20 Sep 2017

France-Hong Kong scientific collaboration: French Senator Olivier Cadic visits HKU-PRP

Malik Peiris, co-director of HKU-Pasteur Research Pole, was pleased to welcome Mr Olivier Cadic, French Senator for the French people living abroad, at HKU-Pasteur Research Pole, on Tuesday 19 September 2017, during the senator's visit to Hong Kong.

Accompanied by a delegation from the Consulate General of France in Hong Kong and Macau which supports the Pole’s activities - Mrs Paule Ignatio (deputy consul general) and Mr Frederic Bretar (Head of Science, Technology & High Education) - Mr Olivier Cadic was introduced to the current issues regarding infectious diseases in Hong Kong and the area. Malik Peiris highlighted the importance of implementing a « One-Health » approach as the determinants of health are converging and increasingly interdependent. Analyses and responses to current global threats require a concerted global approach including climate change issue and improved understanding of major global health challenges through research and public health actions. He also stressed the crucial role of education in training the next generation of scientists and presented the teaching activities of HKU-Pasteur Research Pole. The research teams leaders then invited Mr Olivier Cadic to a guided lab tour to meet the different researchers, including visiting scientists from France.

HKU-Pasteur Research Pole is a significant example of fruitful scientific cooperation between France and Hong Kong since it has been created following a partnership agreement between the Institut Pasteur in Paris and the University of Hong Kong (see the history of the Pole). The laboratory is one of the 33 members of the Institut Pasteur International Network established in 26 countries.

Some pictures of this visit:

From left to right: Sophie Valkenburg, Chris Mok, Malik Peiris, Olivier Cadic, Paule Ignatio, Suki Lee, Frederic Bretar, Sumana Sanyal

Malik Peiris introducing the One Health concept

Chris Mok presents the lab's facilities

08 Sep 2017

Shared insights with Chris Mok on HKU-Pasteur Research Pole’s efforts in H7N9 avian flu surveillance

The avian flu A(H7N9) has appeared in Mainland China since March 2013. Chinese health authorities have confirmed 1,584 cases of infections in humans so far, with a mortality rate coming close to 40%. The latest (fifth) epidemic wave that started in the winter of 2016-2017 caused dramatically more cases in humans compared to the previous waves. This flare-up of H7N9 infections raised serious concerns from the government and the public and highlighted the crucial need to maintain an intensive surveillance of this emerging virus. Since H7N9 has been identified, HKU-Pasteur Research Pole has focused on understanding the pathogenicity of the virus from multiple angles such as basic research, epidemiology and clinical investigation. This research effort aims at exploring how this avian virus has overcome the species barrier to infect humans. Recently, Malik Peiris, Chris Mok and their colleagues published two papers describing the clinical and epidemiological aspects of the H7N9 virus isolated from the fifth wave. Their findings can contribute to explain the sudden raise of human cases during the last season.

Treatment of a patient in Wuhan (Hubei), February 2017. © AFP

The fifth epidemic wave of the avian flu A(H7N9), which appeared in 2013 in Shanghai and Anhui province, has started in October 2016. It caused more human cases than the previous four waves and stretched for a longer period of time. With over 700 detected patients, the fifth wave represents almost the half of the total number of cases since the virus has emerged. Furthermore, governments and scientists know that there might be many mild or asymptomatic cases that have not been recognized and thus the actual numbers could be higher than the official record.

Different from the H5N1 virus (which mainly attacks healthy children and young adults), H7N9 mainly targeted the elderly population or patients with underlying diseases. However, similar to H5N1, human with H7N9 infection usually started up with upper respiratory symptoms: fever, cough, running nose etc. Many cases developed pneumonia, or even progressed to acute respiratory distress syndrome, septic shock and eventually died from multi-organ failure. The mortality rate in humans is high: 40% (60% for H5N1; 0,1% for seasonal flu viruses). Infections are associated with an exposure to infected live poultry or to contaminated environments (such as markets).

According to the Influenza Risk Assessment Tool (IRAT) of the US Centers for Disease Control and Prevention (CDC), H7N9 is the emerging virus with one of the highest potential risk for public health among Influenza A viruses, even though there is still no evidence of sustained human-to-human transmission to date.

