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Continuous challenge to identify and mitigate emerging pathogen risk - Metabiota

MERS-CoV is likely not driven by consumption of camel meat or milk. Picture: iStock

Outbreaks such as Middle East respiratory syndrome coronavirus (MERS-CoV) illustrate continued challenges to epidemic preparedness and the ability to identify and mitigate emerging pathogens, according to Metabiota.

The firm uses real-time data collection and risk analytics for epidemics and secured $30m funding in a Growth Equity round in 2015.

It has co-operations with Munich Reinsurance Company (Munich Re) and the African Union's African Risk Capacity (ARC) agency.

Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (MERS‐CoV) identified in Saudi Arabia in 2012.

Since then, almost 2,000 laboratory-confirmed cases of infection in 27 countries including at least 677 related deaths have been reported to the World Health Organization (WHO).

Approaching risk analytics

Patrick Ayscue, an epidemiologist at Metabiota, said it has a two pronged approach to risk analytics.

“We approach it from the data side so drawing from historic data and contemporaneous monitoring to keep an idea of what is going on in the world, what’s changing, what’s developing and how we can effectively respond to that,” he told FoodQualityNews.

“Obviously there is a lot of uncertainty. We’ve seen some awful events historically due to human and animal diseases but we are all pretty confident that is not necessarily representative of everything that is possible out there.

“To tackle those questions we build out probabilistic models, we work with groups to develop simulations of every person in the world essentially and how they are interacting. Currently our catalogue has 18 million simulations to look at the potential for what could happen if one of these viruses were to emerge or change or take on new properties.”

WHO says consumption of raw or undercooked animal products carries a high risk of infection from a variety of organisms.

Animal products that are processed appropriately through cooking or pasteurization are safe but should also be handled with care to avoid cross contamination with uncooked foods.

Camel meat and milk are nutritious products that can be consumed after pasteurization, cooking, or other heat treatments.

The agency added it expects additional cases will be reported from the Middle East and no vaccine or specific treatment is available. 

Epidemiology difficult ‘to tease out’

Ayscue, who previously worked as the Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Officer for the California Department of Public Health, said the knowledge gaps and lack of vaccine was not uncommon for a virus with so few cases.

“Even though it has been identified for almost five years now we’re dealing with 2,000 observations in the world and for better or worse it takes people a couple of days or weeks to get sick,” he said.

“So we’re not there to observe how that infection took place and, as we’re appreciating more and more, the epidemiology is pretty difficult to tease out. If we have someone who has consumed camel milk they were also probably milking the camel or caring for it when it was sick.”

Ayscue said understanding which action led to infection can be challenging.

“Some of how we go about doing that on the scientific side is conducting different research studies and they are starting to tease some of that out. What we are seeing is that it is likely not driven by consumption of meat or milk but we can’t rule it out entirely,” he said. 

“We appreciate that the risk of infectious and epidemic disease is likely expanding due to global and climatic changes as well as changes in how humans interact with animals and changes in the food production system.

“Food production throughout the world looks quite a bit different than it did 50 years ago and that has meaningful implications for what happens when disease emerges or is introduced into the food production chain.”

Metabiota has also been looking at where a disease can cause an outbreak with avian influenza and African swine fever in Eastern Europe.

“We’ve seen these outbreaks in Poland and Ukraine that have led to the slaughter of whole herds of pigs and disrupted a lot of the food supply chain there. We are currently working to better understand what are the implications of that and where might we expect those effects to expand,” said Ayscue

“Our data monitoring program offers that capability to government or food producers to better understand where the risk is. The user of that data is going to have different interests, for a government health ministry frequently they are interested in the human health aspect.

“But for someone in an agriculture department or a food producer, they are going to be interested in a different set of data. We offer the ability for people to look at the data from different angles and get a view of their own risk and idea of how they can manage that.”

Different regions with different approaches

In Europe, confirmed MERS-CoV cases have been reported from the UK, Germany, France, Italy, Greece and the Netherlands with direct or indirect connection with the Middle East.

However, introduction of camels, their fresh meat and dairy products is regulated.

According to Regulation (EU) No 206/2010 no importation into the EU of any live ungulate (including dromedaries) and their fresh meat is allowed from the Arabic Peninsula.

Imports of dairy products derived from raw camel milk is authorised after adequate heat treatment as stated in Regulation (EU) No 605/2010.

There are inherent differences in preparedness around the world, according to Ayscue.

“It is something we have done analysis on, trying to understand how prepared countries are to both identify a new virus when it emerges and do something about it once it has emerged,” he said. 

“The Metabiota preparedness index compares that preparedness across 20-25 different metrics for every country in the world and you gain an appreciation that we are going to expect things to look differently if they appear somewhere that has a really strong public health and detection system as well as somewhere that has effective mechanisms for communicating their findings.

“For better or worse, that has been one of the limitations with the Kingdom of Saudi Arabia, they have not always been as forthcoming with the data around MERS as we come to anticipate from somewhere like the EU which can lead to barriers in global response to these emerging viruses.”

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