Wolfgang Preiser, German physician, researcher. Fellow: Zoological Society London; member: Royal College Pathologists.

• Background :   Preiser, Wolfgang was born on August 26, 1965 in Frankfurt am Main, Hessen, Germany. Son of Wolfgang Arnold Richard Preiser, Eva Regina (Wiegand) Preiser.

• Education :   Diploma in tropical medicine and hygiene, London, 1992.

• Career :   Lecturer, honorary senior registrar department virology UCLMS, London, 1995—1999. Oberarzt Institute for Medical Virology, Frankfurt am Main, Germany, since 1999.

• Achievements :   Wolfgang Preiser has been listed as a noteworthy physician, researcher by Marquis Who's Who.

• Membership :   Fellow: Zoological Society London. Member: Royal College Pathologists.

Connections

Father:   Wolfgang Arnold Richard Preiser Preiser

• Born :  August 26, 1965  in   Frankfurt am Main, Hessen, Germany

• Nationality :   German

• Ethnicity :   German

Education

• 1992
  London , Diploma in tropical medicine and hygiene

Career

• 1995 - 1999
  Lecturer registrar department virology , UCLMS
  London, Mpumalanga, South Africa

• 1995 - 1999
  honorary senior registrar department virology , UCLMS
  London, Mpumalanga, South Africa

• 1999
  oberarzt , Institute for Medical Virology
  Frankfurt Am Main, Hessen, Germany, Hessen, Germany, Germany

1. SOUNDBITE (English) Doctor [Dr. John S. MacKenzie (born 1943(est.))], Team leader and virologist from the University of Queensland in Australia:   "We hope it will be very productive from both sides. From the global perspective - in terms of knowing more about SARS - but also from the more local perspective, shall we say, in terms of us providing whatever information we can, whatever help we can to our colleagues here in China."

2. Pan from Dr Meirion R. Evans, UK epidemologist (left) and [Dr. Wolfgang Preiser (born 1965)], German virologist to Dr Robert F Breiman, US Infectious disease specialist (left) and MacKenzie

3. SOUNDBITE (English) [Dr. John S. MacKenzie (born 1943(est.))], Team leader and virologist from the University of Queensland in Australia:   "We've had 27 suspected cases in Australia but it's only information of the sort we're getting now - I mean, like we've been getting for the last three weeks - that we've been able to say that those 27 suspect cases in Australia are not SARS. And sure they've travelled in the right place. Sure they've got atypical pneumonia but they're not SARS under the current case-definition. So to be able to find out what the best definition possibly is, is incredibly important."

4. SOUNDBITE (English) Dr Robert F Breiman, American Epidemiologist and Infectious disease specialist:  "In the case of Legionnaires disease and (unclear) virus - and there have been many other emerging diseases - there is plenty of evidence that those diseases existed before. What's made it recognised is the actual clustering, it's the epidemic."

5. SOUNDBITE (English) Dr James H. Maguire, Chief of epidemiology, US National Centre for Infectious Diseases, Centres for Disease Control and Prevention:   "It may be, it may not be but it may be that what we learn, what is learned here in China will provide the key. There may be issues here. The fact that if this was really the first location for where these diseases occurred, there may be some reasons why that happened here that I think are gonna be very interesting to explore."

STORYLINE:   A team of World Health Organization (WHO) experts said on Monday they were analyzing the cases of Chinese sickened in an outbreak of a fatal flu-like illness in hopes of finding out whether it is linked to a mystery disease that has spread to three continents. The five-member team arrived on Sunday and said they would examine Chinese records this week.  They said they had not decided whether to visit the southern province of Guangdong, where five deaths from atypical pneumonia were reported. WHO says it is treating the outbreaks as part of the same emergency that has killed 10 people in Hong Kong, two in Vietnam and two in Canada, though it isn't clear if the deaths were caused by severe acute respiratory syndrome, or SARS. Another 305 people also were sickened in Guangdong since the first cases were reported in November, Chinese health authorities say. The Chinese government didn't report the outbreak until February and its reluctance to release information fueled a panic in Guangdong and neighboring Hong Kong.  People bought up supplies of antibiotics and vinegar for use as a disinfectant. Cases of SARS have also been confirmed in Europe.

