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A novel coronavirus associated with severe acute respiratory syndrome.
N Engl J Med. 2003 May 15; 348(20):1953-66.NEJM

Abstract

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 seven 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

None of the previously described respiratory pathogens were consistently identified. However, a novel coronavirus was isolated from patients who met the case definition of SARS. Cytopathological features were noted in Vero E6 cells inoculated with a throat-swab specimen. Electron-microscopical examination 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 fluorescence antibody tests and enzyme-linked immunosorbent assays made with the new isolate have been used to demonstrate a virus-specific serologic response. This virus may never before have circulated in 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. Because of the death of Dr. Carlo Urbani, we propose that our first isolate be named the Urbani strain of SARS-associated coronavirus.

Authors+Show Affiliations

Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12690092

Citation

Ksiazek, Thomas G., et al. "A Novel Coronavirus Associated With Severe Acute Respiratory Syndrome." The New England Journal of Medicine, vol. 348, no. 20, 2003, pp. 1953-66.
Ksiazek TG, Erdman D, Goldsmith CS, et al. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med. 2003;348(20):1953-66.
Ksiazek, T. G., Erdman, D., Goldsmith, C. S., Zaki, S. R., Peret, T., Emery, S., Tong, S., Urbani, C., Comer, J. A., Lim, W., Rollin, P. E., Dowell, S. F., Ling, A. E., Humphrey, C. D., Shieh, W. J., Guarner, J., Paddock, C. D., Rota, P., Fields, B., ... Anderson, L. J. (2003). A novel coronavirus associated with severe acute respiratory syndrome. The New England Journal of Medicine, 348(20), 1953-66.
Ksiazek TG, et al. A Novel Coronavirus Associated With Severe Acute Respiratory Syndrome. N Engl J Med. 2003 May 15;348(20):1953-66. PubMed PMID: 12690092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A novel coronavirus associated with severe acute respiratory syndrome. AU - Ksiazek,Thomas G, AU - Erdman,Dean, AU - Goldsmith,Cynthia S, AU - Zaki,Sherif R, AU - Peret,Teresa, AU - Emery,Shannon, AU - Tong,Suxiang, AU - Urbani,Carlo, AU - Comer,James A, AU - Lim,Wilina, AU - Rollin,Pierre E, AU - Dowell,Scott F, AU - Ling,Ai-Ee, AU - Humphrey,Charles D, AU - Shieh,Wun-Ju, AU - Guarner,Jeannette, AU - Paddock,Christopher D, AU - Rota,Paul, AU - Fields,Barry, AU - DeRisi,Joseph, AU - Yang,Jyh-Yuan, AU - Cox,Nancy, AU - Hughes,James M, AU - LeDuc,James W, AU - Bellini,William J, AU - Anderson,Larry J, AU - ,, Y1 - 2003/04/10/ PY - 2003/4/12/pubmed PY - 2003/5/22/medline PY - 2003/4/12/entrez SP - 1953 EP - 66 JF - The New England journal of medicine JO - N Engl J Med VL - 348 IS - 20 N2 - 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 seven 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: None of the previously described respiratory pathogens were consistently identified. However, a novel coronavirus was isolated from patients who met the case definition of SARS. Cytopathological features were noted in Vero E6 cells inoculated with a throat-swab specimen. Electron-microscopical examination 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 fluorescence antibody tests and enzyme-linked immunosorbent assays made with the new isolate have been used to demonstrate a virus-specific serologic response. This virus may never before have circulated in 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. Because of the death of Dr. Carlo Urbani, we propose that our first isolate be named the Urbani strain of SARS-associated coronavirus. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/12690092/A_novel_coronavirus_associated_with_severe_acute_respiratory_syndrome_ DB - PRIME DP - Unbound Medicine ER -