PubMed Journals: N Engl J Med

  Source:		PMID: 12690092
  Download:	https://www.nejm.org/doi/pdf/10.1056/NEJMoa030781?articleTools=true

    		N Engl J Med. 2003 May 15;348(20):1953-66.
     		Epub 2003 Apr 10.

			A novel coronavirus associated with
			severe acute respiratory syndrome.

			Ksiazek TG(1), 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; SARS Working Group.

			Author Information
			(1) Special Pathogens Branch, National Center
			for Infectious Diseases,
			Centers for Disease Control and Prevention,
			Atlanta, USA.

			Comment in N Engl J Med. 2003 Aug 14;349(7):709.
			N Engl J Med. 2003 May 15;348(20):1948-51.

			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.

			Copyright 2003 Massachusetts Medical Society

			DOI: 10.1056/NEJMoa030781 PMID: 12690092
			[Indexed for MEDLINE]

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