Linus Spatz, researcher developing a therapy against hantavirus: ‘This outbreak will be studied for decades’

In war and in medicine, the best way to defeat the enemy is to know them as well as possible. This is the maxim that researcher Linus Spatz, 58, has embraced in his scientific career to find vaccines and effective treatments against rare diseases, such as hantavirus cardiopulmonary syndrome. A variant of this pathogen, the Andes variant, is responsible for the outbreak that struck the cruise ship MV Hondius and has so far caused three deaths.

Question. Why did you decide to research hantaviruses?

Answer. The hantavirus variants that predominate in the Americas cause a rare but severe cardiopulmonary syndrome, with case fatality rates as high as 40%. The impact of the disease, which constitutes a critical public health problem, coupled with the lack of approved treatments, creates an urgent and unmet need for specific therapies.

Q. Why is the Andes variant dangerous?

A. It is the only one we know of with a history of person-to-person transmission.

Q. Can it cause a pandemic?

A. No, this is not going to happen. It does affect some people, and there are families who will suffer because of a loved one, unfortunately. But it is not easily transmitted, nor does it present mutations that will change this. Most cases occur through the inhalation of aerosolized viral particles from the saliva, urine, or feces of rodents.

Q. And how are these particles transmitted?

A. The secretions dry, turn into dust, and float in the air. Imagine a shed [tool storage shed] in our Patagonia that was surrounded by snow all winter, closed up, and poorly ventilated. A mouse was there, and after some time, a person enters and does some activity inside. They can inhale these particles. It’s difficult and unlikely; you have to be unlucky. But it happens.

Q. How was the virus’s ability to cause outbreaks discovered?

A. We suspected person-to-person transmission; there was some evidence, but it was difficult to prove scientifically. It occurred between 2018 and 2019, with a large outbreak of 33 cases, 11 of which resulted in death. The infections originated at a birthday party held in a town in southern Argentina called Epuyén. These infected individuals then transmitted the disease to other people who had not been there. Several subsequent transmissions were confirmed. It was a very significant event due to its scale, but above all because it demonstrated that person-to-person transmission is possible.

Q. There is a video in which the captain of the MV Hondius is seen informing the passengers of the first death and saying that the cause was not an infectious agent. There was a doctor on board. How could they have been wrong?

A. Because it remains a little-known disease with a very long incubation period [up to six weeks]. Doctors in areas where cases occur do consider it when treating a patient, but it’s highly unlikely that a doctor on a cruise ship in the middle of the Atlantic Ocean would think about it.

Q. You said it’s a neglected disease.

A. The impact of the virus can be very significant in the affected communities, but they are relatively few in number. Developing a new vaccine or treatment is very expensive, and it’s difficult to secure the necessary funding. This is something that my company, Inmunova, part of the Insud Group, has been working on for some time. I lead the company and was involved in its founding. One of our core missions is to develop drugs for rare diseases, and we do this in partnership with the Mundo Sano Foundation, which is dedicated to promoting this objective.

Q. How do you plan to develop a treatment for the virus?

A.Think of the serum against rabies. We are trying to do something similar: a serum with a large number of antibodies that block the virus circulating in the body and prevent it from entering cells to replicate.

Q. How do antibodies achieve this?

A. The first thing we did was obtain a viral protein that, when injected into a horse, is capable of rapidly producing a large quantity of high-quality antibodies. We now have the protein and the capacity to produce it. We have also succeeded in getting this protein to produce antibodies in horses and have verified in an animal model that they have neutralizing capacity, meaning they would prevent severe forms of the disease.

Q. What stage of development is this at?

A. It’s still in preclinical phases. At the moment, we are not conducting human trials. It is important to clarify this to avoid creating false expectations. But it is an important step in the right direction because, in addition, we have extensive experience in the development of other serums that are being investigated in phase II and phase III [the last phases before drug approval] here in Argentina and in Europe.

Q. Do you also have a vaccine under investigation?

A. Yes. We believe it would be very important to develop a vaccine because there are at-risk populations in very specific areas that could be immunized against a disease with a high mortality rate. It would also be possible to protect people traveling to those areas with a higher prevalence of the virus, such as Patagonia. We are also in the preclinical phase. In addition, we are developing a test that would allow for rapid diagnosis of the disease, which would be a great help in outbreaks like the one we are currently experiencing.

Q. Do you think this outbreak can help boost your research and other research on the same virus?

A. Yes. These episodes have an enormous impact, as we have seen these past few days. This case has elements that will make it a subject of medical study for decades: the source of the initial infection, currently unknown; the transmission on a cruise ship, in a closed space with close quarters; the fact that many nationalities are involved; and the international repercussions this has.

Q.And how does this impact translate?

A. This helps put the issue on the agenda and, in turn, encourages funding agencies to include these illnesses on their list of priority diseases. This helps to expedite the processes that drive research. When viruses don’t garner interest from authorities or those who fund science, they tend to be sidelined. This will surely be easier to change now.

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