Affiliations
AffiliationItem in Clipboard
Identification of severe acute respiratory syndrome in CanadaSusan M Poutanen et al. N Engl J Med. 2003.
Free article . 2003 May 15;348(20):1995-2005. doi: 10.1056/NEJMoa030634. Epub 2003 Mar 31. Authors Susan M Poutanen 1 , Donald E Low, Bonnie Henry, Sandy Finkelstein, David Rose, Karen Green, Raymond Tellier, Ryan Draker, Dena Adachi, Melissa Ayers, Adrienne K Chan, Danuta M Skowronski, Irving Salit, Andrew E Simor, Arthur S Slutsky, Patrick W Doyle, Mel Krajden, Martin Petric, Robert C Brunham, Allison J McGeer; National Microbiology Laboratory, Canada; Canadian Severe Acute Respiratory Syndrome Study Team AffiliationItem in Clipboard
AbstractBackground: Severe acute respiratory syndrome (SARS) is a condition of unknown cause that has recently been recognized in patients in Asia, North America, and Europe. This report summarizes the initial epidemiologic findings, clinical description, and diagnostic findings that followed the identification of SARS in Canada.
Methods: SARS was first identified in Canada in early March 2003. We collected epidemiologic, clinical, and diagnostic data from each of the first 10 cases prospectively as they were identified. Specimens from all cases were sent to local, provincial, national, and international laboratories for studies to identify an etiologic agent.
Results: The patients ranged from 24 to 78 years old; 60 percent were men. Transmission occurred only after close contact. The most common presenting symptoms were fever (in 100 percent of cases) and malaise (in 70 percent), followed by nonproductive cough (in 100 percent) and dyspnea (in 80 percent) associated with infiltrates on chest radiography (in 100 percent). Lymphopenia (in 89 percent of those for whom data were available), elevated lactate dehydrogenase levels (in 80 percent), elevated aspartate aminotransferase levels (in 78 percent), and elevated creatinine kinase levels (in 56 percent) were common. Empirical therapy most commonly included antibiotics, oseltamivir, and intravenous ribavirin. Mechanical ventilation was required in five patients. Three patients died, and five have had clinical improvement. The results of laboratory investigations were negative or not clinically significant except for the amplification of human metapneumovirus from respiratory specimens from five of nine patients and the isolation and amplification of a novel coronavirus from five of nine patients. In four cases both pathogens were isolated.
Conclusions: SARS is a condition associated with substantial morbidity and mortality. It appears to be of viral origin, with patterns suggesting droplet or contact transmission. The role of human metapneumovirus, a novel coronavirus, or both requires further investigation.
Copyright 2003 Massachusetts Medical Society
Comment inHolmes KV. Holmes KV. N Engl J Med. 2003 May 15;348(20):1948-51. doi: 10.1056/NEJMp030078. N Engl J Med. 2003. PMID: 12748314 No abstract available.
Johnson S, Patel M, Mullane K. Johnson S, et al. N Engl J Med. 2003 Aug 14;349(7):709-11; author reply 709-11. doi: 10.1056/NEJMc031367. N Engl J Med. 2003. PMID: 12917312 No abstract available.
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Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, Ahuja A, Yung MY, Leung CB, To KF, Lui SF, Szeto CC, Chung S, Sung JJ. Lee N, et al. N Engl J Med. 2003 May 15;348(20):1986-94. doi: 10.1056/NEJMoa030685. Epub 2003 Apr 7. N Engl J Med. 2003. PMID: 12682352
Vittoria BL, Imbesi C, Irene G, Calì G, Bitto A. Vittoria BL, et al. Pharmaceuticals (Basel). 2021 May 25;14(6):503. doi: 10.3390/ph14060503. Pharmaceuticals (Basel). 2021. PMID: 34070359 Free PMC article. Review.
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Lan YC, Liu HF, Shih YP, Yang JY, Chen HY, Chen YM. Lan YC, et al. Infect Genet Evol. 2005 Apr;5(3):261-9. doi: 10.1016/j.meegid.2004.08.005. Epub 2004 Dec 7. Infect Genet Evol. 2005. PMID: 15737918 Free PMC article.
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