Keywords: trauma, Resilience, Impact of Event Scale, Hospital Anxiety and Depression Scale, infectious disease, China
Posttraumatic stress disorder (PTSD) can arise in patients with medical illness. We used 2 Chinese self-report measures to examine features of PTSD, anxiety, and depression in 131 survivors of severe acute respiratory syndrome at 1 month and 3 months after discharge from the hospital. Risk factors associated with psychological distress were identified.
Centers for Disease Control and Prevention
Infectious and parasitic diseases, Medicine
Viral Load Distribution in SARS Outbreak
SARS, Transmission, Viral load, Amoy Gardens, research, Hong Kong
An unprecedented community outbreak of severe acute respiratory syndrome (SARS) occurred in the Amoy Gardens, a high-rise residential complex in Hong Kong. Droplet, air, contaminated fomites, and rodent pests have been proposed to be mechanisms for transmitting SARS in a short period. We studied nasopharyngeal viral load of SARS patients on admission and their geographic distribution. Higher nasopharyngeal viral load was found in patients living in adjacent units of the same block inhabited by the index patient, while a lower but detectable nasopharyngeal viral load was found in patients living further away from the index patient. This pattern of nasopharyngeal viral load suggested that airborne transmission played an important part in this outbreak in Hong Kong. Contaminated fomites and rodent pests may have also played a role.
Chung-Ming Chu, Vincent C.C. Cheng, Ivan F.N. Hung, Kin-Sang Chan, Bone S.F. Tang, Thomas H.F. Tsang, Kwok-Hung Chan, Kwok-yung Yuen
SARS Clinical Features, United States, 2003
severe acute respiratory syndrome, SARS, SARS-associated coronavirus, clinical features, United States, case-control
We compared the clinical features of 8 U.S. case-patients with laboratory-confirmed severe acute respiratory syndrome (SARS) to 65 controls who tested negative for SARS coronavirus (SARS-CoV) infection. Shortness of breath, vomiting, diarrhea, progressive bilateral infiltrates on chest radiograph, and need for supplemental oxygen were significantly associated with confirmed SARS-CoV infection.
Padmini Srikantiah, Myrna D. Charles, Sarah Reagan, Thomas A. Clark, Mathias W.R. Pletz, Priti R. Patel, Robert M. Hoekstra, Jairam Lingappa, John A. Jernigan, Marc Fischer
SARS Risk Perception and Preventive Measures, Singapore and Japan
Letter, SARS, healthcare workers, social and work impact, Risk perception, Japan
David Koh, Ken Takahashi, Meng-Kin Lim, Teppei Imai, Sin-Eng Chia, Feng Qian, Vivian Ng, Calvin Fones
Precautionary Behavior in Response to Perceived Threat of Pandemic Influenza
Precautionary behavior, Risk perception, pandemic influenza, research, Denmark, the Netherlands
Faced with an epidemic of an infectious disease, persons may take precautionary actions to try to reduce their risk. Such actions include avoiding situations that persons perceive to be risky, which can have negative health and economic effects. Therefore, we conducted a population-based survey of persons’ precautionary actions in response to a hypothetical influenza pandemic. For the 5 European and 3 Asian regions that had been affected by severe acute respiratory syndrome, the pattern of reported precautionary action was broadly similar across the regions; ≈75% of respondents reported that they would avoid public transportation and 20%–30% would try to stay indoors. Some regional differences were noted; Europeans were more likely than Asians to avoid places of entertainment, and Asians were more likely to avoid seeing physicians. This international survey provides insight into what might be expected during an influenza pandemic.
