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On 14 August 2024, the World Health Organization (WHO) declared the current situation regarding the mpox virus to be a Public Health Emergency of International Concern (PHEIC). (The original declaration can be consulted at the following address:https://www.who.int/news/item/14-08-2024-who-director-general-declares-… )

Mpox is not a new virus. It has been known to infect humans since the 1970s. It was previously referred to as monkeypox, because monkeys were accidentally infected, and the name was recently changed to ‘mpox’. The natural reservoir of the virus is not monkeys, but rodents endemic to West, Central and East Africa. In these regions, there has been an increase in mpox cases since vaccination against human smallpox ceased in the 1980s, a trend that has worsened since the global epidemic of 2022.

The sharp increase in the number of cases reported in the Democratic Republic of Congo (DRC) and a growing number of previously unaffected neighbouring countries, and the appearance of a new clade of the virus (a new strain that has evolved), called Clade Ib, prompted the declaration of the UPPPI. In 2022, the UPPSI had already been declared when a global epidemic of another clade (IIb) was identified, which mainly affected men who declared having sex with men and/or numerous sexual partners. This epidemic was brought under control by vaccination and public health measures outside endemic areas, but the virus continues to circulate quietly around the world.

There are currently 3 major strains of the virus in circulation:

• Clade Ia in Central Africa 
• Clade Ib: eastern DRC and neighbouring countries (Uganda, Kenya, Burundi and Rwanda)
• Clade II: West Africa and the global epidemic of 2022 (clade IIb)

Several epidemics caused by different strains are underway simultaneously in many countries, with distinct modes of transmission and levels of risk. Uncertainties remain concerning the case-fatality rate, morbidity and transmissibility of the different strains of the virus, given the paucity of existing data on mpox and on the current epidemic in East Africa.

The virus is transmitted by direct contact (e.g. injured skin or mucous membranes) with lesions or secretions from infected people or animals. Transmission occurs mainly by:

• Zoonotic transmission: (in particular Clade Ia)
• Prolonged sexual or non-sexual contact, (mainly Clade Ib and Clade IIb)
• Transmission during pregnancy from mother to child (with significant risk of foetal death).

Current challenges in the region include a lack of access to diagnostic tests, vaccines and treatments. The WHO and other partners are working with countries and manufacturers to address this need and bring the epidemic under control.

The overall risk to the general public is currently considered low by the ECDC for the EU/EEA. It is likely that cases will be diagnosed in Switzerland and Europe over the coming weeks.

Our Centre is actively involved in the diagnostic validation of mpox tests with our partner FIND and as part of our activities as a WHO Collaborating Centre. 

Our reference laboratory, CRIVE, is able to test samples if clinical suspicion arises.

In addition, clinical studies on mpox are currently underway at the HUG.

More information is available on the CMVE website. 

The SNSF's special Investigator Initiated Clinical Trial (IICT) program has chosen to support a multi-center Swiss study on the treatment of influenza in hospitalized patients led by Dr. Pauline Vetter. This randomized trial will evaluate the clinical efficacy of antiviral treatment in hospitalized patients with symptoms evolving for more than 48 hours. Currently, the efficacy of antivirals for these patients is uncertain. Dr. Pauline Vetter's work seeks to establish an international consensus on the delayed administration of antivirals, which could play a key role in managing resources in the event of future pandemics.

For more information, visit SNSF.

Since 1 May 2024, the Centre for Emerging Viral Diseases has been co-directed by Prof. Isabella Eckerle, who takes over from Prof. Laurent Kaiser as Director, and Dr Pauline Vetter, the new Deputy Director.

Press release in French here

In response to the news of the detection of avian influenza (H5N1) in dairy cattle in the USA, an online information event (in German) is being organised to provide interested and concerned members of the public with up-to-date information on the situation and an opportunity for questions and answers. The event is open to all interested parties and is organised by the Multidisciplinary Centre for Infectious Diseases (University of Bern) and the Geneva Centre for Emerging Viral Diseases (University of Geneva and Geneva University Hospitals).

You can register here to take part in the event:

Please find below the report on the situation as of 06.05.2024 of the H5N1 Avian Influenza Epizootic.
Text in French 
Text in German 
Text in English

We are pleased to announce that the Center for Emerging Viral Diseases of the University of Geneva (UNIGE) and the Geneva University Hospitals (HUG), in collaboration with the Swiss Federal Institute of Virology and Immunology (IVI ) and the Vetsuisse Faculty of the University of Bern (UNIBE), have joined the global CoViNet network. This international research network, launched by the World Health Organization(WHO) and operational in 20 countries, aims at the early detection, analysis and surveillance of coronaviruses on a global scale.

