Clinical Trial Sponsors: Singapore General Hospital

  Source:		NCT01979705

    		Detect Novel Pathogens and Characterize
     		Emerging Infections


			First Update October 30, 2013
			Last Update October 5, 2017

			Brief Summary
			Infectious disease is the single biggest
			cause of death worldwide. New infectious
			agents,such as the Severe Acute Respiratory Syndrome
			coronavirus and new strains of influenza
			continually emerge and require new investigations
			to understand pathogen biology and pathogenesis
			in the host. Witness the Influenza A pandemic.
			Concerns about new viruses and their impact
			on health and the economy are also increasing.
			Current alerts sent out by the Ministry of Health
			(about the novel coronavirus and the Avian influenza
			A virus) are but cases in point. These likely
			reflect advances in science, which have allowed
			novel pathogens to be identified. Because of
			its geography, Singapore is vulnerable to new
			pathogens through importation or the global
			travel of its citizens. Hence we must be ever
			ready to meet unexpected challenges anytime.
			On the administrative front, Singapore General Hospital
			has a Disease Outbreak Task-force which has
			in place many plans that can be activated
			should there be a large-scale epidemic. What
			is missing thus far is a program that will enable
			us to perform scientific studies in the setting
			of an epidemic. Hence in this study, we will,
			in collaboration with the Program in Emerging
			Infectious Diseases (EID) in Duke-National
			University of Singapore Postgraduate Medical
			School, attempt to (i) detect novel, previously
			undescribed pathogens; (ii) characterize viruses
			(not necessarily novel but emerging and
			re-emerging) that are raising concern or causing
			clusters or epidemics in the hospital and/or
			country; (iii) characterize immune responses
			to such viruses in healthcare workers as well
			as patients (those affected by these viruses
			and those exposed to the affected). The
			techniques that will be used will be those not
			routinely available in a hospital's service labs.
			Some patients will remain undiagnosable with
			the best available technology. Since new
			laboratory tools that can detect previously
			undiagnosed pathogens may become available
			in the future, the study also aims to archive
			specimens from patients whose illnesses
			remain undiagnosed.

			Detailed Description
			This study has the following aims: 1. To detect
			novel, previously undescribed pathogens. 2.
			To characterize viruses (not necessarily novel
			but emerging and re-emerging) that are raising
			concern or causing clusters or epidemics in
			the hospital and/or country; 3. To characterize
			immune responses to such viruses in patients.
			4. To archive specimens with no identifiable
			infectious etiological agents for future testing.
			A recent global analysis documented that
			emerging infectious disease events have
			increased significantly over time. Singapore has
			not been spared with the list of pathogens
			since the late 1990s, including Nipahn virus,
			SARS coronavirus, dengue, chikungunya, and
			2009 H1N1. As is widely known, the
			novel coronavirus may potentially impact
			Singapore as Haj pilgrims from Singapore
			travel to Saudi Arabia and are potentially exposed
			to this virus. Novel pathogens continue to be
			discovered. An example of this is the Severe
			Fever with Thrombocytopenia Syndrome
			bunyavirus in Henan, China. Appropriately a
			commentary accompanying the report identified
			China as a country with the largest potential
			for emerging or re-emerging infectious disease,
			due to the close proximity of animals and
			human populations. Similarly, Southeast Asia
			was identified as a potential hotspot, citing the
			avian influenza pandemic and Nipahn virus
			outbreak. As such, it is obvious that there is
			a need to better define undiagnosed infective
			syndromes in Singapore, and subsequently
			characterize emerging pathogens. In Singapore,
			there is currently a lack of research focus on
			discovery of novel pathogens. Our current
			protocol is an attempt to fill this gap. This
			proposal brings together experts in clinical
			infectious diseases in SGH, world renowned
			scientists in laboratory diagnostics of infectious
			diseases and public health epidemiology experts
			in Duke-NUS Postgraduate Medical School.
			We hope by employing state of the art
			technologies, we will be at the frontier of new
			pathogen discovery.

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