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In a dusty, subterranean room beneath a crumbling sand building a few miles north of Naqi, Saudi Arabia, EcoHealth Alliance veterinary epidemiologist Jon Epstein finally found what he was looking for: bats. It was early October 2012; he’d travelled to the country with a team of scientists at the request of the Saudi Ministry of Health. A researcher in Jedda had isolated RNA from a strange virus found in the mucus coughed up by a 60-year-old Saudi businessman who’d recently suffered acute pneumonia and renal failure. The man, whose main place of business was located in Naqi, died 11 days after being admitted into the hospital in mid-June.
Epstein and Columbia University epidemiologist Ian Lipkin had been scouring the man’s homes and businesses around the desert town of Bishah in search of the source of the deadly virus. They were intent on sampling bats because a Saudi scientist had determined the new virus to be a novel type of coronavirus, a family of rapidly evolving viruses that includes the severe acute respiratory syndrome coronavirus (SARS-CoV). Both Lipkin and Epstein had worked extensively on SARS when it ripped through southern China and Hong Kong in 2002 and 2003. That disease eventually spread to some 33 countries, infected more than 8,000 people, and killed more than 800. The disease detectives had been investigating bats as a possible natural reservoir for SARS-CoV, and last year, after more than a decade of work, Epstein and colleagues announced the discovery of a nearly identical coronavirus, with the crucial ability to infect human cells, in the Chinese horseshoe bat (Rhinolophus sinicus). They speculated that the bats could have been directly infecting humans, without the need for an intermediate host, throughout the course of the SARS epidemic.1