BREAKING BIG: POSSIBLE PATHOGEN DETECTED IN SARS CASE

PROMED ^ | 03-18-03

[Mother Abigail]

Paramyxovirus-like particles identified by electron microscopy

Numerous tests have been performed on the 3 patients admitted on Saturday 15 March to the Isolation Unit at Frankfurt am Main with suspected severe acute respiratory syndrome (SARS). Tests from respiratory specimens for influenza A and B virus, respiratory syncytial virus, enteroviruses, _Mycoplasma pneumoniae_ and _Chlamydia_ spp. by antigen enzyme linked immunosorbent assay (ELISA) and/or polymerase chain reaction (PCR) were all negative; antibody tests for dengue, influenza A and B, measles, hantaviruses, _Mycoplasma pneumoniae_ and _Chlamydia_ spp. were likewise negative or unremarkable so far; further test results are pending.

Particles morphologically resembling paramyxoviruses were seen in respiratory specimens (throat swab and sputum) obtained from the index patient, a doctor from Singapore, by the teams in Marburg and in Frankfurt am Main.

It remains to be seen whether this finding can be confirmed -- tests including low-stringency paramyxovirus PCR and tissue culture are currently under way in Hamburg, in Marburg and in Frankfurt am Main. It needs to be emphasised that at this time these preliminary results only indicate a suspicion. Furthermore, even if the presence of a paramyxovirus was confirmed, it is not clear at this stage whether this might represent the causal agent of SARS or rather a coincidental finding.

[Mother Abigail]

We have had some recent experience with this subfamily of virus.

Hendra and Nipah are recent culprits in small outbreaks.

They are so new that they have been given their own genus (Henipavirus).

Hendra and Nipah are both zoonotic meaning they can transmit from animals to man - horses, pigs, bats etc. - Remember this is all very new stuff.

And it might well be that a mutant of the Paramyxoviridae family has broken out in South China spread to Hong Kong and is doing a bit of traveling..

Here is the correct classification of these bugs (as it stands now) Henipavirus becomes the fourth genus within the Paramyxovirinae subfamily of the Paramyxoviridae family. The other genera within the subfamily are Rubulavirus, Morbillivirus and Respirovirus.

Morbillivirus is measles

Rubulavirus is mumps

[twigs]

Thank you for the translation.

[94Revolution]

Many test have been done on the 3 patients admitted on Saturday 15 March to the Isolation
Unit at Frankfurt, Germany. The patients had server upper respiratory infections. Blood was taking and cultures were watched for two types of Flu virus. Type A and B is Respiratory Syncytial Virus (RSV) usually causes symptoms of a simple upper respiratory tract illness or common cold. These symptoms include a stuffy or runny nose, sore throat, mild headache, mild cough, low-grade fever, and a general feeling of being ill. Enterovirusus are viruses that multiply in the stomach and are transmitted from person to person by the feces-oral route (ingestion disease). Mycoplasma pneumoniae is a human bacterium causing inflamed bronchial tubes and inflamed trachea and pneumonia. The researchers and lab workers used ELISA a useful and powerful method in the lab to test certain viruses and bacteria for antibodies. Another tool used to help the researchers was PCR (Polymerase Chain Reaction) will allow a short stretch of DNA to be amplified to about a million fold so that one can determine its size
and type. The tests the researchers used on the specimens all turned up negative. Antibodies were not present for Dengue, TYPE A and B Measles, Hantavirus. Mycoplasma Pneumonia, chlamydia_spp, were also negative. The researchers will be performing more tests.

The researchers have not concluded that the causes of the latest deadly outbreak of the Flu is being caused from Paramyxovirus. The finding may have been coincidental and the patient already had these particles in them but had immunity already from past exposure.

I tried to make that mess as easy to read as possible.

[Endeavor]

no sweat.

[94Revolution]

My gosh

SEVERE not server /sigh

[rwfromkansas]

What does it mean?

[CharlotteVRWC]

There are also the following virus types listed in Merck Vet Manual :

Avian paramyxovirus type 3, and Avian paramyxovirus type 2. I don't see a type 1 listed - so I don't know what happened to that one.

[Snowy]

What does it mean?

I would like to know the following:

1. How is this thing spread?
2. Is it a virus, bacteria, or other?
3. Has anyone gotten better? (I know many are still in hospital)
4. Is this a mutation or completely new?
5. Could this be bioterrorism (likely, not likely, etc)

[TaxRelief]

From Harold Oster at the ivillagehealth.com website:

"While it is possible for an adult to get strep throat every year for 10 years, it is not common at all. Most cases of sore throat are viral infections, not strep infections. A physician can take a culture of the throat to distinguish the two. One problem with the throat culture is that as many as 10 to 15 percent of all people will have strep in their throats even with no illness. These people almost never have any problems whatsoever with the bacterium.

When I have a patient who has been diagnosed with strep throat over and over again, I take a throat culture during a period without illness. If the culture is positive, it confirms that my patient is a carrier -- which means the culture will always come out positive even when strep is not causing illness."

So you see, if your cultures are negative, then you are strep free!!!

[CharlotteVRWC]

Wow..this might be a coincidence...apparantely there are 9 recognized serotypes of avian paramyxovirus (PMV1-PMV9). Newcastle disease virus (PMV1) is the most important pathogen for poulty.

I recently received the following email concerning a Newcastle outbreak in California (Newcastle is a reportable disease).

