Like other viral illnesses, SARS coronavirus infection can present with only mild symptoms, according to a study published in the February 15 issue of The Journal of Infectious Diseases, online now. The findings help to flesh out the clinical portrait of this novel illness, which emerged in 2003 as a syndrome in which fever and mylagia progressed rapidly to pneumonia and respiratory distress, prompting its initial designation of SARS, or severe acute respiratory syndrome. One implication of the current study is that early detection of future SARS-associated coronavirus outbreaks will require attention to the mild end of the disease's spectrum.

The study, reported by Khek-Yu Ho, P.A. Tambyah, and coworkers in Singapore, involved 372 health care workers at a large teaching hospital where 21 patients with SARS (including 5 of the hospital's staff) were treated. A questionnaire was used to determine which workers had had direct contact with SARS patients, which had no direct contact but were exposed, and which were not exposed. Subjects provided serum samples at the time of possible SARS exposure and a median of 31 days later; the samples were then screened for SARS antibodies using an enzyme-linked immunosorbent assay or a dot-blot immunoassay, and those with positive results were confirmed by an indirect immunofluorescence assay and a virus neutralization assay.

The investigators reported that none of the 260 hospital workers classified as not exposed was seropositive for the virus. Of 112 classified as exposed, 8 were seropositive. Four of the 8 had had direct contact with SARS-infected patients; the others had been in wards where SARS patients had been before transfer to a SARS facility. All 8 had fever, but only 6 also had radiographic evidence of pneumonia and thus met clinical criteria for SARS. Symptoms in the 2 mildly infected subjects included chills and myalgia or cough, all of which resolved within 3 days of symptomatic therapy.
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Contact: Diana Olson
dolson@idsociety.org
703-299-0201
Infectious Diseases Society of America
2-Feb-2004

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