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Tales from the Battlefield

Prof Linfa Wang, a renowned researcher in new and emerging infectious diseases, shares his passion for bat-borne diseases and his vision for Duke-NUS' signature Emerging Infectious Diseases (EID) research program, in an interview with Vital Science.

Professor Linfa Wang, Duke-NUS' new director for the EID research program and Senior Principal Research Scientist in Commonwealth Scientific and Industrial Research Organisation (CSIRO) Livestock Industries' Australian Animal Health Laboratory in Geelong, Australia, did not always aspire to be an infectious diseases expert – least of all one that specializes in bats.

Trained as a biochemist, the Shanghai-born Australian said, "I always say my career is determined by fate. I moved to Australia in the 1990s and saw an opening in the CSIRO for a molecular biologist. In those days, biochemists also did a bit of molecular biology, so that is where I started. I joined the CSIRO in 1990, and the first Hendra virus outbreak occurred in 1994. In 1996, we established that the virus came from bats." The rest, as they say, is history.

16 years on, Prof. Wang has won numerous scientific awards for his influential work in isolating and studying many deadly bat-borne viruses including Hendra, Nipah, and the SARS-like coronavirus. His work has even inspired the movie, Contagion. "I always have to correct people, I'm not the Bat Man; I'm the Bat Virus Man," Prof. Wang points out in jest, "Everyone thinks it was visionary of me to choose to work with bats, but actually the bats chose me."

 For Prof. Wang, joining the EID team has been a strategic move. For one, his experience in dealing with unknown animal viruses complements the five-year-old program's existing research strengths in dengue and influenza. "When Duke-NUS approached me for the role, I was interested. Singapore, from the emerging infectious diseases standpoint, is a hub of disease transmission. For anyone working in infectious diseases, we want to work close to the battlefield so to speak, so Singapore is an excellent place to be to do this." Prof. Wang was also impressed by the collaboration of both Duke University and NUS.

Another reason was the chance to form strategic ties between the CSIRO and Duke-NUS and tap on mutual strengths. "The CSIRO in Geelong has the world's largest bio-containment facility and expertise in animal and wildlife viruses. But Australia is geographically remote and relatively isolated with a lower risk of emerging infectious diseases. In Singapore however, we have access to a dense human population and are closer to many tropical animal-borne diseases," he explained. Working in both institutions, he said, would more "powerfully equip" him to take a holistic "one health" approach to animal and human health. After all, he pointed out, "75 per cent of emerging human infectious diseases are caused by animal-borne viruses. I can close the gap between two approaches and also bridge the expertise between Australia and Singapore."

His vision for the EID program is two-fold: to drive translational research in emerging infectious diseases and work with stakeholders to improve Singapore's ability to respond to future outbreaks. On the research front, Prof. Wang noted how the EID program has made significant progress and "more can be done to understand why viruses cause the harm that they do."

Prof. Wang has also made it a personal commitment to meet with various government bodies and research agencies even before he took the job. "We need all the stakeholders to work together to improve the response. The EID program can play a role in providing the information on which to develop policies and response plans."

EID Research Highlights

(1) Human antibody able to kill dengue virus discovered

A team of research scientists from Duke-NUS and the NUS Yong Loo Lin School of Medicine (YLLSoM) has discovered a human antibody that can neutralize and kill the dengue virus within two hours and found a way to reproduce this antibody in large quantities.

Principal Investigator, Associate Professor Paul Macary from the NUS YLLSoM's Department of Microbiology said, "This represents the best candidate therapy that currently exists for dengue and thus is likely to be the first step in treating dengue-infected patients who currently have no specific medicine or antibiotic to take and may take days to fully recover."

Duke-NUS' Assistant Professor Lok Shee-Mei, who was part of the team, explained that the newly discovered antibody attacks one strain of the dengue virus, DENV1, which accounts for up to half of the dengue cases in Singapore. "Our next quest is to find other antibodies that treat Dengue serotypes 2, 3 and 4 infections. We hope to combine these antibodies into one concoction in the near future."

(2) Antiviral for dengue fever on trial

SGH and Duke-NUS have started Singapore's first trial of an antiviral medicine for the treatment of dengue fever. The antiviral medicine called Celgosivir is derived from a natural compound found in the seeds of the Moreton Bay Chestnut tree.

Associate Professor Subhash Vasudevan, who directs the Emerging Infectious Diseases Therapeutics Laboratory at Duke-NUS, explained that the clinical trial will investigate whether Celgosivir can be used as a potential treatment for dengue fever by lowering the amount of virus in the blood and reducing the painful symptoms and fever. "Laboratory experiments at Duke-NUS have shown that Celgosivir inhibits all four serotypes of dengue virus and improves survival in infected mice so we are taking this important next step to find out how well it works in patients," he said.

Those who suspect they are suffering from dengue fever and have had fever for only a day or so may visit their doctors at polyclinics and GP clinics around Singapore for a simple blood test to confirm the diagnosis. Patients identified with early stages of dengue fever may be referred to the CELgosivir as a treatment Against DENgue (CELADEN) trial at the Investigational Medicine Unit (IMU) located at SGH. They will receive either Celgosivir or a placebo, stay for five days in the treatment suites at the IMU and return for three visits after discharge. The medicine and treatment will be free.

The trial is carried out under the STOP Dengue Translational Clinical Research Program. Visit www.celaden.sg for details.

(This story was published in Duke-NUS Vital Science, September 2012. For more stories, please go to: http://www.duke-nus.edu.sg/vitalscience/201209/edm.html).