Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China

Zhao, Zhendong

doi:10.1099/jmm.0.05320-0

Cited by 366 publications

(352 citation statements)

References 13 publications

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“…In some SARS case series, early use of continuous positive airway pressure (CPAP) therapy or NIV was associated with lower risk of intubation and mortality [21][22][23] and no infection/seroconversion in staff, but there have been no randomised studies. NIV/ CPAP can be delivered in a high-dependency or respiratory ward area, thus offloading intensive care beds, and may be valuable in individuals with exacerbations of chronic obstructive pulmonary disease or heart failure.…”

Section: Lessons From the Sars Epidemicsmentioning

confidence: 99%

Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters

Simonds¹,

Sokol²

2009

European Respiratory Journal

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Pandemics and acute emergencies raise pressing medical, ethical and organisational challenges. These include global governance, priority setting, triaging of patients, allocation of scarce resources and restricting individual liberty in the interests of public health. We will focus particularly on an issue of direct relevance to all respiratory team members, i.e. what is the duty of the healthcare worker to continue working in the face of personal risk, and draw lessons from guidelines, ethical considerations, past pandemics and evolving experience with H1N1 swine influenza.

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Section: Lessons From the Sars Epidemicsmentioning

confidence: 99%

Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters

Simonds¹,

Sokol²

2009

European Respiratory Journal

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“…©2006 Pulsus Group Inc. All rights reserved ORIGINAL ARTICLE S evere acute respiratory syndrome (SARS) was initially reported in southern China in November 2002 (1,2). It received international attention after persons exposed to an ill patient in a Hong Kong hotel travelled internationally and subsequently infected other persons in early 2003 (3).…”

mentioning

confidence: 99%

Risk of Ruling out Severe Acute Respiratory Syndrome by Ruling in another Diagnosis: Variable Incidence of Atypical Bacteria Coinfection Based on Diagnostic Assays

Zahariadis

Gooley

Ryall

et al. 2006

Canadian Respiratory Journal

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G Zahariadis, TA Gooley, P Ryall, et al. Risk of ruling out severe acute respiratory syndrome by ruling in another diagnosis: Variable incidence of atypical bacteria coinfection based on diagnostic assays. Can Respir J 2006;13(1):17-22.BACKGROUND: Severe acute respiratory syndrome (SARS) caused the first epidemic of the 21st century and continues to threaten the global community. OBJECTIVE: To assess the incidence of coinfection in patients confirmed to have SARS-associated coronavirus (SARS-CoV) infection, and thus, to determine the risk of ruling out SARS by ruling in another diagnosis. METHODS:The present report is a retrospective study evaluating the incidence and impact of laboratory-confirmed SARS-CoV and other pulmonary pathogens in 117 patients. These patients were evaluated in a Toronto, Ontario, community hospital identified as the epicentre for the second SARS outbreak. RESULTS: Coinfection with other pulmonary pathogens occured in patients with SARS. Seventy-three per cent of the patient population evaluated had laboratory-confirmed SARS-CoV infection. Serology showing acute or recent Chlamydophila pneumoniae or Mycoplasma pneumoniae infection revealed an incidence of 30% and 9%, respectively, in those with SARS. These rates are similar to previously published studies on coinfection in pneumonia. All nucleic acid diagnostic assays were negative for C pneumoniae and M pneumoniae in respiratory samples from patients with SARS having serological evidence for these atypical pathogens. CONCLUSIONS: Diagnostic assays for well-recognized pulmonary pathogens have limitations, and ruling out SARS-CoV by ruling in another pulmonary pathogen carries significant risk. Despite positive serology for atypical pathogens, in a setting where clinical suspicion for SARS is high, specific tests for SARS should be performed to confirm or exclude a diagnosis.

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“…A n unusual atypical pneumonia or severe acute respiratory syndrome (SARS) 3 emerged in China in November 2002 and spread to 30 countries in early 2003 (1)(2)(3)(4)(5). This disease is characterized by progressive respiratory failure and death in ϳ10% of cases and has garnered significant attention from many public health, social, economic, and political institutions worldwide due to its feared pandemic potential.…”

mentioning

confidence: 99%

Screening and Identification of Severe Acute Respiratory Syndrome-Associated Coronavirus-Specific CTL Epitopes

Zhou

De-sheng

et al. 2006

The Journal of Immunology

107

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Severe acute respiratory syndrome (SARS) is a highly contagious and life-threatening disease that emerged in China in November 2002. A novel SARS-associated coronavirus was identified as its principal etiologic agent; however, the immunopathogenesis of SARS and the role of special CTLs in virus clearance are still largely uncharacterized. In this study, potential HLA-A*0201-restricted spike (S) and nucleocapsid protein-derived peptides were selected from an online database and screened for potential CTL epitopes by in vitro refolding and T2 cell-stabilization assays. The antigenicity of nine peptides which could refold with HLA-A*0201 molecules was assessed with an IFN-γ ELISPOT assay to determine the capacity to stimulate CTLs from PBMCs of HLA-A2+ SARS-recovered donors. A novel HLA-A*0201-restricted decameric epitope P15 (S411–420, KLPDDFMGCV) derived from the S protein was identified and found to localize within the angiotensin-converting enzyme 2 receptor-binding region of the S1 domain. P15 could significantly enhance the expression of HLA-A*0201 molecules on the T2 cell surface, stimulate IFN-γ-producing CTLs from the PBMCs of former SARS patients, and induce specific CTLs from P15-immunized HLA-A2.1 transgenic mice in vivo. Furthermore, significant P15-specific CTLs were induced from HLA-A2.1-transgenic mice immunized by a DNA vaccine encoding the S protein; suggesting that P15 was a naturally processed epitope. Thus, P15 may be a novel SARS-associated coronavirus-specific CTL epitope and a potential target for characterization of virus control mechanisms and evaluation of candidate SARS vaccines.

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Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China

Cited by 366 publications

References 13 publications

Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters

Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters

Risk of Ruling out Severe Acute Respiratory Syndrome by Ruling in another Diagnosis: Variable Incidence of Atypical Bacteria Coinfection Based on Diagnostic Assays

Screening and Identification of Severe Acute Respiratory Syndrome-Associated Coronavirus-Specific CTL Epitopes

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