Human Viruses: Diseases, Treatments and Vaccines: The New Insights

742 Pages·2021·24.896 MB·English

by  Shamim I. Ahmad

Human Viruses:
Diseases, Treatments
and Vaccines
The New Insights
Shamim I. Ahmad
Editor
123
Human Viruses: Diseases, Treatments and Vaccines
Shamim I. Ahmad
Editor
Human Viruses: Diseases,
Treatments and Vaccines
The New Insights
123
Editor
Shamim I.Ahmad
Wollaton,Nottingham, UK
ISBN978-3-030-71164-1 ISBN978-3-030-71165-8 (eBook)
https://doi.org/10.1007/978-3-030-71165-8
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The editor dedicates this book to his late
father and mother, Abdul Nasir and Anjuman
Ara, who played important roles to bring
him to this stage of academic achievements
with their esteemed love, sound care and
sacrifice. Dedication also goes to his wife,
Riasat Jan, for her patience and persistent
encouragement to produce this book, as well
as to their children, Farhin, Mahrin, Tamsin,
Alisha and Arsalan, especially the latter two
for providing great pleasure with their
innocent interruptions, leading to the energy
of the editor to be revitalized. Next, his best
wishes go to the ailing patients, suffering
from various viral diseases especially
COVID-19, for their recovery from the ailing
diseases and the rest of the life to run
smoothly. Finally, his dedication goes to his
loving and caring Professors, Dr. Fumio
Hanaoka continuing his work in Japan, and
Dr. Robert H. Pritchard and Dr. Abe
Eisenstark, who passed away now.
Acknowledgements
The editor cordially acknowledges the authors of various chapters to contribute
their works, employing their in-depth knowledge, high skills and professional
presentations.Withouttheirinput,itwouldnothavebeenpossibletobringoutthis
book on this highly topical and important subject. He would also like to
acknowledge Melissa Morton, Karthikeyan Durairaj, Ritu Chandwani and Leo
Johnson of Springer publication for their hard work, friendly approach, patience
and highly professional handling of this project. Final acknowledgement goes to
myson-in-lawMirAzamAliKhanforhisvaluableassistancewithITthathelpedto
bring this book to the stage of publication. Without this help, it would have been
extremely difficult to publish this work.
vii
—
Viral Pandemics: COVID-19 is Only a Trailer
We Ought Not to Wait for the Whole Film
to Run
An Appeal to World Leaders, Health Officers, Medical Organizations, and,
Corporations, and those trying to manage the fear of pandemics
Past Pandemics and Epidemics
Before November 2019, most people were unaware what a pandemic is or even
what viruses are! But people now, even in the most remote areas of the world, are
awareatleastofthetermsvirusandCOVID-19.Also,althoughtheycannotseethis
germ,theyhavebeenmadeawareoftheconsequencesofinfection,includinghigh
numbersofdeaths;andincertaincases,peopleconsiderittobesomekindofhorror
coming from the sky. The sequel to this horror film is unclear—we neither know
when it will end nor if and when it will come back. Let us look at how the horror
film ran in the past, and what may be expected in any rerun.
Occurrence of pandemics is not new. Indeed, history reports that as far back as
3000BC,pandemicsoccurred,buthereonlythosearementionedwhichoccurredin
the last two millennia: The Black Death: 1346–1353; Cocoliztli epidemics: 1545–
1548; 16th Century American Plague; The Great Plague of London: 1665–1666;
The Great Plague of Marseille: 1720–1723; The Russian Plague: 1770–1772;
Philadelphia Yellow Fever Epidemic of 1793; Russian Flu Pandemic, 1889–1890;
Spanish Flu of 1918–1920; and Asian Flu of 1957–1958.
Pandemics and Epidemics Which Continue Sporadically:
Dengue virus originated 800 years back, Measles virus may have been originated
aroundeleventhtotwelfthcentury,AmericanPolioepidemicin1916,H1N1Swine
flu pandemic in 2009, the Avian Flu in 2018, West African Ebola pandemic in
1976,Chikungunyavirusin2006,ZikavirusepidemicofSouthEastAsiain2015,
Crimean-Congo hemorrhagic fever virus in 2017, AIDS pandemic in 1981, and
SARS and MERS in 2003 and 2012, respectively, and now SARS-CoV-2.
ix
x ViralPandemics:COVID-19…
Sporadic human viruses lurking around: Please see Appendix
Zoonotic Viruses and Their Reservoirs:
Zoonotic viruses are those organisms which mostly reside in vertebrate animals,
birds,batsandinsectsastheirreservoirsandthencanjumptohumans.Thediseases
they cause are called zoonoses.
