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S&P Market Intelligence — 21 Jan, 2020

CDC reports 1st US case of Chinese virus; NIH working with Moderna on vaccine

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By Donna Young

The Centers for Disease Control and Prevention confirmed the first U.S. case of a novel coronavirus that is rapidly spreading through China, infecting about 300 people and killing at least six people.

A man in his 30s, who had traveled to Seattle from Wuhan, China — the center of the outbreak — contacted his healthcare providers Jan. 19. It was confirmed a day later through a new CDC diagnostic test that he had the 2019 novel coronavirus, or 2019-nCoV.

The U.S. is the sixth nation to report at least one case of 2019-nCoV. Thailand, Japan, South Korea and Taiwan have all reported cases, in addition to China, according to the World Health Organization.

The U.S. patient is hospitalized in isolation at Providence Regional Medical Center in Everett, Wash., out of an abundance of caution and not because of severe illness, health officials told reporters during a Jan. 21 briefing. The patient is being given supportive care and is in good condition, they said.

CDC and Washington state health officials are now trying to track down people the infected man had come into contact with since arriving in the U.S. The man did not show any symptoms of 2019-nCoV when he first arrived in Seattle on Jan. 15, according to the officials.

The CDC started screening travelers arriving from Wuhan on Jan. 17 at three U.S. international airports in New York, San Francisco and Los Angeles.

So far, 1,200 travelers have been screened at those three airports, with none being sent to the hospital for a secondary screening, Nancy Messonnier, director of the CDC's National Center for Immunization and Respiratory Diseases, told reporters Jan. 21.

Messonnier had warned during a Jan. 17 call with reporters that it was "highly possible there will be a case" of the 2019-nCoV virus that eventually emerged in the U.S.

The health officials emphasized that the chances of the disease spreading in the U.S. remain low.

Nonetheless, the CDC is now starting screenings at Chicago O'Hare International Airport and Hartsfield-Jackson Atlanta International Airport and has raised its risk level, Messonnier said.

The agency is not conducting any screenings at the Seattle-Tacoma International Airport, or Sea–Tac, for the time being, she said.

Even if the CDC had been actively screening at Sea-Tac, the man infected with 2019-nCoV would not have been detected because he had no symptoms, Washington Health Secretary John Wiesman told reporters.

Human-to-human transmission

The U.S. patient reported that he did not visit the Wuhan markets implicated in the initial cases of the 2019-nCoV outbreak and did not know anyone who was ill with the virus, officials said.

While the virus was originally thought to be spreading from animal-to-person, U.S. and global health officials are now saying there are growing indications that person-to-person spread is occurring, though it remains unclear how easily 2019-nCoV is being transmitted among humans, officials said.

The 35-year-old woman diagnosed with the virus in South Korea also did not visit any of the Wuhan markets, nor did she have any contact with anyone known to have a confirmed case of 2019-nCoV, the WHO reported Jan. 21.

Information about the latest infections "suggests there may now be sustained human-to-human transmission," WHO's Western Pacific office tweeted Jan. 20.

"But more information and analysis are needed on this new virus to understand the full extent of human-to-human transmission and other important details," the WHO office said.

Illnesses from coronaviruses can range from cold-like symptoms to deadly diseases, such as severe acute respiratory syndrome, or SARS, or the Middle East respiratory syndrome, or MERS.

During a 2003 outbreak of SARS, nearly 800 people died. MERS has killed over 400 people since 2012.

All six of the reported deaths so far from 2019-nCoV were in Wuhan, where most of the infections have occurred, according to the WHO.

WHO Director-General Tedros Adhanom Ghebreyesus plans to convene an emergency committee on Jan. 22 to determine if a public health emergency of international concern should be declared.

Vaccine development

Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said his agency is partnering with Moderna Inc. to develop a vaccine against the 2019-nCoV.

"We anticipate that unless we get in any landmines or unforeseen obstacles, that we will likely have material available to do an early phase 1 study in about three months," Fauci told S&P Global Market Intelligence.

Securing an industry partner this quickly was an unusual move by the agency, which is part of the U.S. National Institutes of Health.

But Fauci noted that the NIH has had a long-standing relationship with Moderna on other vaccines using the company's messenger RNA platform technology.

Messenger RNA, or mRNA, plays a fundamental role in human biology, transferring the instructions stored in DNA to make the proteins required in every living cell, according to Moderna.

While Moderna is helping to cover some of the costs of the phase 1 trial, the NIH will be funding the bulk of the study, Fauci said.

He said the agency currently has the funding necessary for the phase 1 trial, "but if we have to go beyond that in a larger trial, we would need more funds."

Fauci noted that the NIH had developed a SARS vaccine, getting it into phase 1 testing. But after that virus dissipated, there was no industry interest in taking it further into development.

The work on both the SARS and 2019-nCoV vaccines will aid the NIH's research if it eventually pursues a coronavirus universal vaccine, Fauci acknowledged.

"Theoretically, we are always looking for developing universal vaccines for entire families of viruses," he said. "Getting a universal vaccine for an entire family of viruses is a difficult, not impossible, process."

"Since we've had three viruses that have now caused serious illnesses in humans, it's not unreasonable to think in terms of a universal coronavirus vaccine," he added.

But Fauci emphasized the NIH and Moderna are strictly focused for the time being on a specific vaccine against the 2019-nCoV virus.