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	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Wenzel, R. P. Perspective by Holmes, K. V. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article by Tsang, K. W. Related Article by Poutanen, S. M. PubMed Citation

ABSTRACT

Background Abstract

The severe acute respiratory syndrome (SARS) has recently been identified as a new clinical entity. SARS is thought to be caused by an unknown infectious agent.

Methods Clinical specimens from patients with SARS were searched for unknown viruses with the use of cell cultures and molecular techniques.

Results A novel coronavirus was identified in patients with SARS. The virus was isolated in cell culture, and a sequence 300 nucleotides in length was obtained by a polymerase-chain-reaction (PCR)–based random-amplification procedure. Genetic characterization indicated that the virus is only distantly related to known coronaviruses (identical in 50 to 60 percent of the nucleotide sequence). On the basis of the obtained sequence, conventional and real-time PCR assays for specific and sensitive detection of the novel virus were established. Virus was detected in a variety of clinical specimens from patients with SARS but not in controls. High concentrations of viral RNA of up to 100 million molecules per milliliter were found in sputum. Viral RNA was also detected at extremely low concentrations in plasma during the acute phase and in feces during the late convalescent phase. Infected patients showed seroconversion on the Vero cells in which the virus was isolated.

Conclusions The novel coronavirus might have a role in causing SARS.

Source Information

From the Bernhard Nocht Institute for Tropical Medicine, National Reference Center for Tropical Infectious Diseases, Hamburg (C.D., S.G., M.P., K.G., S.K., S.M., S.V., H.S.); the Institute of Medical Virology (W.P., H.R., A.B., J.C., M.S., H.W.D.) and the Medical Clinic III (H.-R.B., V.R.), Johann Wolfgang Goethe University, Frankfurt am Main; and the Institute of Virology, Philipps University, Marburg (S.B., L.K., M.E., H.-D.K.) — all in Germany; the Pasteur Institute, Molecular Genetics of Respiratory Tract Viruses, National Influenza Center (Northern France), Paris (S.W., A.-M.B., N.E., J.-C.M.); and the Institute of Virology, Erasmus University, Rotterdam, the Netherlands (R.A.M.F., A.D.M.E.O.).

Drs. Drosten and Günther contributed equally to this article.

This article was published at www.nejm.org on April 10, 2003.

Address reprint requests to Dr. Drosten at the Department of Virology, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht Str. 74, 20359 Hamburg, Germany, or at drosten{at}bni-hamburg.de.

Full Text of this Article

Related Letters:

Managing SARS
Bouadma L., Noël V., Schortgen F., Donohue C., Wenzel R. P., Edmond M. B.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:707-708, Aug 14, 2003. Correspondence

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