New Drugs, Vaccines Continue to Advance in the Global Fight Against MERS-CoV: Public Health Watch

A recent survey by Research!America and the American Society of Microbiology has revealed that a stunning 95% of Americans believe that “infectious and emerging diseases” in other countries will pose a threat to the United States in the near future.

Although Middle East respiratory syndrome coronavirus (MERS-CoV) was not mentioned in the survey, it’s likely that the infectious disease would be among the most fearsome—simply due to the stark data to date. Since MERS-CoV was first identified in 2012, the World Health Organization (WHO) has recorded 2206 laboratory-confirmed cases and 787 deaths attributed to the virus. Indeed, through the end of April this year, MERS-CoV has been reported in 27 countries worldwide—although the virus’ inherent characteristics likely mean the risk for an outbreak in the United States remains low.

“The risk has not changed,” Stanley Perlman, MD, PhD, professor, departments of microbiology and immunology, and pediatrics, University of Iowa, told Contagion^®. Dr. Perlman has written about MERS-CoV and other coronaviruses in the past.

“It is spread primarily from camels in the community and within hospitals in Saudi Arabia when cases are not recognized,” he continued. “Human-to-human spread occurs but is inefficient. There is no evidence that the virus is adapting to humans to enhance virulence or transmission. In the absence of virus adaptation, I think that the likelihood of it causing significant disease in the United States is low.”

Still, for those in areas where MERS-CoV remains a legitimate threat, there is some good news to report: On May 18th, the National Institute of Allergy and Infectious Diseases (NIAID) announced that enrollment has begun for an early-stage clinical trial testing the safety of 2 human monoclonal antibodies—REGN3048 and REGN3051—designed to treat the virus. The NIAID- and Biomedical Advanced Research and Development Authority-funded trial will be the first to test the novel treatments in humans.

Developed by researchers at Regeneron and tested in mouse models at the University of Maryland, REGN3048 and REGN3051 are the first antibodies that have shown the ability to neutralize MERS-CoV. The new trial testing the antibodies in humans will enroll 48 healthy adults between 18 and 45 years of age at WCCT Global, a clinic in Cypress, California.

Participants will be divided into 6 groups of 8, with 2 people in each group receiving an inactive placebo and the remaining 6 receiving both monoclonal antibodies, administered intravenously, at the lowest dose (1.5 mg/kg), according to NIAID. The agency added that participants in successive cohorts will receive increasing dosages until the highest dosage (75 mg/kg) is reached in the sixth group.

“Currently, we lack specific treatments for MERS,” NIAID Director Anthony S. Fauci, MD, said in a statement released with the announcement of the trial. “Having targeted therapeutics available to treat this unpredictable and frequently fatal respiratory disease would help us reduce MERS-associated deaths and control future outbreaks.”

“These antibodies… would be useful for treating health care workers in the event of a major outbreak but, in fact, appropriate precautionary measures are equally [effective],” added Dr. Perlman. One possible preventive measure being discussed, he continued, is vaccination of camel populations in the Middle East (the virus originated in camels); however, such a vaccine may be years away, according to recent reports.

Thankfully, though, the monoclonal antibodies are not the only anti-MERS-CoV product in development. Indeed, the Coalition for Epidemic Preparedness Innovation (CEPI) recently announced plans to provide Inovia Pharmaceuticals with $56 million in funding, which will be used in part to finance trials of the company’s DNA-based vaccine for MERS-CoV. In a statement released with the announcement, CEPI CEO Richard Hatchett said: “Epidemics don’t respect borders; they destroy lives and devastate economies and we need to move swiftly to prepare for them. Partnering with Inovio is a considerable move forward for CEPI’s vaccine portfolio and developing a global insurance policy against these diseases.”

And so, while the dangers associated with MERS-CoV are not likely to reach these shores, those who do face the perils of the deadly virus have some hope—albeit some time off in the future.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous health care-related publications. He is the former editor of Infectious Disease Special Edition.