SARS-associated coronavirus transmission, United States.

Elmira T Isakbaeva,Indra Pandya Smith,Larry J Anderson,Thomas G Ksiazek,Sara Lowther,Dean Erdman,Stephan S Monroe,Marc-Alain Widdowson,Angela Peck,Suxiang Tong,Jairam Lingappa,Nino Khetsuriani,R Suzanne Beard

doi:10.3201/eid1002.030734

Abstract

To better assess the risk for transmission of the severe acute respiratory syndrome–associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S. SARS patients and their 10 household contacts. SARS-CoV was detected in a day-14 sputum specimen from one case-patient and in five stool specimens from two case-patients. In one case-patient, SARS-CoV persisted in stool for at least 26 days after symptom onset. The highest amounts of virus were in the day-14 sputum sample and a day-14 stool sample. Residual respiratory symptoms were still present in recovered SARS case-patients 2 months after illness onset. Possible transmission of SARS-CoV occurred in one household contact, but this person had also traveled to a SARS-affected area. The data suggest that SARS-CoV is not always transmitted efficiently. Laboratory diagnosis of SARS-CoV infection is difficult; thus, sputum and stool specimens should be included in the diagnostic work-up for SARS-CoV infection.

Highlights

To better assess the risk for transmission of the severe acute respiratory syndrome–associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S Severe acute respiratory syndrome (SARS) patients and their 10 household contacts
Household contacts were defined as persons who had lived in the same household with SARS case-patients during their illness
Serum was separated before being shipped to CDC for testing

Summary

Introduction

To better assess the risk for transmission of the severe acute respiratory syndrome–associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S SARS patients and their 10 household contacts. Epidemiologic evidence suggested that SARS-CoV was transmitted by respiratory droplets or direct contact with infected patients and possibly by fomites [9,10,11,12]. A better understanding of the duration of SARS-CoV shedding and virus quantities in respiratory secretions, stool, urine, and other body fluids and of the risk factors for spreading illness to close contacts is critical to accurately assess the risk for transmission and to develop effective control strategies. We obtained serial biologic specimens and clinical and exposure data for 5 to 10 weeks after onset of illness from seven laboratory-confirmed U.S SARS patients and their household contacts

Methods

Results

Conclusion