The genetic changes in the virus can have important consequences on the control and surveillance strategies. Thus, HKU-Pasteur Research Pole is maintaining continuous research on H7N9 since it has emerged. The team of Malik Peiris (co-director) and Chris Mok (principal investigator) was one of the first group to characterize H7N9 pathogenicity and identify the viral determinants using a mouse model in 2013. They have kept pursuing a better understanding of the virus with serological, epidemiological and clinical studies. Recently, they found that the H7N9 virus circulating in the Guangdong province adjacent to the border of the Special Administrative Region of Hong Kong, has further adapted and evolved to a high-pathogenecity phenotype in poultry, similar to the H5N1 virus. In their study, a new genetic insertion in the hemagglutinin gene (the viral surface protein responsible for the binding of the virus to the membrane of host cells) was identified in the H7N9 virus. This adaptation makes the virus deadly to chickens and some other avian species (death within 24 hours after infection), and it was shown that such mutation in the H5N1 virus increases the virulence in mammalian hosts. In collaboration with the Guangdong CDC, HKU-PRP scientists found that 9 out of 60 human cases were actually infected by the new highly pathogenic avian influenza H7N9 (HPAI), while it had not been recognized during patients' hospitalization. They published their findings in two papers in July and August 2017 (in Eurosurveillance and Emerging Infectious Diseases) with a detailed clinical description of an infected patient and the epidemiological situation in Guangdong.

Dr Chris Mok in HKU-Pasteur Research Pole laboratories. © HKU-PRP

We are actively collaborating with the Chinese CDC and the First Affiliated Hospital of the Guangzhou Medical University with which we have a close partnership since 2014. We then have a privileged access to surveillance data and clinical samples in the Guangdong province, especially for H7N9 infections” Chris Mok said. “The information obtained through this network enabled us to describe the prevalence of H7N9 viruses in Guangdong poultry markets during the fifth wave, and to compare the epidemiological and basic clinical characteristics between patients infected with the low pathogenic and the highly pathogenic H7N9 viruses” he added.

Their research further showed that the duration of hospitalisation was longer in the patients infected with the mutated virus compared to the previous one. However, there is still a lack of strong evidence showing that the virus can transmit from human to human. Surprisingly, drug resistance was found in the case study patient as early as 2 days after the antiviral treatment.

By analysing the results of standardized questionnaires, we showed that the exposure to poultry markets is still a comparable risk factor for both HPAI and LPAI viruses, but we found touching sick or dead poultry as a more important risk factor for the mutated H7N9 infection, followed by raising backyard poultry. These results are important and must be taken into account for the control of future outbreaks, especially now that the latest cases of H7N9 infections are detected in more rural area of China where backyard poultry is more prevalent” Mok warned. “We still have a lot of questions on this newly identified virus as we don’t really know yet its impact on human and poultry. Rapid occurrence of drug resistance after the antiviral treatment is definitely our major concern. But we still need more data to come up with a conclusion” Chris Mok reported.

During summer, environmental conditions are not favourable for virus transmission to humans, so new cases are now detected sporadically, but what will happen during the next outbreak season in October-November? “There will probably be a competition between the two strains, but we cannot know yet if the highly pathogenic H7N9 virus will replace the low pathogenic virus or if they will coexist. Besides, H7N9 vaccine which targets the previous virus strain will be launched in China very soon, and it will cause a new source of uncertainty. It has to be considered, even if scientific points of view on that matter are divided. Vaccination prevents symptoms in birds, but cannot prevent the transmission and the circulation of the virus in animals, and so one doesn’t have a warning signal anymore by observing dead poultry when an outbreak occurs. Thus, an intense surveillance must be maintained” the researcher explained.

The two published articles:

Epidemiology of human infections with highly pathogenic avian influenza A(H7N9) virus in Guangdong, 2016 to 2017, Euro Surveill. 2017 Jul 6;22(27).
Kang M, Lau EHY, Guan W, Yang Y, Song T, Cowling BJ, Wu J, Peiris M, He J, Mok CKP

Human Infection with Highly Pathogenic Avian Influenza A(H7N9) Virus, China
, Emerg Infect Dis. 2017 Jul;23(8):1332-1340.
Ke C, Mok CKP, Zhu W, Zhou H, He J, Guan W, Wu J, Song W, Wang D, Liu J, Lin Q, Chu DKW, Yang L, Zhong N, Yang Z, Shu Y, Peiris JSM.