Fellow Veterinarians, Your attention is directed to the attached news release regarding Exotic Newcastle Disease (END) and the continued threat that it poses to our state's poultry, pet bird, and hobby fowl population. As you may be aware, END is the most virulent of the avian foreign animal diseases and was detected in the fighting game bird population in southern California on Oct. 1, 2002. It has since spread to 13 commercial premises in that state, as well as several locations in Nevada and Arizona. To date, over 2000 premises (primarily backyard and hobby birds) have been confirmed or quarantined as dangerous contacts, resulting in the depopulation of over 2 million birds. Indications from California are that the disease is not under control, with many instances of illegal movements from the quarantine area. All avian species are susceptible, including pet birds, many of which can be inapparent carriers of the virus.

Your help is requested in expanding our surveillance capabilities within NC for END. As you may recall, the initial index case in California was seen by a private small animal practitioner who was presented with a sick fighting bird. Please contact us or one of the referenced diagnostic laboratories regarding any suspicious case, or suspected illegal movements of fowl or pet birds from the southwestern US. Large animal practitioners, please be alert for any signs of syndromic disease patterns or heavy morbidity among bird populations on farms that you may be visiting as part of your normal practice visits. You may contact Dr. Jo Anna Quinn at 919-733-3986, Dr. Mark Camacho at 919-807-4340, or me at 919-733-5657 with questions or concerns. We will be providing continued updates and refer you to the CA Dept. of Agriculture web site (http://www.cdfa.ca.gov/ahfss/ah/Newcastle_info.htm) for additional information on the situation. Thanks for you help as we expand capabilities in protecting our animal populations.

Dr. David T. Marshall State Veterinarian, NCDA&CS

[ksen]

I wonder how long people are contagious before their symptoms start to show.

[xsmommy]

i am rarely sick, and have never had strep. but what was odd was when my children were toddlers and routinely exposed to other kids, they never had a positive strep test. as a mother, you always long for an antibiotic to get rid of illness, instead of being sent away with a sick kid. and YES, i know all about the overprescribing of antibiotics!

[TaxRelief]

Many tests have been done on the 3 patients admitted on Saturday 15 March to the Isolation Unit at Frankfurt, Germany. The patients had severe upper respiratory infections. Blood was taken...
These patients are the Singapore Doctor who traveled through NYC, his pregnant wife and his mother. My guess is this Dr. is helping with the research of his own disease. I am praying for their baby!!!!

[Snowy]

i am rarely sick, and have never had strep. but what was odd was when my children were toddlers and routinely exposed to other kids, they never had a positive strep test. as a mother, you always long for an antibiotic to get rid of illness, instead of being sent away with a sick kid. and YES, i know all about the overprescribing of antibiotics!

We have never had strep either. My kids haven't been to the doctor for an illnes in several years. As a matter of fact, I can't remember the last time they went for an illness. They are 9 and 11.

[aristeides]

PARAINFLUENZA.

[xsmommy]

me too! mine are 9,11, and 14.

[anymouse]

Fantasy WH press conference:

Reporter: Am I or my loved ones going to get sick and die?

Ari Fleicher: Yes. Next question please.

[aristeides]

From that link:

Epidemiology and Transmission

The virus is ubiquitous; infections occur as epidemics as well as sporadically.

Parainfluenza viruses are sensitive to detergents and heat but can remain viable on surfaces for up to 10 hours.

Transmission occurs via the following routes:

Large droplets - person to person through close contact

Aerosols of respiratory secretions

Fomites (virus survives on surfaces)

Figure . Weekly reports of parainfluenza type 1 in the US. Seasonal variation. CDC

Figure . Weekly reports of parainfluenza type 2 in the US. Seasonal variation. CDC

Figure . Weekly reports of parainfluenza type 3 in the US. Seasonal variation. CDC

Clinical Features

Incubation period is 2 to 6 days.

Most infections are asymptomatic, especially in older children and adults.

Primary infections and re-infections occur.

Most persons have had primary infections before the age of 5 yrs.

Reinfections are clinically less severe, most commonly involve the upper respiratory tract and occur throughout life.

Fever and a spectrum of respiratory infections are caused by PIVs:

Rhinorrhea/rhinitis, pharyngitis, cough, croup (laryngotracheobronchitis), bronchiolitis, and pneumonia.

Croup - the subglottic region becomes narrower and results in difficulty with breathing, a seal bark-like cough and hoarseness.

PIV types 1 and 2 most often cause outbreaks of croup in autumn/early winter, with an alternate year pattern. PIV-1 tends to attack children ages 2-6 years.

PIV-3 can cause croup, though less commonly than PIV-1 and 2 and is sporadic, without a particular seasonal occurrence [spring and summer also].

Primary infection with PIV 3 in young infants and children of less than two years of age is a common cause of bronchiolitis (RSV more common).

PIV-4 is associated with mild upper respiratory infections

Otitis media, parotitis, aseptic meningitis occur although they are rare.

Particularly severe and persistent infections are known to occur in immunocompromised children and adults; prolonged viral shedding is seen.

[Mother Abigail]

We honestly do not know.

Remember some form of contact is required, at least we hope - but transmission has been consistant with casual contact, and that might be more dangerous in the days when the fever and cough materialize. Say day 3,4,or 5 of the onset.

Understand that this could be all wrong.

Something very odd is going on in Hong Kong - the virus? is out in the public and spreading. There are some indications that we may not know the scope of the Hong Kong cluster yet. Follow freeper per loin, he is all over the Hong Kong situation. To his credit he picked up on the bogus numbers from the first.