Virus World

Hong Kong issued a major health alert as a man battles for his life in intensive care after contracting a deadly form of herpes from monkeys. A concerning health alert has been issued in Hong Kong as a 37-year-old man fights for his life in intensive care after contracting a deadly form of herpes from monkeys. The man's condition has prompted health officials to caution against interactions with wild macaques, urging the public to exercise caution. The victim sustained injuries from wild macaques in February during a visit to Kam Shan Country Park, colloquially known as 'Monkey Hill'. Initially admitted to the hospital with a fever on March 21, his condition deteriorated rapidly, leading to a transfer to the intensive care unit (ICU) where he remains in critical condition.

Health authorities confirmed the man's ailment as herpes B virus, also known as herpes simiae, a disease commonly found in macaques. While this virus typically manifests as mild symptoms or remains asymptomatic in monkeys, it poses severe risks to humans, potentially leading to life-threatening complications. Symptoms of the virus in humans can escalate from fever to respiratory issues, nausea, neurological impairments such as numbness or coordination problems, and in severe cases, irreversible brain damage or fatality. Despite being first discovered in 1932, human cases remain rare, with approximately 50 recorded instances and 21 fatalities globally. Dr. Wilson Lam, president of the Hong Kong Society of Infectious Diseases, highlighted the seriousness of the situation saying: "We don’t know the virus very well, but based on the limited data, if humans are in contact with the virus, there’s a high chance of infection. It can have serious health consequences that affect the spinal nerves and central nervous system." The incident marks the first recorded case of human infection with the B virus in Hong Kong, despite the prevalence of macaques in the region. Health officials urged residents and visitors to refrain from touching or feeding wild monkeys to prevent potential transmission of the virus. As investigations continue, authorities stressed the importance of public cooperation in preventing the spread of this potentially lethal virus.

Hong Kong reported 12,631 confirmed COVID-19 cases and 213 deaths in the first two years of the pandemic but experienced a major wave predominantly of Omicron BA.2.2 in early 2022 with over 1.1 million reported SARS-CoV-2 infections and more than 7900 deaths. Our data indicated a shorter incubation period, serial interval, and generation time of infections with Omicron than other SARS-CoV-2 variants. Omicron BA.2.2 cases without a complete primary vaccination series appeared to face a similar fatality risk to those infected in earlier waves with the ancestral strain.

Preprint available (April 14, 2022):

https://doi.org/10.1101/2022.04.07.22273595  

SARS-CoV-2 emerged in Wuhan in December 2019 and caused the pandemic respiratory disease, COVID-191,2. In 2003, the closely related SARS-CoV had been detected in domestic cats and a dog3. However, little is known about the susceptibility of domestic pet mammals to SARS-CoV-2.

Two out of fifteen dogs from households with confirmed human cases of COVID-19 in Hong Kong SAR were found to be infected using quantitative RT–PCR, serology, sequencing the viral genome, and in one dog, virus isolation. SARS-CoV-2 RNA was detected in a 17-year-old neutered male Pomeranian from five nasal swabs collected over a 13-day period. A 2.5-year-old male German Shepherd dog had SARS CoV-2 RNA on two occasions and virus was isolated from nasal and oral swabs.

Both dogs had antibody responses detected using plaque reduction neutralization assays. Viral genetic sequences of viruses from the two dogs were identical to the virus detected in the respective human cases. The animals remained asymptomatic during quarantine. The evidence suggests that these are instances of human-to-animal transmission of SARS-CoV-2. It is unclear whether infected dogs can transmit the virus to other animals or back to humans.

Published in Nature (May 14, 2020):

https://doi.org/10.1038/s41586-020-2334-5

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The city kept the pandemic at bay for two years. Why didn’t it take measures that would help in an inevitable outbreak—like an all-out campaign to vaccinate the elderly? Around 8 p.m. one evening in late February, an elderly man in a Hong Kong nursing home began struggling to breathe. He wasn’t the only one who was ill. An unprecedented outbreak of Covid-19 was gathering pace, and roughly half of the facility’s 100 residents had already tested positive for the virus. Less than a third were fully vaccinated; even fewer had received a booster dose. Isolating the infected was impossible. Like most dwellings in the city of 7.4 million, the nursing home was cramped. Instead of a private room, each resident’s dedicated space was only big enough for a 2½-foot-wide bed, separated from neighbors by thin wooden dividers. As the man’s condition worsened, staff called an emergency hotline for help. According to Cheng Ching-fat, the secretary-general of a union representing nursing-home workers, they waited more than 10 hours before an ambulance arrived to bring the man to a hospital. He died on the way, one of more than 4,000 Hong Kongers age 80 and older who’ve succumbed to the virus in the past few months. More than two years after Covid began spreading around the globe, Hong Kong is experiencing one of the deadliest outbreaks of the entire pandemic. It began early this year, when the omicron variant breached the Chinese territory’s ferocious quarantine system for inbound travelers, which had previously kept cases almost at zero. Soon it became clear that the authorities had done little to prepare for the possibility that the travel restrictions wouldn’t be enough. Within weeks, parts of the health-care system had effectively collapsed, and since January there have been about 5,600 fatalities. Although there are tentative signs that the worst may be over, right now more people are dying from Covid in Hong Kong, relative to population, than anywhere else in the world. For some, the situation has engendered a sort of dazed shock. How could a wealthy, sophisticated city, with a top-notch health-care system and ample time to learn from experiences elsewhere, get its response so wrong? “During the past two years the government has done nothing,” Cheng says. “It seems like it’s never come across to them that Hong Kong may face a serious outbreak.”