Pathogenicity of the Novel A/H7N9 Influenza Virus in Mice (Mok et al., 2013)

Epidemiology of human infections with highly pathogenic avian influenza A(H7N9) virus in Guangdong, 2016 to 2017 (Kang et al., 2017) 

Human Infection with Highly Pathogenic Avian Influenza A(H7N9) Virus, China (Ke et al., 2017)

FAO, H7N9 situation update

WHO, Human infection with avian influenza A(H7N9) virus – China

European Centre for Disease Prevention and Control, Factsheet on A(H7N9)

14 Jun 2017

Our photo library has been updated!

Immerse yourself in the teaching & training activities of HKU-Pasteur Research Pole.

You are a former participant of our HKU-Pasteur Courses Series and you are feeling nostalgic for the intense 2-week training you had here with your group of colleagues and friends from all over the world?

You can now revive these moments, from the first Pasteur-Asia Virology Course in 2004 to the last 9th HKU-Pasteur Immunology Course in March 2017, including epidemiology workshops organized in Vietnam.

You can also browse through some of the main highlight images of the Pole.

Visit our photo library here. And get motivated if you wish to apply for a future course!

Stay tuned for our next courses announcements on our website, and connect to us through our Facebook page to be notified of the calls for applications.

17 May 2017

Malik Peiris joins the distinguished scholars of the National Academy of Sciences of the United States

Malik Peiris, world-renowned clinical virologist, co-director of the HKU-Pasteur Research Pole, of the WHO-H5 Reference Laboratory at HKU, Chair Professor of Virology of the School of Public Health, Li Ka Shing Faculty of Medicine at HKU, and Affiliated Professor at the Institut Pasteur, has just been elected Foreign Associate of the US National Academy of Sciences on early May 2017. He joins in this prestigious institution five researchers from Hong Kong, and five researchers from the Institut Pasteur. This election is a good opportunity to take a step back with him and consider his high-achieving career. With a lot of humility, this is rarely in terms of “I” as he prefers to remind that research is a collective undertaking. Interupting the writing of a manuscript, Malik takes time to answer some questions.

Did you know you were going to be elected?

I knew I was nominated, because obviously I had to provide information for the nomination process about a year ago, but after that, I quite honestly didn’t take it very seriously so I didn’t know anything until a few days prior to the official announcement when the person who nominated me informed me that I had been elected.

You already have a lot of distinctions now, what does it mean to you to be elected as a Foreign Associate of the American National Academy of Sciences?

The foreign associate fellowship of The National Academy of Sciences of the United States, as well as the fellowship of the Royal Society of London, are two extremely prestigious honors, so I am really grateful to my colleagues in these respective institutions for nominating and electing me. I think it is important to emphasise that this achievement cannot be made by one person alone, it really is a reflection on the efforts of a great team of people who have been working together for the last two decades or so.

Who are these colleagues at your side, committed to research?

When I joined The University of Hong Kong in 1995, my initial task was to set up the clinical virology laboratory at the Queen Mary Hospital, the teaching hospital for The University of Hong Kong. In these efforts, I worked closely with Dr KH Chan (Chan Kwok Hung), Dr Seto Wing Hong and Dr (now Professor) KY Yuen. Given that our laboratory was very small, we had to focus our efforts. I chose to focus on rapid diagnosis of respiratory virus infections and infections of the immunocompromised patients. Within two years, H5N1 bird flu had hit Hong Kong and our lab was able to make important contributions in responding to this threat. Following on from this, with the strong encouragement from Dr Rob Webster, we set up a research program on avian and swine influenza viruses to inform zoonotic and pandemic threat. Guan Yi, Leo Poon and I worked on this program and gradually built it up from a handful of people to over 60 people today. Early on, I also built collaborations with other departments at HKU, such as Pathology, Paediatrics, Community Medicine and others to investigate influenza in multidisciplinary manner. It was in this context that SARS struck in 2003. The whole clinical virology lab and the influenza team was mobilised to respond to this threat and luckily we were able to quickly identify and characterise the causative agent as a novel coronavirus and to develop and deploy diagnostic tests to help contain the outbreak. Key collaborators in this effort included Chan Kwok Hung, Guan Yi, Leo Poon, John Nicholls, KY Yuen, WH Seto and many others. Subsequently, Guan Yi was able to identify game live animal markets as the animal human interface from where the virus crossed to humans. 