CoViNet members met in Geneva on March 26 and 27, 2024 to establish their strategic priorities and coordinate their actions. For more information, please consult the following press releases.

• HUG press release here.
• UNIGE press release here.

Dear colleagues and friends of our Centre,

2023 has been a remarkable year, marked by many achievements in our quest to combat emerging viral threats. 

We invite you to go through the pages of this newsletter, where you will find a compilation of highlights that encapsulate the essence of our Centre's mission and vision. 

We look forward to a future filled with collaboration, discovery and transformative impact. 
Thank you once again for your continued support.

Happy reading.

Click here.

The reference centers and the laboratory of virology of the Geneva University Hospitals provide the diagnosis of common, rare or emerging viral infections, 24/7. Given the ability of viruses to mutate, this work also requires constant monitoring of test performance.

Measles diagnostic relies on viral RNA detection by real-time reverse-transcription-PCR (RT-rPCR), in combination with virus-specific IgM detection. Genetic variability can reduce the sensitivity of a RT-rPCR assay due to primers- and/or probe–template mismatches. Here we describe measles virus variants detected through the Swiss molecular surveillance, which have genetic mutations in the primer annealing site of a commonly employed RT-rPCR.

Article available here .

Report on rapid assessment of SARS-CoV-2 Antigen Rapid Diagnostic Test for Omicron JN.1 and other BA.2.86-derived variants

Report available here.

From 11 to 15 December 2023, Dr Frédérique Jaquerioz Bausch from the Centre for Emerging Viral Diseases will be joining a team of WHO experts in Ndola, Zambia, to provide training in Ebola and Marburg virus disease.Organised jointly by the WHO and the Zambian Ministry of Health, the training will enable some thirty clinicians from the country to familiarise themselves with the clinical management of patients, including treatments, vaccines and infection control measures, in order to provide optimum care and work safely in a treatment centre.

The week will end with a day of simulation in a centre with patient actors.Having trained teams in at-risk countries is crucial to containing epidemic outbreaks quickly and effectively.

We are delighted to welcome Pre Kanta Subbarao, who will be talking about "SARS-CoV-2 biology, antivirals and vaccines". (Conference in English)

Wednesday 6 December 2023 | 11.00 am
CMU - rooms S4/S5 (C02.1538.A), 2nd floor, old building.

Pre Kanta Subbarao is Director of the WHO Collaborating Centre for Influenza and Professor in the Department of Microbiology and Immunology at the University of Melbourne's Peter Doherty Institute. She is a medical scientist whose research focuses on emerging and re-emerging viral diseases of global importance, including pandemic and seasonal influenza and coronaviruses. She is a Fellow of the Australian Academy of Health and Medical Sciences, the American Academy of Microbiology and the Infectious Diseases Society of America.

"Direct dengue virus genome sequencing from antigen NS1 rapid diagnostic tests (RDT: a pragmatic and robust alternative for the genomic surveillance of dengue virus".

In this study, we show the feasibility of sequencing by mNGS dengue virus genomes directly from positive Ag-RDT cassettes stored for more than 4 weeks at room temperature after testing. Our protocol enabled to determine not only the serotypes but also the genotypes. Therefore, such approach should facilitate the genomic surveillance of dengue virus.

Link to article

Please find enclosed the result of the assessment of two different SARS-CoV-2 rapid antigen tests for Omicron EG.5 variants using left-over clinical specimen, performed by the team of the Geneva center for emerging viral diseases.

In brief, the team retrospectively assessed the accuracy of the Abott and the Wondfo rapid antigen tests for their ability to detect Omicron EG.5 sublineages. Both Ag-RDTs demonstrated comparable sensitivity in the detection of the virus. Their performance was consistent with previously examined SARS-CoV-2 variants, performed by us with the same methodology.

The Faculty and Hospital Centres for Vaccinology and Emerging Viral Diseases organised their first joint retreat to strengthen their links and stimulate the many research projects and complementary activities that link these two Centres, including research, clinical activities and high-level expert activities for WHO.

In all, more than 40 researchers, technicians, clinical doctors and project coordinators came together to present their projects and give an overview of existing technical capabilities and infrastructures. Workshops focused on future synergies between the two centres and areas of research.

Through a series of presentations and workshops, the retreat provided an opportunity to forge new links between the teams, foster synergies and collaborations, and highlight the unique skills of the two centres : translational research, optimizing patient care and contributing to public health.