A PubMed search (27 January 2021) for zoonotic viruses showed that there are
8329 research papers on this subject and highlighted the presence of 224 human
viruses and their associated traits. Out of a number of reservoirs of human viruses
reported, the most common primary viral hosts are humans, ducks, geese, and
shorebirds, bats, pigs, dogs, seals, horses and mosquitoes. Other reservoirs
regionally found are bamboo bats, Belgian hedgehogs, rhesus monkey, honey and
bumblebees,dromedarycamel(MERS),palmcivets,smallandbigcats,minksand
ferrets.
Current Crises with SARS-CoV-2 and Its Variants:
In early 2021 when the SARS-CoV-2 pandemic was slowly and steadily coming
under control, it was recorded that three significant variants of this virus have
emerged causing additional issues around the control of the pandemic. These
specific variants are more contagious and more virulent than the Wuhan strains.
These variants have emerged due to new mutations in their genomes. Questions
have been raised as to whether the vaccines currently in use can also confer pro-
tection against these variants. It has been seen for some other viral infections that
highratesofmutagenesis,givingrisetoalargenumberofvariants,makeitdifficult
to produce vaccines which can control all the different strains, e.g. avian viruses
of the H1N1 series cause influenza at regular intervals (for details of viral varia-
tions, see chapter “SARS-CoV-2 Mutations: An Insight” of this book).
Consequences of the COVID-19 Pandemic:
ItwasJanuary2021whenthefinalmaterialforthisbookwasgoingtopressandthe
world is still going through the global calamity of COVID-19, which started in
December 2019. The whole world is now experiencing very high numbers of
infectionsanddeaths.Turmoilincludeseconomicdamageduetoalargenumberof
factories, industries and shops closing, leading to increased unemployment and
reductions in industrial productivity and agriculture. Other human sufferings
include increased depression and mental health issues and increased domestic
violence. More worryingly, it is not known how long this will last and how many
morehumanliveswillperish.Thepredictionisthatevenwhenthecurrentwaveof
infections is over, the virus may re-appear either in other mutated forms or by
finding another suitable environment/host.
Soon after the discovery of COVID-19, strenuous searches started to find
effective treatments, and hundreds of antiviral and other putative drugs, including
Chinese herbal medicines, were tested. As far as my searches have found, no
proveneffectivetherapiesforthisviruscurrentlyexist.Somedrugshavebeenused
in clinical trials, but there is no satisfactory data showing that these drugs, either
aloneorincombination,areeffective.Dexamethasone,whichreducesmortalityby
ViralPandemics:COVID-19… xi
25%inseverecases,hasbeeninuseasananti-inflammatorydrug.Otherdrugswith
limited success may be remdesivir, tocilizumab, chloroquine phosphate, hydroxy-
chloroquinesulphateandmonoclonalantibodies.Fromthestartofthepandemic,a
numberof companies anduniversities entered into therace toproduce avarietyof
vaccines, and today a number of companies in different countries including the
USA, the UK, Germany, France, India, Russia and China have produced and
released vaccines with the hope that they will control infections and the resulting
disease (for further details, please see chapter “Treatment of COVID-19 by
Combination Therapy with 5-fluorouracil, Ribonucleosides and Ribavirin—A
Modified Strategy” of this book).
Reasons for Rapid Global Spread of Pathogenic Viruses:
The present SARS-CoV-2, causing COVID-19, started in Wuhan, China. The
speculationisthatinWuhan,thevirusmayhavespreadfrombatsorotherlivestock
being sold in market places and infected humans. Subsequently, the virus rapidly
spread to other cities in China and to neighbouring countries such as South Korea
and Japan. Then fairly rapidly, it spread to almost 160 counties in the world.
