavirus that caused the outbreak in Wuhan may have been derived from the zhejiang Zhoushan bat and spread to humans through a currently unknown wild animal sold in the South China seafood market. Bat coronavirus is more prone to mutation, so that the source of the new coronavirus is not very good to judge, if more closely related animal viruses found, you can resolve the intermediate host.

In addition, Shi Zhengli’s team at the Wuhan Virus Research Institute of the Chinese Academy of Sciences reported on bioRxiv, an unconsidered academic platform, that a short RdRp region was found in BatCoV RaTG13, a virus detected in bats. This region shows high-sequence homologousness for new coronaviruses, with a genome-wide sequence of homologousness of 96.2%. The system development analysis also showed that RaTG13 is a close relative of the new coronavirus, that is, Shi Zhengli team believes that the bat virus is the source of the new coronavirus.

Two studies provide more evidence of the “bat origin” of the new coronavirus.

CDC team's latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

Wu Guizhen interview with CCTV

“These data are consistent with the bat library commonly used for coronaviruses, and in particular with new coronaviruses. However, while bats are important, it seems that other animal hosts are acting as intermediate hosts between bats and humans. Wu Guizhen explained to the paper.

“First, the outbreak was reported in late December 2019, when most of The Bat species in Wuhan were hibernating. Second, bats are not sold or found in the South China seafood market, and many non-aquatic animals have less than 90% genetic sequence similarity, which means that the South China seafood market is not the first host source, in SARS and MERS, bats are the source, the other animal is the intermediate host, humans are the end-of-life host, This again highlights the hidden virus banks in wild animals and their potential to lurk in mammals. “

At the same time, CCTV Wu Guizhen’s China CDC has successfully developed high-specific PCR testing reagents on the 28th of this month, the first new coronavirus strain information, and launched a new coronavirus vaccine research and development work.

The working hours of vaccine development are also of more concern to the general public. Earlier, Gaofu academician interview with CCTV, said that the (new coronavirus) vaccine can certainly be successful research, the virus has its own development law, research and development of vaccines also have its own laws, not a one-off, the vaccine in the laboratory after the successful development, in order to safety need to do animal experiments, to the population to do clinical experiments, which requires time.

According to Xinhua News Agency, the current use of messenger RNA (mRNA) vaccine technology platform, we can reduce the vaccine development cycle of the new coronavirus to 3.25 months, coupled with the National Health and Reform Commission high-level expert group member Li Lanxuan said, “to get the vaccine strain takes a month and a half, and then a month and a half of the approval process.”

As a result, the Lancet’s study of the new coronavirus host could significantly speed up the trial time of the vaccine. Overall, the vaccine will have to wait until after May of this year to conduct clinical trials in the population.

Analysis of nearly 100 cases of infection: fever and cough are important signs of illness

This week, titanium media reported (“The Lancet” originated or non-South China seafood market, new crown pneumonia added a cloud of doubt), analyzed 41 cases of early confirmed infection in Wuhan, and this time the Lancet published the latest paper, the previous report, through 99 The confirmed cases of new coronavirus infection in humans were studied and analyzed by the laboratory, and the scientific research team expanded the number of case samples, and the clinical characterization of patients became more and more obvious.

The new paper shows that the patients were all confirmed patients who were treated at Jinyintan Hospital in Wuhan between January 1 and January 20 this year. The authors combined clinical records, laboratory results and imaging findings with epidemiological data. It was found that the majority of patients were middle-aged (average age 55.5 years old), male (67 patients), about 49% of patients had a history of exposure to the South China seafood market (49 patients), the majority (46 patients) worked in the South China seafood market, the position as a manager or sales person, compared to last week’s “The Lancet” In the paper, the proportion is about 66%.

CDC team's latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

Screenshot of sample data for 99 patients

In addition, the paper data show that about half of the cases (50 cases) occur in patients with potential chronic diseases including cardiovascular and cerebrovascular disease (40 cases) and diabetes (12 cases), meaning that elderly men with chronic diseases are more susceptible to neo-coronavirus. WHO mentioned several times at last week’s emergency briefing that many of the infections were of underlying diseases, and the results of this study are consistent with this view.

Fever and cough are the most common clinical characteristics of new coronary pneumonia, the paper said. The data showed that all patients admitted to the hospital had pneumonia and that most patients had both lungs infected (74 cases). Most patients also had fever (82 cases), cough (81 cases), shortness of breath (31 cases), and five severe lysers also experienced clinical characteristics such as a combination of bacteria (1 case) and fungal (4 cases).

