Chair Professor of Virology
The University of Hong Kong
AsianScientist (Aug. 28, 2018) – Being on the frontlines of a life-threatening epidemic is not something that doctors wish upon themselves. But that was exactly where Professor Malik Peiris found himself in 2003 when severe acute respiratory syndrome (SARS) broke out. Making matters worse was the fact that the pathogen causing SARS was unknown, making it difficult to contain and control infections.
Undaunted by the challenge, Peiris, who was then leading the diagnostic virology lab he founded in 1995 at the Queen Mary Hospital in Hong Kong, mobilized resources to identify and characterize the SARS coronavirus. With his colleagues and collaborators, Peiris was able to optimize methods to grow and isolate the virus in vitro, as well as use electron microscopy to obtain the virus’ morphology—critical steps in the development of a diagnostic tool for SARS.
Today, Peiris is the Tam Wah-Ching Professor in Medical Science and Chair Professor of Virology at the University of Hong Kong, where he continues to study viruses that cause influenza and the Middle East Respiratory Syndrome (MERS). By understanding how human-to-human transmission of these viruses occurs, he hopes to devise interventions that could prevent future outbreaks and perhaps lead to therapies that reduce mortality from these infectious diseases.
For his outstanding research, Peiris was inducted into the French Legion of Honor in 2017, and in 2018 was recognized by Nature as one of ten ‘Science stars of East Asia’.
- Who or what inspired you to become a clinician-scientist with an interest in virology?
As a high school boy in Sri Lanka, I was inspired to pursue microbiology and infectious disease after reading a book on the life of Louis Pasteur. I found his life story to be inspiring. From that time, I wanted to go into research and to investigate microbes.
I graduated from a medical school in Sri Lanka [University of Peradeniya] and joined the academic staff in the department of microbiology there. I was subsequently awarded a Commonwealth Scholarship to do my PhD in virology at the University of Oxford.
- Could you please tell us about your role in the discovery of the SARS coronavirus in 2003?
At that time, I was responsible for the diagnostic virology laboratory at the Queen Mary Hospital in Hong Kong. We first heard of an outbreak of severe pneumonia in Guangzhou in mid-February 2003. Since it was likely that such an outbreak would spill over to Hong Kong, I worked with colleagues at the Hospital Authority of Hong Kong to set up intensive investigation of all patients with severe pneumonia in Hong Kong.
Of course, severe pneumonia is not uncommon, and there were many patients that needed to be investigated in detail by testing for known pathogens as well as for unusual ones. During this time, I also thought of unusual viruses such as hantaviruses and coronaviruses and wrote to colleagues overseas to get protocols for setting up such real-time polymerase chain reaction diagnostic tests, which were not available in Hong Kong back then.
With my colleague Dr. KH Chan, we also tried to grow any virus present in these clinical specimens using a range of cell lines. On March 17, 2003 we observed very subtle changes in cell cultures obtained from the lung biopsy of one patient and the nasopharyngeal aspirate from another patient. By March 21 we had finally coaxed these viruses to grow in vitro. When our pathologist colleague John Nicholls fixed these cells [from the lung biopsy] and looked at them under the electron microscope, we could see the cells full of virus particles.
We then obtained paired (early and late) serum samples from eight suspected patients with SARS from Dr. Wilina Lim at the Department of Health Laboratory and tested these sera for reactivity on these virus-infected cells. We found that the late (convalescent) sera from all eight patients reacted with our virus-infected cell cultures when tested using indirect immunofluorescence tests. None of the control sera had any reaction, and neither did 20 randomly selected blood donor sera. This suggested that the virus we had isolated was the cause of SARS.
But at that time, we still did not know what type of virus it was. We reported these findings to the Department of Health and to the World Health Organization which was having daily teleconferences on the SARS outbreak.
Within the next two days, my colleague Dr. Leo Poon had obtained a partial sequence of the virus, and electron microscopy in Dr. Wilina Lim’s lab at the Department of Health also suggested that the morphology of the virus in culture was compatible with a coronavirus. Within four days, we had developed diagnostic tests that could be used to diagnose patients with SARS, and this testing service was subsequently provided to the whole of Hong Kong.
- You currently coordinate the Influenza Transmission and Pathogenesis-themed research grant for the Research Grants Council, Hong Kong. Could you please explain the research goals of this grant?
Influenza still remains a major public health problem. Seasonal influenza regularly causes epidemics, and animal influenza viruses such as avian influenza H7N9 and H5N1 cause occasional zoonotic infections with high case fatality. Influenza also causes pandemics at unpredictable intervals and such pandemics spread very rapidly across the world.
For example, on April 24, 2009, we heard there was a new potentially pandemic virus that had emerged in Mexico. In collaboration with epidemiologists Ben Cowling and Joe Wu, we started doing serological surveys in Hong Kong.
By September that year, we observed that 40 percent of all children in Hong Kong had been infected by this novel virus that emerged half the world away. No vaccines were available at this stage. We were lucky that the 2009 pandemic H1N1 virus was not very severe. If it had been, there would have been no vaccines to prevent its global spread at that time.
This is why we are interested in gaining a better understanding of how influenza viruses are transmitted from one person to another. Such knowledge will help suggest evidence-based interventions to reduce the spread of such viruses. We also want to understand why viruses like H5N1 are so severe in humans. This knowledge helps us to develop new therapeutic options for the disease.
- Could you please describe a project that you are working on right now?
My current work focuses on influenza and the MERS coronavirus, which is a virus related to SARS.
- What are some of the critical challenges that remain in your field of study?
Understanding respiratory virus transmission is one big challenge. Developing novel therapeutic modalities that target the host is another.
- As a member of the advisory committees of the WHO and FAO, what are some of the regional (specific to Asia) and global infectious disease threats that you see on the horizon?
I think the most concerning challenges to global public health are animal viruses that may acquire pandemic capacity (e.g. H7N9 virus) and the MERS coronavirus, which has already caused outbreaks involving more than 150 people in places like South Korea in 2005.
- How can countries work together to avert or contain an infectious disease outbreak?
Global disease surveillance is critically important. It is crucial that there are no blind spots in such surveillance systems. Early detection and response to these outbreaks reduces the overall disease impact.
- What are your thoughts on the research landscape in Hong Kong?
I think there is excellent research that goes on in Hong Kong in many different disciplines. But research does not get high priority or adequate funding in Hong Kong, compared with neighboring countries. It is heartening that, more recently, the Hong Kong government has decided to increase funding for research.
- What advice do you have for early career scientists in Asia?
I would say that research is one of the most rewarding careers as you get to solve mysteries, puzzles and challenges that are of importance to global wellbeing.
This article is from a monthly series called Asia’s Scientific Trailblazers. Click here to read other articles in the series.
Copyright: Asian Scientist Magazine; Photo: The University of Hong Kong
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