David S.
Giovanni A.
and Sebastian L.
Viral respiratory tract infections are important and common causes of morbidity and
mortality worldwide. Over the past two decades, several novel viral respiratory infections with
epidemic potential that threaten global health security have emerged. Human cases of the
highly pathogenic avian influenza A(H5N1) were initially detected in Hong Kong in 1997,
before spreading to other parts of Asia, the Middle East, Europe and Africa, with a case
fatality rate close to 60%. Influenza A(H1N1)pdm09 virus first emerged in 2009 as a novel
swine-origin strain, which rapidly led to a pandemic and has remained a common circulating
strain in many parts of the world. Human infections with the novel avian influenza A(H7N9)
virus were first reported in mainland China in March 2013 and the infection has since spread
to Hong Kong and Taiwan. Avian influenza A(H5N1) and A(H7N9) viruses have continued
to circulate widely in some poultry populations and infect humans sporadically; sporadic
human cases of avian A(H5N6), A(H10N8) and A(H6N1) have also emerged.
In March 2003, the World Health Organization (WHO) issued a global alert about an
emerging SARS caused by a novel CoV, which rapidly spread from mainland China via
Hong Kong to at least 29 countries/regions and finally ended in July 2003, with 8096
probable cases and 774 deaths. Since its first discovery in a patient who died of severe
pneumonia in Saudi Arabia in 2012, MERS-CoV has spread to 26 countries. The mortality
rates of MERS-CoV infection are high, especially in those with comorbid disease.
In addition to the threat of novel CoV and avian influenza viruses, the burden of the
common respiratory viruses, such as seasonal influenza, RSV and human rhinoviruses
(HRV), on healthcare utilisation remains high, and yet is also a largely unmet medical need.
This highlights the urgent need for developing more effective therapies in order to reduce
the morbidity and mortality associated with novel threats, as well as the regular offenders.
The Platform for European Preparedness Against (Re-)emerging Epidemics (PREPARE)
( is an European Union funded network aiming to
harmonise large-scale clinical research studies on infectious diseases, and provide real-time
evidence for clinical management of patients and for informing public health responses. To
advance our understanding of the clinical, epidemiological and scientific aspects of
important respiratory viruses and facilitate planning of research studies on emerging
Copyright ©ERS 2016. Print ISBN: 978-1-84984-069-9. Online ISBN: 978-1-84984-070-5. Print ISSN: 2312-508X. Online ISSN: 2312-5098.
Correspondence: David S. Hui, Dept of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Center for Emerging Infectious Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Pediatrics, Pulmonary and Allergy Disease Units, Istituto G. Gaslini, Genoa, Italy.
Heart & Lung Institute, Imperial College
London, London, UK.
ERS Monogr 2016; 72: ix–x. DOI: 10.1183/2312508X.10008516 ix
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