M Zia Sadique, W. John Edmunds, Richard D Smith, William Jan Meerding, Onno de Zwart, Johannes Brug, Philippe Beutels
Detection of Group 1 Coronaviruses in Bats in North America
coronavirus, bat coronavirus, coronavirus group 1, bats, phylogeny of bat coronaviruses, wildlife viral surveillance
The epidemic of severe acute respiratory syndrome (SARS) was caused by a newly emerged coronavirus (SARS-CoV). Bats of several species in southern People’s Republic of China harbor SARS-like CoVs and may be reservoir hosts for them. To determine whether bats in North America also harbor coronaviruses, we used reverse transcription–PCR to detect coronavirus RNA in bats. We found coronavirus RNA in 6 of 28 fecal specimens from bats of 2 of 7 species tested. The prevalence of viral RNA shedding was high: 17% in Eptesicus fuscus and 50% in Myotis occultus. Sequence analysis of a 440-bp amplicon in gene 1b showed that these Rocky Mountain bat coronaviruses formed 3 clusters in phylogenetic group 1 that were distinct from group 1 coronaviruses of Asian bats. Because of the potential for bat coronaviruses to cause disease in humans and animals, further surveillance and characterization of bat coronaviruses in North America are needed.
Samuel R. Dominguez, Thomas J. O’Shea, Lauren M. Oko, Kathryn V. Holmes
Topographic Changes in SARS Coronavirus–infected Cells during Late Stages of Infection
SARS coronavirus replication, Atomic Force Microscopy, scanning electron microscopy, research, Singapore
Scanning electron and atomic force microscopy was used for the first time to view the maturation of the severe acute respiratory syndrome–associated coronavirus at the cell surface. The surface form of the cells at advanced infection displayed prolific pseudopodia that, in addition to the rest of the plasma membrane, were also active sites of virus release. High magnification of the maturing virus particles showed a rosette appearance with short knoblike spikes under both the scanning electron and atomic force microscopes. The final expulsion step of the maturing virus particles seemed to result in some disruptions to the plasma membrane. The cytoskeletal network along the edge of the infected cells was enhanced and could be involved in transporting and expelling the progeny virus particles. Thickening of the actin filaments at the cell edge provided the bending force to extrude the virus particles.
Mah-Lee Ng, J.W.M. Lee, M.L.N. Leong, A.-E. Ling, H.-C. Tan, E.E. Ooi
Anti–SARS-CoV Immunoglobulin G in Healthcare Workers, Guangzhou, China
SARS, seroprevalence, healthcare workers, China, research
To determine the prevalence of inapparent infection with severe acute respiratory syndrome (SARS) among healthcare workers, we performed a serosurvey to test for immunoglobulin (Ig) G antibodies to the SARS coronavirus (SARS-CoV) among 1,147 healthcare workers in 3 hospitals that admitted SARS patients in mid-May 2003. Among them were 90 healthcare workers with SARS. As a reference group, 709 healthcare workers who worked in 2 hospitals that never admitted any SARS patients were similarly tested. The seroprevalence rate was 88.9% (80/90) for healthcare workers with SARS and 1.4% (15/1,057) for healthcare workers who were apparently healthy. The seroprevalence in the reference group was 0.4% (3/709). These findings suggest that inapparent infection is uncommon. Low level of immunity among unaffected healthcare workers reinforces the need for adequate personal protection and other infection control measures in hospitals to prevent future epidemics.
Wei-Qing Chen, Ciyong Lu, Tze-wai Wong, Wen-Hua Ling, Zhong-Ning Lin, Yuantao Hao, Qing Liu, Ji-Qian Fang, Yun He, Futian Luo, Jin Jing, Li Ling, Xiang Ma, Yimin Liu, Guihua Chen, Jian Huang, Yuan-Sen Jiang, Wen-Qi Jiang, Hequn Zou, Guang-Mei Yan
Severe Acute Respiratory Syndrome: Temporal Stability and Geographic Variation in Death Rates and Doubling Times
Canada, China, Hong Kong, Singapore, Taiwan, Vietnam
We analyzed temporal stability and geographic trends in cumulative case-fatality rates and average doubling times of severe acute respiratory syndrome (SARS). In part, we account for correlations between case-fatality rates and doubling times through differences in control measures. Factors that may alter future estimates of case-fatality rates, reasons for heterogeneity in doubling times among countries, and implications for the control of SARS are discussed.
Alison P. Galvani, Xiudong Lei, Nicholas P. Jewell