Hong Kong’s situation is the product of several specific policy failures, which stem partly from Beijing’s decision to take greater control of the financial hub after 2019’s pro-democracy protests. Above all, the city’s government utterly failed at vaccinating older adults, botching public-education campaigns and allowing misinformation about the shots to run rampant among those residents. As of March 18 just 37% of people 80 and older had received at least two doses, mostly of the Chinese-made Sinovac vaccine—perhaps the lowest rate in the developed world. Other missteps resulted from the doctrinaire application of China’s Covid-zero strategy, a suite of policies designed to stamp out every outbreak the moment it’s detected. Aggressive contact tracing and mandatory hospitalization of infected people, regardless of symptoms, worked well enough with daily case counts in the single digits, but they became useless as omicron raced through densely packed high-rises. Under pressure from China’s central government, Hong Kong officials stuck to them anyway, forcing people into daylong waits for compulsory testing and dedicating precious hospital beds to patients who could have easily stayed at home. The authorities maintained, and in some cases deepened, Hong Kong’s international isolation, completely banning flights from “high-risk” countries such as the U.S. and the U.K., as though the virus was still something that could be kept out.  Hong Kong’s situation is the product of several specific policy failures, which stem partly from Beijing’s decision to take greater control of the financial hub after 2019’s pro-democracy protests. Above all, the city’s government utterly failed at vaccinating older adults, botching public-education campaigns and allowing misinformation about the shots to run rampant among those residents. As of March 18 just 37% of people 80 and older had received at least two doses, mostly of the Chinese-made Sinovac vaccine—perhaps the lowest rate in the developed world. Other missteps resulted from the doctrinaire application of China’s Covid-zero strategy, a suite of policies designed to stamp out every outbreak the moment it’s detected. Aggressive contact tracing and mandatory hospitalization of infected people, regardless of symptoms, worked well enough with daily case counts in the single digits, but they became useless as omicron raced through densely packed high-rises. Under pressure from China’s central government, Hong Kong officials stuck to them anyway, forcing people into daylong waits for compulsory testing and dedicating precious hospital beds to patients who could have easily stayed at home. The authorities maintained, and in some cases deepened, Hong Kong’s international isolation, completely banning flights from “high-risk” countries such as the U.S. and the U.K., as though the virus was still something that could be kept out.

The most significant implications, however, could be felt in the rest of China, where authorities are rushing to contain the largest surge of infections since the 2020 outbreak in Wuhan. “What is happening in Hong Kong seems to vindicate their worst fears of what would happen if China were to open,” says Yanzhong Huang, a senior fellow at the Council on Foreign Relations and an expert on the Chinese health system. Outside of large cities, mainland facilities are rudimentary, and in a large outbreak, “you’re going to see hospitals quickly inundated with people seeking care. And it’s very possible the health-care system could be overwhelmed, which could lead to panic that would threaten political stability.” Until early this year, the total number of Covid deaths in Hong Kong stood near 200—about one-fifth of the current daily total in the U.S. This remarkable record was essentially the result of a single policy, implemented consistently and remorselessly: putting everyone who wanted to enter from abroad in quarantine in a hotel room for up to 21 days. It hardly mattered that, with mandatory PCR tests before departure and again on arrival at Hong Kong International Airport, almost no one who made it as far as checking into their isolation room actually tested positive. The point was to eliminate even the tiniest risk that the virus could enter, regardless of the consequences to the economy. On the rare occasions that an infected person slipped through, contact tracers swung into action, ordering everyone they’d been in contact with to Penny’s Bay, a spartan dormitory complex on an outlying island. Sometimes all it took to be sent there was having dined at the same restaurant as a positive case. But as long as a Hong Konger didn’t travel and avoided being swept up in a contact tracing dragnet, daily life retained a reassuring normalcy, with eateries, offices, and beaches still open and busy, even as cities in the U.S. and Europe swung in and out of sweeping social distancing campaigns......

People who recover after being infected with the novel coronavirus can still be left with substantially weakened lung capacity, with some left gasping for air when walking quickly, doctors in Hong Kong have found. The Hong Kong Hospital Authority made the findings after studying the first wave of patients who were discharged from the hospital and had fully recovered from COVID-19.

Out of 12 people in the group, two to three saw changes in their lung capacity. "They gasp if they walk a bit more quickly," Owen Tsang Tak-yin, the medical director of the authority's Infectious Disease Centre, told a press conference Thursday, according to the South China Morning Post. "Some patients might have around a drop of 20 to 30% in lung function" after full recovery, he said. Tsang added, however, that patients can do cardiovascular exercises, like swimming, the improve their lung capacity over time.

While it's too early to establish long-term effects of the disease, scans of nine patients' lungs also "found patterns similar to frosted glass in all of them, suggesting there was organ damage," Tsang said, according to the Post.