After SARS, Guan Yi, Leo and I returned to our focus with influenza and other emerging viruses. I have been lucky to be able to build strong multi-disciplinary collaborative links with epidemiologists, statisticians and modellers (Gabriel Leung, Ben Cowling, Joe Wu, Eric Lau), pathologists (John Nicholls), paediatricians (Susan Chu, YL Lau) and immunologists (Wenwei Tu). Our collaborations also extended to other universities in Hong Kong. During this time, I also became involved with the HKU-Pasteur Research Pole and worked with Roberto Bruzzone to develop a research program on the cell biology of viral infections, again focusing on influenza and emerging viral infections. In due course, we were joined by the next generation of researchers including Michael Chan, Hui ling Yen, Renee Chan, Chris Mok, Suki Lee, Sophie Valkenburg, Sumana Sanyal, and many others. Many of these younger scientists are now developing into independent researchers in their own right. This multi-disciplinary approach developing in one research institution to address one major problem, influenza, has been very exciting and somewhat unique.

I am most grateful for the support I have received over the years from my colleagues at the Institut Pasteur in Paris, and from the Institut Pasteur International Network. We have had good collaborations with the Institut Pasteur in Cambodia and Senegal. I  would like to thank Christian Bréchot for nominating me as Affiliated Professor of the Institut Pasteur. We have also established a very strong collaboration with CIRAD, in Montpellier, France with whom we have many collaborative studies on influenza and MERS-coronavirus in animals. I am convinced that we need to apply the One Health approach, involving researchers working on humans, animals and the environment to tackle these problems.  

Right now, what are you investigating?

Currently, my main focus is on the MERS coronavirus. For that, again, we have been collaborating with many people, in Saudi Arabia, in Africa, in South Korea, with the Center for Global Health at the Institut Pasteur in Paris, with the CIRAD in Montpellier. One major puzzle with MERS coronavirus is the following. The virus comes to humans from dromedary camels. The virus distribution in camels is very wide across the entire African continent and the Arabian Peninsula, and it has been circulating for at least thirty years in camels, maybe even longer. Wherever you find dromedary camels, almost invariably, you find that they have been infected with MERS coronavirus. However, the human zoonotic disease has not been reported from Africa. MERS cases have been reported in Algeria, Egypt and Tunisia but these have been acquired from the Arabian Peninsula, not within Africa. Same scenario with the outbreak in South Korea in 2015. We are very interested in trying to address this question: why is there this difference? Is it a true difference? It could be that cases also occur in Africa but are not reported. Or is there a difference in the virus itself? The strains circulating in Africa could be different. Or is it a difference resulting from different type of interactions humans have with camels in Africa compared to Saudi Arabia? We have some clues that we are working on at the moment…

For Hong Kong, and more generally for global health, what is motivating you to push you research further and further?

Helping the next generation of researchers to establish themselves and take their place in the international research community is fundamental to me. Some of our younger members of the research team are addressing some key questions.

Avian influenza viruses and swine influenza can cross species barriers to infect humans. There is wide diversity of influenza viruses out there in animals, hundreds of them. Then it becomes very important to have a rational way for assessing risks regarding these different viruses. One cannot make vaccines for every single animal virus that is out there. We also know that once a pandemic arises, it spreads across the world much faster than the process of vaccine development based on the newly emerged virus strain. For example, the 2009 H1N1 pandemic emerged in Mexico and we first heard about it in April 2009. By September that year, 40% of children in Hong Kong had been infected – long before a vaccine was ready. So we should try to get ahead of the virus if we can. We have been collaborating with WHO to refine a systematic framework to assess the risk of animal viruses for human health and pandemic threat. Such frameworks have to be better refined because the parameters we are using are still quite crude. This really is something we are eager to understand better. What are the determinants that allow an animal virus to cross to humans? This is an unknown area. Some of our teams are working to understand the basic science underlying this. Others are developing and evaluating tools to investigate how well an animal virus can infect the human respiratory tract. Of course, we cannot experimentally infect humans to find out. So our team have developed methods to culture human lung tissue in the test tube and use this to investigate how well animal viruses can replicate in the human airways.

