LA CONSULTA SEMANAL

CONSULTA

1: Science 2003 Apr 25;300(5619):558-9

SARS outbreak. Modelers struggle to grasp epidemic's potential scope.

Vogel G.

Publication Types: News

2: BMJ 2003 Apr 26;326(7395):929 [Texto completo]

Policies on SARS in UK boarding schools are confused.

Wong I.

Publication Types: Letter

3: BMJ 2003 Apr 26;326(7395):897 [Texto completo]

Canada reports more than 300 suspected cases of SARS.

Spurgeon D.

Publication Types: News PMID

4: BMJ 2003 Apr 26;326(7395):897 [Texto completo]

SARS virus identified, but the disease is still spreading.

Parry J.

Publication Types: News

5: Lancet 2003 Apr 19;361(9366):1386-7

Severe acute respiratory syndrome (SARS): infection control.

Yang W.

Taipei Representative Office UK, SW1W 0EB, London, UK

6: Lancet 2003 Apr 19;361(9366):1386

Severe acute respiratory syndrome (SARS): infection control.

Li TS, Buckley TA, Yap FH, Sung JJ, Joynt GM.

Intensive Care Unit, Department of Anaesthesia and Intensive Care and Department of Medicine, The Chinese University of Hong Kong, Hong Kong

7: Lancet 2003 Apr 19;361(9366):1313-5

Guideline on management of severe acute respiratory syndrome (SARS).

Ho W.

Hospital Authority Building, Kowloon, Hong Kong, China

8: Wkly Epidemiol Rec 2003 Mar 28;78(13):89

Severe acute respiratory syndrome (SARS).

9: AJR Am J Roentgenol 2003 May;180(5):1247-9

SARS: Imaging of Severe Acute Respiratory Syndrome.

Nicolaou S, Al-Nakshabandi NA, Muller NL.

All authors: Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W. 12th Ave., Vancouver, B. C., V5Z 1M9, Canada.

10: BMJ 2003 Apr 19;326(7394):839 [Texto completo]

SARS shows no sign of coming under control.

Parry J.

Hong Kong.

11: N Engl J Med 2003 Apr 14; [Texto completo]

A Major Outbreak of Severe Acute Respiratory Syndrome in Hong Kong.

Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, Ahuja A, Yung MY, Leung CB, To KF, Lui SF, Szeto CC, Chung S, Sung JJ.

Background There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. We report the clinical, laboratory, and radiologic features of 138 cases of suspected SARS during a hospital outbreak in Hong Kong. Methods From March 11 to 25, 2003, all patients with suspected SARS after exposure to an index patient or ward were admitted to the isolation wards of the Prince of Wales Hospital. Their demographic, clinical, laboratory, and radiologic characteristics were analyzed. Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed. Results There were 66 male patients and 72 female patients in this cohort, 69 of whom were health care workers. The most common symptoms included fever (in 100 percent of the patients); chills, rigors, or both (73.2 percent); and myalgia (60.9 percent). Cough and headache were also reported in more than 50 percent of the patients. Other common findings were lymphopenia (in 69.6 percent), thrombocytopenia (44.8 percent), and elevated lactate dehydrogenase and creatine kinase levels (71.0 percent and 32.1 percent, respectively). Peripheral air-space consolidation was commonly observed on thoracic computed tomographic scanning. A total of 32 patients (23.2 percent) were admitted to the intensive care unit; 5 patients died, all of whom had coexisting conditions. In a multivariate analysis, the independent predictors of an adverse outcome were advanced age (odds ratio per decade of life, 1.80; 95 percent confidence interval, 1.16 to 2.81; P=0.009), a high peak lactate dehydrogenase level (odds ratio per 100 U per liter, 2.09; 95 percent confidence interval, 1.28 to 3.42; P=0.003), and an absolute neutrophil count that exceeded the upper limit of the normal range on presentation (odds ratio, 1.60; 95 percent confidence interval, 1.03 to 2.50; P=0.04). Conclusions SARS is a serious respiratory illness that led to significant morbidity and mortality in our cohort.

12: Science 2003 Apr 11;300(5617):224-5

INFECTIOUS DISEASES: Deferring Competition, Global Net Closes In on SARS.

Enserink M, Vogel G.

