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Posted on 04/10/2003 10:42:20 AM PDT by Prince Charles
10 Apr 2003 16:58:09 GMT
Scientists identify virus behind deadly SARS
By Maggie Fox, Health and Science Correspondent
WASHINGTON, April 10 (Reuters) - Scientists said on Thursday they had identified the virus behind the deadly respiratory illness spreading worldwide and proposed naming it after a doctor who first identified the disease and later became a victim.
The new coronavirus, a relative of one of the many viruses that cause the common cold, is, as suspected, new to humans, two research teams reported in the New England Journal of Medicine.
The finding means that doctors can now concentrate on developing a simple test for the virus that will tell them right away whether a patient has Severe Acute Respiratory Syndrome, or SARS.
The U.S. Centers for Disease Control and Prevention, or CDC, has three such tests but says they are not suitable for everyday use.
In one of the studies reported on Thursday, the CDC's Dr. Larry Anderson and colleagues tested samples from patients in six countries with SARS..
"Nineteen patients with SARS have been identified as infected with the new coronavirus. All have direct or indirect links to the SARS outbreak in Hong Kong and Guangdong province, China," the researchers said in their report released early by the journal.
"A coronavirus with identical (genetic) sequences has also been detected in a patient with SARS in Canada."
They said the virus should be named after Dr. Carlo Urbani, the World Health Organization doctor who died of SARS last month after treating one of the first patients infected with the virus in Vietnam.
"Because of the death of Dr. Carlo Urbani during the investigation of the initial SARS epidemic, we propose that the virus be named Urbani SARS-associated coronavirus," they wrote.
SARS is marked by a high fever, dry cough and other flu-like symptoms but it progresses to pneumonia. Some patients must be put on respirators to help their lungs function.
About four percent of patients with SARS die.
SARS, which was spread around the world by travelers, has killed an estimated 110 people and infected more than 3,000. But authorities in the United States and other countries believe they have the infection under control.
In China, Hong Kong and Singapore, areas hardest hit by the virus, the picture is less clear.
The CDC, World Health Organization and doctors in affected areas, eager to find the root of the mystery disease, tested for the usual suspects, such as influenza and other known bacterial and viral causes of pneumonia, which turned out negative.
SUSPECT VIRUSES
At first a virus related to measles, mumps and some other more exotic diseases emerged as the cause of SARS, but scientists later ruled that out.
It is possible that the virus, called a paramyxovirus, or other microbes may help make patients more ill or make them more likely to transmit SARS, Anderson's team said.
The lung damage seen in patients who died of SARS looks more like the damage done by measles, respiratory syncytial virus and some other diseases, and not like the damage done by other coronaviruses, they said.
It is possible the damage is caused by the body's immune response. When the immune system attacks a bacterial or viral infection, it sometimes kills healthy cells along with the microbes.
The CDC team is working to sequence the DNA of the virus, which will give a better idea of what it is and where it originates. But it does not look like anything they have seen before in animals or people.
"Preliminary studies suggest that this virus may never before have infected the U.S. population," they wrote.
No one they have tested who does not have SARS has antibodies to the virus, suggesting it is new and that no one has been exposed to it before.
"Certainly, it has not circulated widely in humans," they wrote. "Presumably, this virus originated in animals and mutated or recombined in a fashion that permitted it to infect, cause disease, and pass from person to person."
In a second study Dr. Christian Drosten of the Bernhard Nocht Institute for Tropical Medicine in Hamburg and colleagues across Germany, France and the Netherlands also pointed to coronavirus.
They tested samples from 18 SARS patients in Hanoi and 21 healthy people who had been in contact with the patients.
All of the patients with severe SARS had the virus, while none of the healthy people had it. Of those with suspected SARS, the virus could be found in 23 percent.
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Meaning, the statistics we are currently looking at are distorted by a fair number of non-SARS cases.
I assume the "suspected" SARS cases they looked at were in the U.S., since we are the nation most likely to classify a case as "suspected" SARS.
J S M Peiris, S T Lai, L L M Poon, Y Guan, L Y C Yam, W Lim, J Nicholls, W K S Yee, W W Yan, M T Cheung, V C C Cheng, K H Chan, D N C Tsang, R W H Yung, T K Ng, K Y Yuen, and members of the SARS study group
Summary
Background An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong. We investigated the viral cause and clinical presentation among 50 patients.
Methods We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters. We defined the clinical presentation and risk factors associated with severe disease and investigated the causal agents by chest radiography and laboratory testing of nasopharyngeal aspirates and sera samples. We compared the laboratory findings with those submitted for microbiological investigation of other diseases from patients whose identity was masked.
Findings Patients' age ranged from 23 to 74 years. Fever, chills, myalgia, and cough were the most frequent complaints. When compared with chest radiographic changes, respiratory symptoms and auscultatory findings were disproportionally mild. Patients who were household contacts of other infected people, and had older age, lymphopenia, and liver dysfunction were associated with severe disease. A virus belonging to the family Coronaviridae was isolated from two patients. By use of serological and reverse-transcriptase PCR specific for this virus, 45 of 50 patients with SARS, but no controls, had evidence of infection with this virus.
Interpretation A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease. Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression.
Domestic Church speculates they take aspirin.
I know I've read ibuprofin can cause liver problems. Can aspirin?
Secondly, they've found evidence of two pathogens working in conjunction (however, not necessarily Chlamydia):
SARS a combination of bacteria and virus
China: SARS May Be Linked to Chlamydia-Like Agent
If this were the case, one would have to have a defense against both pathogens. IMO, this is why the virus is more difficult for the body to battle. As far as the case of the super-spreaders, the pathogen that is working in conjunction with the coronavirus may make the combination deadly. However, if a carrier passes the coronavirus to someone without a secondary infection (or one the body can handle), the effects are not fatal.
Maybe in the case of the super-spreader, both viruses were passed, and in the case of the apartment building, an underlying virus was already at work in the building.
If any of this is true, it would mean that two viruses would be active at the same time. Finding a cure for any combination of two viruses would be extremely difficult.
If it's the combination that's deadly, why wouldn't it be enough just to find a cure for one of the two viruses (or, alternatively, find some way to block their synergistic effect)?
By the way, a propos of another comment of yours, I wonder if we should seek out getting colds, to improve our resistance to SARS.
While the disease was spread at the wake, it was not by the deceased (directly). Several relatives of the deceased contracted it from him/her while visiting at the hospital and consequently, passed it on to others at the funeral.
Treating one would probably better than treating none. Blocking the synergistic effect would be a great step forward, but I don't think we'll see that for a long time. Immuno-depressed cancer patients are succeptible to all kinds of common viruses and we cannot currently do much to help.
I wonder if we should seek out getting colds, to improve our resistance to SARS.
You guys should know I'm just speculating here. Some viruses have trouble re-infecting a person once that person had the virus (ie: chicken pox). However, there are people who get re-infected even if they have had it before (ie: Shingles). Staying healthy by exercise and proper diet are the best bet. Seeking out a cold is not productive at all.
IMO, SARS is here. I would bet that it's much more widespread than we think and that some people are not even showing 'classic' symptoms. The cases that are being reported are the cases where an opportunistic, secondary virus is causing hospitalization and even death.
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