In the treatment programme, according to the “New Coronary Virus Infection Pneumonia Treatment Programme” (trial fourth edition) issued by the Health and Reform Commission on 27 January, there are currently three types of programmes to assist patients with new coronary pneumonia:

Trial of drug regimens such as alpha-interferon atomized inhalation, Remidiv or Lundisivir (Remdesivir, GS-5734), chloroquine (Sigma-C6628), Lopinavir/Litonavi;

Antibacterial, oxygen therapy, electrolyte balance and other measures, so that patients solve lung problems;

Critically ill patients with respiratory support, hormones, intestinal micro-ecology, plasma, Chinese medicine, AIDS drugs and other treatment methods, so that patients alleviate the disease.

But on the whole, it is necessary to make a medical decision according to the condition, local climate characteristics and different physical conditions.

According to the data of this paper, most patients received antiviral treatment (75 cases), antibiotics (70 cases) and oxygen therapy (75 cases), with a good prognosis. However, 17 patients developed acute respiratory distress syndrome (ARDS), of which 11 died of multiple organ failure. This mortality rate is comparable to SARS infection (10 per cent), but not as severe as MERS infection (35 per cent). Over time, the authors say, there may be new deaths among patients who are hospitalized.

As of 25 January, more than half of the 99 patient samples (57 patients) were still in hospital and nearly one-third (31 patients) had been discharged.

In fact, the range of susceptible populations of new coronary pneumonia is noted in data for the 99 samples currently available, and the paper also points out that the lymphocyte count in most patients has decreased based on laboratory tests. This may be because, after infection, cytokine storms in the body trigger a series of immune responses that cause a change in the number of lymphocytes. These results suggest that the new coronavirus may affect lymphocytes, which may be one of the parameters of clinical diagnosis.

Yesterday, Beijing CDC Deputy Director Pang Xingxing also pointed out that the current new coronal pneumonia susceptibility to the population range, or from the input period to the spread period, the current outbreak is in a transition period, that is, clinically, contact with Wuhan’s local cases gradually increased, spreading power gradually. Earlier, disease control experts Zeng Guang in an interview with CCTV pointed out that SARS can not be used to set the new coronal pneumonia outbreak, the two have a fundamental difference.

The authors also point out that while this is the largest data analysis of its kind, involving 99 confirmed cases of neo-coronary pneumonia, a broader study is needed, including from patients from other cities and countries, to gain a more comprehensive understanding of the new coronavirus.

AI, big data and other information means are fighting the new epidemic

The new coronavirus has spread across species, from bats to wild animals and reinfections to mammals, the third successful cross-species spread in nearly 20 years, after SARS and MERS. It is spreading faster around the world, and although it has been said to be preventable, the number of confirmed cases has increased by thousands per day.

How to control the spread of the epidemic, in addition to everyone through wearing masks, disinfection and other public health means to combat the outbreak, AI, drones, big data and other information technology methods are constantly affecting the development of the epidemic.

As the Lancet paper points out, big data allows relevant departments to deploy and treat more scientifically.

In a CCTV interview on January 28, Academician Li Lanxuan said that she had encountered a patient in Zhejiang, and that I had not been in contact with Wuhan people and had not been to the South China Seafood Market in Wuhan. But through big data analysis, it is concluded that it has been in contact with three Hubei people. Li Lanxuan believes that the use of big data and other information-based means, the spread of the epidemic can be a good explanation.

CDC team's latest paper appears on The Lancet: Virus Source Linked to Zhoushan Bats

A foreign team uses map big data to report on the outbreak of new crown pneumonia

In addition, earlier researchers used AI machine learning Bayesian algorithm to analyze and predict the outbreak and R0 (basic infection) values of the new coronavirus. It is worth mentioning that the R0 value reflects the potential and severity of an infectious disease outbreak, and the higher the value, the more severe the outbreak.

According to WHO data, the initial “basic infection” of the virus, R0, is currently 1.4-2.5 and the infection index is even higher in medical institutions. The university team from the U.S. and the U.K. updated r0 to 3.11, which means that a person infected with an infectious disease would pass the disease to the average number of others without external intervention and withno immunity. Dimitrios Paraskevis, a biologist at the University of Auckland who conducted the experiment, told Titanium Media that the algorithm was not clinically based, but the data were correct.

Some researchers believe that the high number of transmission of this new coronavirus, the virus has experienced at least three to four generations of transmission of the view, but also shows that effective and strict public health measures must be taken to reduce the burden of the spread of the new virus.

Li Lanxuan in an interview with CCTV, the use of AI, big data and other information means, the fastest transfer of information on the outbreak to the hands of users, this is the new crown pneumonia than the advantages of SARS that year. More people believe that these techniques, or become the best booster engine to beat the outbreak of new coronary pneumonia. (This article is published by Titanium Media, author of the Reporting by Lin Zhijia, Editor Zhao Yuhang)