EID-SEARCH

In June 2020, together with our partners in Malaysia, Conservation Medicine and EcoHealth Alliance started the Emerging Infectious Diseases – South East Asia Research Collaboration Hub.

There is substantial evidence that diverse coronaviruses, henipaviruses and filoviruses related to known human pathogens are circulating in wildlife reservoirs in South East Asia. There is growing evidence that these viruses spillover regularly to people, are often unreported or misdiagnosed, and their clinical manifestations and potential to cause pandemics are unknown and underestimated. Our ongoing strategy for targeted surveillance in wildlife and livestock and the detection of spillover and illness in high-risk human populations can be used as an ‘early warning system’ to conduct public health interventions and disrupt disease emergence. EID-SEARCH (the Emerging Infectious Diseases – South East Asia Research Collaboration Hub), will scale-up this approach to better understand, and respond to, the risk of zoonotic viral emergence in South East Asia.

Field work began in September 2020; archived and newly collected wildlife samples are being screened for known and novel viruses using molecular and serological techniques. Spatial and phylogeographic analyses will allow us to identify high-risk locations and species of wildlife to test samples from, and will help further characterise new viruses we find and those recently discovered through PREDICT and other projects to determine their potential for spillover into high-risk human populations.

We will continue to engage with the Orang Asli communities we have been working with, and identify new communities in Sabah and Sarawak, to conduct targeted cross-sectional serological surveys of human communities with high levels of animal contact to find evidence of viral spillover, and identify occupational and other risk factors for zoonotic virus transmission. Serological tests targeting coronaviruses, henipaviruses and filoviruses will allow us to identify the baseline spillover of viruses from these viral families into these populations. Serological findings will be analysed to identify zoonotic risk factors and routes of exposure from specific wildlife or vector species. Working with these communities will also provide an opportunity to continue education and outreach about zoonoses, the One Health concept, and the risks posed by contact with wildlife and how to minimize these risks, such as not touching dead wildlife.

The syndromic surveillance started in Sabah through PREDICT will be expanded to new clinical human cohorts across Malaysia to identify evidence of viral aetiology for otherwise ‘cryptic’ outbreaks. Patients from high-risk communities for disease emergence, who present at clinics and hospitals with syndromes previously linked to known viral agents or that cannot be diagnosed, will be enrolled and sampled. We will conduct molecular and follow-up serological diagnostic assays to identify evidence of virus outbreaks not being detected by normative diagnostics. Where viruses are identified, we will attempt to further characterise them, and identify likely reservoir hosts which will help inform intervention programs.