In a strange quirk of fate, when Wolfgang Preiser worked in Frankfurt, Germany, back in 2003, he was part of the team that isolated the aetiological coronavirus new to humans from the first SARS patient in Germany. Fast forward almost two decades to the COVID-19 pandemic, and Preiser is part of the team who discovered, in November 2020, the beta variant of SARS-CoV-2 and a year later the omicron variant, which just 2 months later is dominant almost everywhere. “It is hard to believe, my connections to both coronavirus pandemics!” Preiser tells The Lancet Infectious Diseases. Today, he is Professor and Head of the Division of Medical Virology at Stellenbosch University and the National Health Laboratory Service (NHLS) Tygerberg, Cape Town, South Africa.

Born and raised in Frankfurt, Preiser knew science and medicine were his calling. During medical training in Frankfurt, he found himself inspired by the virologist who would become his mentor and boss, Hans Wilhelm Doerr. “I was fascinated by the ecology and natural history of these tiny biological molecules”, explains Preiser. “Really, they are not even alive, just genomes in a protein hull”. After completing his medical degree at the Goethe University Frankfurt, he did further training at The London School of Hygiene & Tropical Medicine and University College London in the UK.

Preiser remembers the panic in 2003 around the SARS patient, a doctor returning from New York to Singapore via Frankfurt. “He had this really bad pneumonia, after exposure to a patient with the newly described condition, and no-one knew its aetiology. One of the biggest differences between SARS then and the COVID-19 pandemic today is that in 2003, everyone infected with SARS had symptoms and became infectious only once ill. With SARS-CoV-2, many infections are asymptomatic, which makes pandemic control near impossible, even before these super-infectious variants like delta and omicron arrived”.

South Africa is one of the places worst hit by the COVID-19 pandemic, struggling with the financial, social, and health consequences of the pandemic and lockdown measures and facing international travel bans due to first the beta and then the omicron variant. Preiser believes South Africa's strong network of public health and private laboratories and the ability to quickly adapt pre-existing HIV and tuberculosis surveillance and research capacity have been vital assets. The country was able to closely monitor the COVID-19 pandemic, including sequencing many thousands of infections. “Along with the UK, our genomic surveillance system was set up early in the pandemic and continues to be among the best, while even developed countries have struggled”, he explains.

Omicron was discovered when a lab scientist spotted that samples from infection clusters in Gauteng province in South Africa showed a particular pattern with a widely used PCR test and referred them for sequencing. This analysis found an unprecedented number of mutations, including many suggesting concerning virus properties. “We were scared initially”, Preiser recalls. But it quickly became clear that while omicron was more infectious and could overcome immune responses, it was causing less severe disease, and fewer hospitalisations and deaths. “When sharing this information with the world, South Africa was again hit with travel bans”, he explains. “Such unfair and disproportionate reactions might deter countries from sharing information about new variants, or even looking for them”. The personal cost to Preiser's co-discovery of omicron included receiving even death threats.

Preiser's team recently identified an immunocompromised patient, now in her 20s, whose long-standing HIV infection had not been adequately treated. When she was infected with SARS-CoV-2, the virus persisted and over time acquired multiple mutations. “This is how variants may develop— persisting many months in the same patient unable to clear it, a virus can mutate extensively”, explains Preiser.

He also co-published correspondence in The Lancet about omicron infections in seven young doctors visiting Cape Town, the first evidence globally that omicron can cause breakthrough infections in double-vaccinated and boosted individuals.

At the time of going to press, Preiser's team was surprised by renewed interest in work they carried out a decade ago, finding a novel coronavirus in a South African bat, termed NeoCoV. Researchers in China recently reported that a mutation in NeoCoV may enhance its ability to infect human cells through the human ACE2 receptor. “This suggests that this virus might still acquire the ability to infect human cells efficiently through viral evolution,” says Preiser. “While this preprint study must be peer reviewed and the findings confirmed by further research, this is worrying and shows why we must keep a very close eye on all coronaviruses moving forward.”

The world now needs to prepare for subsequent pandemics. “Coronaviruses warrant close scientific attention. That they can cross over from animal reservoirs and cause outbreaks or pandemics became evident with SARS in 2003 and was confirmed by MERS since 2012. Thus SARS-CoV-2 should not have been a surprise. Unfortunately it possesses a combination of properties that led to the COVID-19 pandemic”, says Preiser. “That known high-risk activities like poorly regulated commerce in various wild animal species were allowed to continue despite what we knew, and that most countries were ill-prepared to deal with an incipient pandemic, attests to dangerous gaps between knowledge and implementation”, he adds.