Spreading of the virus can be imagined to have occurred from infected persons
travelling from China to other countries and within the country by travelling from
onecitytoanother.Spreadingofthevirusisexponential,whichinitssimplestform
meansonepersoninfectingasecondpersonandthe2ofthemtoafurther2making
4 and then 8 making 16 and then 32 and on and on. Imagine when it reaches say
50,000,thenextinfectionis100,000.Itisnotdifficulttoimaginethattheinfection
of oneperson after 20 rounds of infection canreach overa millionpeople. Infact,
thenaturalinfectionrateforSars-CoV-2isaround3,makingthespreadevenfaster.
Themainreasonfortheviralspreadisphysicalperson-to-personcontact:either
withinfamiliesorviainterfamilycontacts.Ithasbecomeapparentthataswithother
diseases, transmission can occur through contact between an asymptomatic person
(unknowingly carrying the infection) and a healthy person.
By March 2020, guidance was issued by governments to people to use face
masks,keepadistanceofatleast2metersbetweenindividuals,andtowashhands
more regularly and thoroughly especially when entering home from outside trips.
Unfortunately, the guidance has not been taken, by some, as seriously as required,
resulting in a limited downturn in the number of infections. Hence, more stringent
actions have been taken including the closure of non-essentials shops, restaurants
etc. and the requirement that people stay home as much as possible.
FactsAboutHumanVirusesAffectingOurLife,UnknownorBarelyKnownto
People
Virusesliveallaroundus,intheair,attachedtolivingandnon-livingthings,being
viableoutofhostsforshortorlongtimes,andcanenterlivingbodies.Inthebody,
virusesentercellsandproducetheirprogenyandthenreleasethemfromthecellto
invade other healthy cells. If this process continues especially when the immune
system is compromised, it can be lethal. Another important feature of human
viruses is that almost all are zoonotic; they can live stably inside their reservoir
hostswithoutcausingdiseases.Butattimes,theirgenomeschangebymutationand
xii ViralPandemics:COVID-19…
when they enter into humans, they can cause catastrophic results. It is also con-
sideredthatmanymoreviruseshaveevolvedovermillionsofyears,andsomemay
surfaceasandwhentheygettheopportunity.RecentexamplesareAvianinfluenza,
Ebola, Dengue, AID, Zika and Chikungunya viruses. Viral impact is highly vari-
able in that it can range from asymptomatic up to lethal.
Vaccines are Used Prophylactically to Prevent Disease Rather Than Treat it:
Thefactisvaccinesarenotforuseinthetreatmentofestablisheddiseases.Theyare
given to the general public to safeguard themselves by activating the immune
system:vaccinecomponentsactingasantigens.Vaccinesarepreparedinanumber
ofdifferentways:asattenuatedwholevirus,inactivatedvirusorengineeredviruses.
Thethirdmethodisprevailingnowwhichinvolvestheuseofviralgeneticmaterial:
specific sequences of DNA or RNA are used, which drive the production of the
specificproteinwhichactsastheantigen(suchastherecentuseofthespikeprotein
ofSARS-CoV-2).Toprotectthesequencefromdegenerationandprovideefficient
packaging,thesequencerequiresavehicle.Avehicledevelopedforthispurposeis
thelipidnanoparticle.Thisnanoformulationenablesthesafedeliveryofthegenetic
material, biodistribution, intracellular localization and release. The antigen induces
the immune system, which incapacitates the invading live viruses (for more about
vaccines,pleaseseechapter“GlobalPolioEradication:ProgressandChallenges”of
this book).
Difficulties in Generating the Antiviral Drugs:
Although a large number of antiviral drugs have either been isolated from natural
sourcesorsynthesizedinlaboratories,onlyahandfulofthemhavebeenfoundtobe
effectiveonCOVID-19.Incontrasttoantibioticswhicharecommonlyavailableto
killbacterialinfections,thereareonlyahandfulofantiviralagentsavailablewhich
can be used to treat more than one virus. One reason for this failure is that unlike
other microbial infections, in which the infective agent can live and grow outside
the cells in the body and hence their drugs can find the targets more easily, most
viruseslivesilentlyinsidehostcells.Thismeansthattosenddrugstothetargets,it
is important that the drugs be produced which can easily enter the cell without
harmingit which isnot that easy, or only treat thesymptomsrather than the cause
of infection.