This event, which we hope to hold again in the near future, will bring together a large number of groups from our faculty working in the field of immuno-vaccinology, infections and viral diseases.

On 11.09.2023, the Kerala Health Department fist suspected Nipah Virus in two deceased patients, in which the virus was later confirmed.
As of 17.09.2023, there are 6 cases reported, two of which died, and over 1000 individuals classified as contacts. The outbreak is already the 5th in India, and frequent outbreaks are also known from Bangladesh.

The Nipah virus belongs to the genus of Henipa-Virus of the family of Paramyxoviruses, a large virus family that included many viruses relevant for human and animal health. Nipah ias a zoonotic virus, which has its natural reservoir in flying foxes of the genus Pteropodidae.

The Nipah Virus is not a new virus, but it is already known since over 20 years. It was first identified in 1999 during an outbreak in Malaysia, where the virus was transmitted from infected pigs to humans. The origin of the virus was found to be in fruit bats, which most likely contaminated the pigs’ food. After culling millions of pigs, this outbreak came to a stop.

A second way of transmission is directly from the reservoir hosts, when flying foxes contaminate fruits and other human foods by urine or feces. In particular, date palm sap that is collected during the night was identified as a source of infection, when the bats feed on the same trees and urine or feces ends up in the sap.

Nipah virus infection in humans can cause mild to severe disease, while the latter is usually characterized with encephalitis and a high fatality rate between 40-75%. Human to human transmission can also occur to close contacts, such as within families or in health care facilities, especially when no appropriate PPE is available.

There are not approved drugs nor vaccine available for this disease. In the current outbreak, strict public health measures are implemented to stop the virus from spreading.

So far, no Nipah virus cases have been exported to Europe, neither in this nor in previous outbreaks. Due to the type of risk setting, the rather low transmissibility from person to person and the regional setting of this outbreak, the risk of an imported case to Switzerland or other European countries is very unlikely. Also, spread of Nipah virus in Europe or other regions outside India and Bangladesh is extremely unlikely.

Neither the virus nor the type of bats are endemic in Europe.  Bats that are endemic to Europa, including Switzerland, are not carrier of this virus and there is not risk of this virus outside known endemic areas.

In the unlikely case of a clinical suspicion, our National Reference Centre for Emerging viruses (CRIVE/NAVI) has a diagnostic test available for Nipah-virus (RT-PCR).

Clinicians and laboratories involved in such a suspicion can find all information here:

CDC : Nipah Virus (NiV)
OMS : Nipah virus
ISID : Nipah virus

Pandemic? Preparing today for a better response tomorrow. Pre. Isabella Eckerle - Center for Emerging Viral Diseases (HUG).
Text co-authored by Dr. Frédérique Jacquerioz Bausch, Center for Emerging Viral Diseases (HUG).

Tribune de Genève, Published: 12.07.2023, 08h58, article in Fench.

The World Health Organization (WHO), the University of Geneva (UNIGE) and Geneva University Hospitals (HUG), yesterday formalized the designation of the University Hospital Centre for Emerging Viral Diseases as a WHO collaborating centre for epidemic and pandemic diseases. The latter forms part of the long-standing partnership between HUG, UNIGE and WHO, as reflected by six joint collaborating centres. This follows its extensive work in recent years as a WHO reference laboratory for the diagnosis of COVID-19, as well as for other activities.
 

The 16th International Symposium on Nidoviruses, organised by the Centre for Emerging Viral Diseases, the Institute of Infectious Diseases (IFIK) and the Institute of Virology and Immunology (IVI) of the University of Bern, was held from 14 to 18 May 2023 in Montreux. Over 300 researchers from all over the world exchanged exciting discussions in interesting lectures and poster sessions on the biology of nidoviruses, their interaction with their host, their transmission and new vaccine and drug approaches against this family of viruses. Speakers included Maria van Kerkhove (WHO, Switzerland), Christian Drosten (Charité Hospital, Germany), Ralph Baric (University of North Carolina, USA) and Kanta Subbarao (Doherty Institute, Australia). A special episode of the podcast This week in Virology was recorded there and is available at https://www.microbe.tv/twiv/.

Dr. Frederique Jacquerioz deployed to the field to participate in the response to the Marburg virus disease in Equatorial Guinea, as part of the Center for Emerging Viral Diseases' collaboration with WHO

Members of the Center for Emerging Viral Diseases are regularly deployed to the field to participate in the response to viral hemorrhagic fever outbreaks. This support to clinical management is one of the terms of reference of our action as a WHO Collaborating Centre for Epidemic and Pandemic Diseases. 