And when you look broader, it is not only influenza viruses that come from animals to humans, there are many others. Coronaviruses are one other example. Trying to extend a similar framework that has now been devised for risk assessing influenza to other emerging viruses is a huge task, but at the conceptual level, it should be possible for us to systematically move forward towards this.

What do you expect from the fellowship at the American National Academy of Sciences?

As I do as a founding member of the Academy of Sciences of Hong Kong, I would like to actively take part in the activities of the National Academy of Sciences of the United States, on issues I contribute to. I hope it can also help me to be an advocate of science, of the role of science and the importance of bringing the scientific and evidence based approach to important policy decisions. It is essential to share science with the general public and the younger generations, and highlight the relevance of science in everyday decision making at any level, especially in an era where the role of science is being increasingly challenged…

Also, being one of the few Sri Lankan [editor's note: the first] to be elected to the US National Academy or the Royal Society of London gives me a special responsibility to continue to promote science in Sri Lanka, by taking part in meetings large and small where I can promote research there. The conditions of doing scientific research in Sri Lanka, as middle income country, are very challenging: resources are limited, the scientific community is small, pressures are many, role models are few. Despite all these challenges, there are still some excellent researchers in Sri Lanka, and I think it is important to continue to inspire scientific careers.

Following your recent election, what are the issues for public health that you would like to make heard by the community?

Almost every year, emerging viral diseases appear to challenge us as a new, completely unexpected threats such as Zika, Ebola, MERS, avian flus, SARS, etc… The responses to these challenges have been very short-lived, fragmented and memories short. When they happen, there is huge concern and everybody wants action – vaccines, drugs, control measures, etc. Once immediate events have abated, everything just goes back to normal. A classic example is SARS. More than ten years ago the outbreak started, and a lot of progress was been made at that time, including developing vaccine and antivirals. For example, a vaccine candidate was developed by Ralf Altmeyer at the HKU-Pasteur Research Pole and tested in pre-clinical trials successfully. However, with SARS being controlled, funding and interest died down. So when a related coronavirus, the MERS coronavirus emerged, we had to go back to square one to develop these interventions. Politicians and science administrations remain to be convinced that emerging infectious diseases will continue to threaten us and that we need to have a sustained investment in this area, from basic research to applied research. Each of these events has impacted governments societies with economic costs in the billions of US dollars. SARS is estimated to have cost the global economy over 40 billion US$. After Ebola, four different commissions came out with many recommendations, but they are now again being forgotten until the next crisis strikes. To keep pressing and raising consciousness on these issues is essential to me and my colleagues.

Malik Peiris (credits: G. Benet)

Malik Peiris during the presentation of the latest research findings on H3N2 influenza virus from HKU in 2015 (credits: Li Ka Shing Faculty of Medicine, The University of Hong Kong)

Interview conducted by Gabriel Benet, on Tuesday 16th, May 2017

31 Mar 2017

Celebration day at the Residence of France!

On Wednesday 29 March 2017, a festive reception was organized at the Residence of France by Mr Eric Berti, Consul General of France in Hong kong and Macau, with the sponsorship of BioMérieux, a French multinational biotechnology company. HKU-Pasteur Research Pole was in the spotlight, as well as Malik Peiris, co-director of the Pole.

This reception was the occasion to celebrate two important moments. First, Malik Peiris was awarded the honorific title of “Officier de la Legion d’Honneur” in the name of the president of the French Republic. It is a further acknowledgement of his dedication to France after he had already been nominated “Chevalier de la Legion d’Honneur” in 2007. Through this honour, the French republic pays tribute to Malik’s key role in the scientific cooperation between Hong Kong and France, to his support to strengthen the relationship between HKU and the Institut Pasteur, and to his continuous advice to the French community in Hong Kong in terms of public health.