In the 4 weeks since the SARS epidemic surfaced in Asia, a dozen labs around the world have created a network to track the infection to its source. More than 2600 cases have been identified in 19 countries, and more than 100 deaths have been reported. So far, the most likely cause appears to be a new coronavirus, possibly aided by a metapneumovirus.

13: N Engl J Med 2003 Apr 16; 348:1953-66. [Texto completo]

A Novel Coronavirus Associated with Severe Acute Respiratory Syndrome.

Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, Tong S, Urbani C, Comer JA, Lim W, Rollin PE, Dowell SF, Ling AE, Humphrey CD, Shieh WJ, Guarner J, Paddock CD, Rota P, Fields B, DeRisi J, Yang JY, Cox N, Hughes JM, LeDuc JW, Bellini WJ, Anderson LJ.

Background A worldwide outbreak of severe acute respiratory syndrome (SARS) has been associated with exposures originating from a single ill health care worker from Guangdong Province, China. We conducted studies to identify the etiologic agent of this outbreak. Methods We received clinical specimens from patients in six countries and tested them, using virus isolation techniques, electron-microscopical and histologic studies, and molecular and serologic assays, in an attempt to identify a wide range of potential pathogens. Results No classic respiratory or bacterial respiratory pathogen was consistently identified. However, a novel coronavirus was isolated from patients who met the case definition of SARS. Cytopathological features were noted microscopically in Vero E6 cells inoculated with a throat-swab specimen. Electron-microscopical examination of cultures revealed ultrastructural features characteristic of coronaviruses. Immunohistochemical and immunofluorescence staining revealed reactivity with group I coronavirus polyclonal antibodies. Consensus coronavirus primers designed to amplify a fragment of the polymerase gene by reverse transcription-polymerase chain reaction (RT-PCR) were used to obtain a sequence that clearly identified the isolate as a unique coronavirus only distantly related to previously sequenced coronaviruses. With specific diagnostic RT-PCR primers we identified several identical nucleotide sequences in 12 patients from several locations, a finding consistent with a point source outbreak. Indirect fluorescent antibody tests and enzyme-linked immunosorbent assays made with the new coronavirus isolate have been used to demonstrate a virus-specific serologic response. Preliminary studies suggest that this virus may never before have infected the U.S. population. Conclusions A novel coronavirus is associated with this outbreak, and the evidence indicates that this virus has an etiologic role in SARS. The name Urbani SARS-associated coronavirus is proposed for the virus.

14: N Engl J Med 2003 Apr 10; [Texto completo]

Identification of a Novel Coronavirus in Patients with Severe Acute Respiratory Syndrome.

Drosten C, Gunther S, Preiser W, Van Der Werf S, Brodt HR, Becker S, Rabenau H, Panning M, Kolesnikova L, Fouchier RA, Berger A, Burguiere AM, Cinatl J, Eickmann M, Escriou N, Grywna K, Kramme S, Manuguerra JC, Muller S, Rickerts V, Sturmer M, Vieth S, Klenk HD, Osterhaus AD, Schmitz H, Doerr HW.

Background The severe acute respiratory syndrome (SARS) has recently been identified as a new clinical entity. SARS is thought to be caused by an unknown infectious agent. Methods Clinical specimens from patients with SARS were searched for unknown viruses with the use of cell cultures and molecular techniques. Results A novel coronavirus was identified in patients with SARS. The virus was isolated in cell culture, and a sequence 300 nucleotides in length was obtained by a polymerase-chain-reaction (PCR)-based random-amplification procedure. Genetic characterization indicated that the virus is only distantly related to known coronaviruses (identical in 50 to 60 percent of the nucleotide sequence). On the basis of the obtained sequence, conventional and real-time PCR assays for specific and sensitive detection of the novel virus were established. Virus was detected in a variety of clinical specimens from patients with SARS but not in controls. High concentrations of viral RNA of up to 100 million molecules per milliliter were found in sputum. Viral RNA was also detected at extremely low concentrations in plasma during the acute phase and in feces during the late convalescent phase. Infected patients showed seroconversion on the Vero cells in which the virus was isolated. Conclusions The novel coronavirus might have a role in causing SARS.

15: BMJ 2003 Apr 12;326(7393):784 [Texto completo]

Fear of SARS thwarts medical education in Toronto.

Clark J.

Publication Types: News