Dr. Frédérique Jacquerioz left on Sunday, April 9 for Equatorial Guinea for a one-month mission to support the response to the Marburg virus epidemic. 

To date, 11 people have died since the beginning of the epidemic declared in January 2023, according to the Ministry of Health of Equatorial Guinea.

In addition to the 15 confirmed cases, more than 20 probable cases (people with compatible symptoms and an epidemiological link to confirmed cases) have died before they could be tested and are not included here. 

Since January 2023, 2 outbreaks of Marburg virus disease have been reported in sub-Saharan Africa: one in Equatorial Guinea and the second in Tanzania. This is the first occurrence of Marburg virus fever in these countries.

Marburg virus disease is one of the viral hemorrhagic fevers, like Ebola virus disease. It can cause severe viral hemorrhagic fever in humans, and has a high mortality rate of around 50%. Bats of the species Rousettus aegyptus are considered to be the reservoir of this virus in the wild. The disease is first transmitted from animals to humans, and then human-to-human transmission occurs through direct contact with biological fluids of infected individuals. There is currently no specific validated treatment, but several antivirals and vaccines are under development. More information is available on the WHO website.

Publication: A case of mpox reinfection (CID, 2023) - 4 April 2023

A case of mpox reinfection that raises the question of the effectiveness and duration of immunity against mpox virus after a past infection. To read the full article: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciad147/7076064

Study of the mechanisms of asthmatic exacerbations during rhinovirus and respiratory enterovirus D68 infections - 24 March 2023

A study conducted by Professor Caroline Tapparel-Vu's team has just been published in the journal Frontiers in Microbiology. The aim of the study was to understand better the mechanisms underlying the pathogenesis of asthmatic exacerbations in rhinovirus and respiratory enterovirus D68 (RVs and EV-D68) infections. Using a model mimicking respiratory viral infections in patients, the authors demonstrate increased permissiveness to RVs and EV-D68 in in vitro reconstituted respiratory epithelium from asthmatic donors compared to epithelium from healthy donors, as well as an overall impairment of epithelial cell function. The research group of Prof. Caroline Tapparel-Vu has a long-standing collaboration with the Centre for Emerging Viral Diseases and some of the authors of this paper have now joined the Centre.   
The full article can be found here: https://www.frontiersin.org/articles/10.3389/fmicb.2023.1106945/full

Low transmission risk of avian influenza virus to humans  

The number of avian influenza cases has been increasing since 2020, both in wild birds and in domestic poultry. In 2020-2021, the avian subtype A(H5N8) was dominant. This has been replaced in the current epidemic by the A(H5N1) subtype, and more specifically by a highly pathogenic "version" (HPAI A(H5N1)).  This HPAI A(H5N1) virus has been detected not only in waterfowl, but also in other wild bird species. Cases have also been detected in other animals, including mammals (mink, seals, etc.). The spread of the virus between minks is suspected. It is therefore legitimate to ask whether there is transmission to humans, or even sustained transmission between humans (human-to-human transmission).   

The World Health Organization currently considers the risk of transmission of avian flu to humans to be low. Indeed, human cases remain rare and have exclusively been people in close contact with poultry and other birds infected with the avian flu virus. Moreover, no cases of human-to-human transmission have been reported.  

In human infections, symptoms may appear between 2 and 14 days after infection. Symptoms can vary in severity and are similar to those of human seasonal influenza. If flu-like symptoms appear after exposure to a bird or other animal suspected of being infected with avian influenza, medical attention should be sought as soon as possible.  

Veterinary cases are diagnosed by the Institute of Virology and Immunology (IVI) in Mittelhäusern, and human cases would be diagnosed  by the National Reference Centre for Influenza (CNRI, HUG, Geneva) which has the necessary tests for diagnosing suspected human cases. The antivirals used against human influenza also appear to be active against the currently circulating avian influenza, but no data on their clinical efficacy are available.  

The H5N1 virus is not part of the composition of the seasonal vaccine, so vaccination against seasonal influenza does not confer protection against the H5N1. There are candidates for H5N1 vaccines in humans, but these vaccines are not widely used or available at this stage.  

To minimize the risk of infection, please do not touch sick or dead birds and report their location to the cantonal veterinary service.  