It was also a chance to welcome at the Residence of France the 20 participants of the 9th HKU-Pasteur Immunology course coming to an end this week and praise the success of HKU-Pasteur Research Pole’s training activities bringing together in Hong Kong high level speakers coming from different places in the world, including from the Institut Pasteur in Paris.

Mr Eric Berti decorating Malik Peiris

Mr Eric Berti and Malik Peiris

Malik Peiris with the students of the 9th HKU-Pasteur Immunology Course

Malik Peiris with the students of the 9th HKU-Pasteur Immunology Course, HKU-PRP and School of Public Health colleagues

From left to right: Roberto Bruzzone (Co-Director HKU-PRP), Tam Wah-Ching (who created the Tam Wah-Ching Professorship in Medical Science for which Malik Peiris was appointed in 2010), Malik Peiris, Eric Berti, Peter Mathieson (Vice Chancellor and President of HKU), Haofeng WANG (BioMerieux general manager)

02 Mar 2017

Getting ready to open another long-term chapter…

HKU-Pasteur Research Pole is very pleased to inform you that on Friday 3 March 2017, the University of Hong Kong and the Institut Pasteur have renewed their partnership agreement for the HKU-Pasteur Research Pole under the School of Public Health, Li Ka Shing Faculty of Medicine, HKU. This new agreement, which will run over a 10-year period, extends the  Pole's successful research and training activities in the long term.

Professor Peter Mathieson, Vice-Chancellor and President of The University of Hong Kong and Professor Christian Brechot, President of Institut Pasteur, and Mr Leo Kung Lin-Cheng, BBS, JP, Officier de la Légion d'Honneur and benefactor of the Pole met at the Convocation Room of the Main Building of HKU for a signing ceremony. On this important occasion, they had the pleasure to welcome Professor Gabriel Leung, Dean of Medicine, HKU, and Mr Eric Berti, Consul General of France in Hong Kong and Macau as distinguished officiating guests.

The co-directors of HKU-Pasteur Research Pole, Professors Malik Peiris and Roberto Bruzzone, were also pleased to welcome Professor Keiji Fukuda, former Assistant Director-General for Health, Security and Environment at WHO, and Clinical Professor at the Division of Community Medicine and Public Health Practice (School of Public Health, HKU).

From left to right: Prof Roberto Bruzzone, Prof Keiji Fukuda, Mr Eric Berti, Mr Leo Kung, Prof Peter Mathieson, Prof Christian Brechot, Prof Gabriel Leung, Prof Malik Peiris

Prof Peter Mathieson addresses the audience

Prof Peter Mathieson addresses the audience

Prof Christian Brechot addresses the audience

Prof Christian Brechot addresses the audience

The 3 parties sign the 10-year agreement for HKU-Pasteur Research Pole. From left to right: Mr Leo Kung, Prof Peter Mathieson, Prof Christian Brechot

Prof Peter Mathieson and Prof Christian Brechot exchange the signed agreement

Mr Leo Kung and Prof Christian Brechot exchange the signed agreement

Prof Christian Brechot

From left to right: Mr Leo Kung, Prof Peter Mathieson, Prof Christian Brechot

Prof Peter Mathieson

Mr Leo Kung, Prof Peter Mathieson, and Prof Christian Brechot

Mr Leo Kung, Prof Peter Mathieson, and Prof Christian Brechot

Prof Christian Brechot and Prof Peter Mathieson

Prof George Tsao (School of Biomedical Sciences, Li Ka Shing Faculty of Medicine), Prof Malik Peiris and Prof Christian Brechot at the cocktail reception before the signing ceremony

Prof Keiji Fukuda, Prof Roberto Bruzzone, Mr Leo Kung, Prof Christian Brechot and Prof Gabriel Leung at the cocktail reception before the signing ceremony


Prof Christian Brechot during the visit at HKU-Pasteur Research Pole before the signing ceremony. From left to right: Dr Suki Lee, Dr Sumana Sanyal, Prof Malik Peiris, Prof Roberto Bruzzone, Dr Barbara Gayraud-Morel, Dr Chris Mok

Photo credits: H.Wong, G.Benet

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