For more information please see the link below:  

https://www.who.int/publications/m/item/assessment-of-risk-associated-with-recent-influenza-a(h5n1)-clade-2.3.4.4b-viruses  

Please find the contacts of the cantonal veterinary services under the following link  

https://www.blv.admin.ch/dam/blv/de/dokumente/import-export/import/adressliste-kantonalen-veterinaeraemter-db.pdf.download.pdf/Adressliste%20der%20kantonalen%20Veterinaeraemter.pdf 

The Geneva Centre for Emerging Viral Diseases has hosted its 3rd Symposium „Covid-19 and beyond: Emerging viral diseases and their public health impact” from Dec 7-9, 2022 at the Campus Biotech.

In 13 sessions and with 32 international speakers, the symposium has covered a range of timely topics in emerging viral diseases such as SARS-CoV-2, Monkeypox, Ebola, and many others.

Latest studies on COVID-19 covered new vaccines and the impact of mucosal immunity, but also protection through infection and hybrid immunity, and the latest overview of circulation Omicron variants. In a session dedicated to poxviruses, the evolutionary history of smallpox, the challenges in smallpox eradication, and the current monkeypox outbreak were discussed. Other topics were modeling and surveillance of infectious diseases by wastewater sequencing, the latest trends in influenza surveillance and the presentation of the newly founded WHO Biohub that is located in Spiez in Switzerland.

A half day was dedicated to a session on science communication, misinformation and the “infodemic”, with talks from international experts from WHO, academia and a journalist writing for “Science”. The session was followed by a panel discussion with Swiss experts “Science, policy & pandemics – Better prepared for the next crisis?”, with panel members Matthias Egger from the SNSF, Volker Thiel from the Vetsuisse Bern, Alexandra Calmy from the HUG, Tanja Stadler from the ETH Zürich and Celine Gardiol from the Federal Office of Public Health, moderated by Laurent Kaiser and Isabella Eckerle.

Challenges in putting existing vaccines and scientific findings into use were covered with talks from Prof Gary Kobinger from the University of Texas and Andrew Azman from MSF Geneva and John Hopkins University. Also, the role of ethics, global responsibility and access in a pandemic were discussed.

Keynote lectures were given by Maria van Kerkhove, WHO, on the current global situation with SARS-CoV-2 and by Emma Hodcroft on the role of genomics in a pandemic, as well as by Prof. Florian Krammer on the future of vaccines against respiratory viruses and by Prof. Johannes Krause on the origin and genetic history from ancient pathogens through genomic sequencing such as plague.

The interdisciplinarity of speakers and the broad range of topics, from virology to clinical medicine to public health and even beyond, has stimulated a lot of discussions and profound exchange between partners, or, as one participant has expressed “what I really liked is the fact that it brings together many disciplines that do not often exchange and allows to discover the emerging viruses under new perspectives“

Over 250 international participants attended the symposium, from academia, international organizations and NGOs such as the CDC, Institute Pasteur, WHO, FIND, MSF, many of which are collaborating partners of our Centre as well as industry partners.

Some feedback that we received:

Thank you for organizing such a great symposium and bringing together a fantastic group of people!

I would like to thank you for organising this great symposium, with excellent speakers, inspiring discussions and a warm and open atmosphere throughout the event and during the breaks! 
It was really great and one of the best symposia I have attended so far! 

Thank you very much for organizing the symposium: It was very interesting and as always, I learned a lot.

The main feature that I like is the fact that it brings together many disciplines that do not often exchange and allows to discover the emerging viruses under new perspectives.

The program, talks and speakers were excellent. 

SAVE THE DATE!

3^nd Symposium of the Geneva Centre for Emerging Viral Disease

Our 3rd symposium of the Centre for Emerging Viral Diseases will be upcoming soon!

December 7-9, 2022

«COVID19 AND BEYOND - UNDERSTANDING EMERGING VIRUSES AND THEIR PUBLIC HEALTH IMPACT»

Please check this link for all details: https://www.unige.ch/emerging-virus-symposium/

The Center for Emerging Viral Diseases is enthusiastic to announce that Dr. Emma B Hodcroft MSc PhD will be sharing her time between the Institute for Social and Preventive Medicine (ISPM) in Bern and the Center for Emerging Viral Diseases in Geneva. Dr. Hodcroft is a specialist in virus evolution, having trained in virology and virus genetics in Edinburgh. In recent years, Dr. Hodcroft has been at the forefront of the genetic and evolutionary analysis of SARS-CoV-2. She is a member of several societies and committees, active in the management of the COVID-19 crisis including advisory activities within the WHO. Her presence in our Center will provide valuable expertise which will be further enhanced through collaborations on the Lake Geneva area, in particular with the Genome Center at Campus Biotech and EPFL.