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                <text>We analyzed the dynamics of cumulative severe acute respiratory syndrome (SARS) cases in Singapore, Hong Kong, and Beijing using the Richards model. The predicted total SARS incidence was close to the actual number of cases; the predicted cessation date was close to the lower limit of the 95% confidence interval.</text>
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                <text>DOI: 10.3201/eid0912.030382</text>
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                <text>Jiang Wu, Fujie Xu, Weigong Zhou, Daniel R. Feikin, Chang-Ying Lin, Xiong He, Zonghan Zhu, Wannian Liang, Daniel P. Chin, Anne Schuchat</text>
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                <text>Most cases of severe acute respiratory syndrome (SARS) have occurred in close contacts of SARS patients. However, in Beijing, a large proportion of SARS cases occurred in persons without such contact. We conducted a case-control study in Beijing that compared exposures of 94 unlinked, probable SARS patients with those of 281 community-based controls matched for age group and sex. Case-patients were more likely than controls to have chronic medical conditions or to have visited fever clinics (clinics at which possible SARS patients were separated from other patients), eaten outside the home, or taken taxis frequently. The use of masks was strongly protective. Among 31 case-patients for whom convalescent-phase (&gt;21 days) sera were available, 26% had immunoglobulin G to SARS-associated coronavirus. Our finding that clinical SARS was associated with visits to fever clinics supports Beijing’s strategy of closing clinics with poor infection-control measures. Our finding that mask use lowered the risk for disease supports the community’s use of this strategy.</text>
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                <text>DOI: 10.3201/eid1002.030730</text>
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                <text>Stella R. Quah, Lee Hin-Peng</text>
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                <text>We discuss crisis prevention and management during the first 3 months of the severe acute respiratory syndrome (SARS) outbreak in Singapore. Four public health issues were considered: prevention measures, self-health evaluation, SARS knowledge, and appraisal of crisis management. We conducted telephone interviews with a representative sample of 1,201 adults, ≥21 years of age. We found that sex, age, and attitude (anxiety and perception of open communication with authorities) were associated with practicing preventive measures. Analysis of Singapore’s outbreak improves our understanding of the social dimensions of infectious disease outbreaks.</text>
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                <text>DOI: 10.3201/eid1002.030418</text>
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                <text>Junhui Zhai, Thomas Briese, Erhei Dai, Xiaoyi Wang, Xin Pang, Zongmin Du, Haihong Liu, Jin Wang, Hongxia Wang, Zhaobiao Guo, Zeliang Chen, Lingxiao Jiang, Dongsheng Zhou, Yanping Han, Omar Jabado, Gustavo Palacios, W. Ian Lipkin, Ruifu Yang</text>
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                <text>During the 2003 severe acute respiratory syndrome (SARS) outbreak, a real-time quantitative polymerase chain reaction, which targets the nucleocapsid gene at the 3′-end of the viral genome, was established to detect and identify the SARS-associated coronavirus. We describe the use of this assay to screen &gt;700 clinical samples.</text>
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                <text>DOI: 10.3201/eid1002.030799</text>
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                <text>Cynthia S. Goldsmith, Kathleen M. Tatti, Thomas G. Ksiazek, Pierre E Rollin, James A. Comer, William W. Lee, Paul A. Rota, Bettina Bankamp, William J. Bellini, Sherif R. Zaki</text>
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                <text>Severe acute respiratory syndrome (SARS) was first described during a 2002–2003 global outbreak of severe pneumonia associated with human deaths and person-to-person disease transmission. The etiologic agent was initially identified as a coronavirus by thin-section electron microscopic examination of a virus isolate. Virions were spherical, 78 nm in mean diameter, and composed of a helical nucleocapsid within an envelope with surface projections. Herein, we show that infection with the SARS-associated coronavirus resulted in distinct ultrastructural features: double-membrane vesicles, nucleocapsid inclusions, and large granular areas of cytoplasm. These three structures and the coronavirus particles were shown to be positive for viral proteins and RNA by using ultrastructural immunogold and in situ hybridization assays. In addition, ultrastructural examination of a bronchiolar lavage specimen from a SARS patient showed numerous coronavirus-infected cells with features similar to those in infected culture cells. Electron microscopic studies were critical in identifying the etiologic agent of the SARS outbreak and in guiding subsequent laboratory and epidemiologic investigations.</text>
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                <text>severe acute respiratory syndrome, SARS virus, coronavirus, electron microscopy, immunogold techniques, in situ hybridization</text>
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                <text>DOI: 10.3201/eid1002.030913</text>
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                <text>Emerging Infectious Diseases</text>
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                <text>Multiple Contact Dates and SARS Incubation Periods</text>
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                <text>Martin I. Meltzer</text>
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                <text>Many severe acute respiratory syndrome (SARS) patients have multiple possible incubation periods due to multiple contact dates. Multiple contact dates cannot be used in standard statistical analytic techniques, however. I present a simple spreadsheet-based method that uses multiple contact dates to calculate the possible incubation periods of SARS.</text>
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                <text>2004</text>
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                <text>severe acute respiratory syndrome, Incubation period, multiple contact dates, estimation, Spreadsheet, Canada</text>
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              <elementText elementTextId="8878">
                <text>DOI: 10.3201/eid1002.030426</text>
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                <text>Emerging Infectious Diseases</text>
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                <text>Centers for Disease Control and Prevention</text>
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                <text>Infectious and parasitic diseases, Medicine</text>
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                <text>Po-Ren Hsueh, Pei-Jer Chen, Cheng-Hsiang Hsiao, Shiou-Huei Yeh, Wen-Chen Cheng, Jiun-Ling Wang, Bor-Luen Chiang, Shan-Chwen Chang, Feng-Yee Chang, Wing-Wai Wong, Chuan-Liang Kao, Pan-Chyr Yang</text>
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                <text>Of the first 10 patients in the epidemic of severe acute respiratory syndrome (SARS) in Taiwan, 4 were closely associated with a SARS patient in an airplane. Loose stools or diarrhea, hemophagocytosis syndrome, and high serum levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α associated with lung lesions were found in all 10 patients.</text>
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                <text>DOI: 10.3201/eid1003.030571</text>
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                <text>Emerging Infectious Diseases</text>
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                <text>Centers for Disease Control and Prevention</text>
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                <text>Infectious and parasitic diseases, Medicine</text>
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              <name>Description</name>
              <description>An account of the resource</description>
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                  <text>Dominio científico: Coronavirus</text>
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      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
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                <text>SARS in Hospital Emergency Room</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
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                <text>Yee-Chun Chen, Li-Min Huang, Chang-Chuan Chan, Chan-Ping Su, Shan-Chwen Chang, Ying-Ying Chang, Mei-Ling Chen, Chien-Ching Hung, Wen-Jone Chen, Fang-Yue Lin, Yuan-Teh Lee</text>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Thirty-one cases of severe acute respiratory syndrome (SARS) occurred after exposure in the emergency room at the National Taiwan University Hospital. The index patient was linked to an outbreak at a nearby municipal hospital. Three clusters were identified over a 3-week period. The first cluster (5 patients) and the second cluster (14 patients) occurred among patients, family members, and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare workers. Six healthcare workers had close contact with SARS patients. Six others, with different working patterns, indicated that they did not have contact with a SARS patient. Environmental surveys found 9 of 119 samples of inanimate objects to be positive for SARS coronavirus RNA. These observations indicate that although transmission by direct contact with known SARS patients was responsible for most cases, environmental contamination with the SARS coronavirus may have lead to infection among healthcare workers without documented contact with known hospitalized SARS patients.</text>
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          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="8896">
                <text>2004</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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              <elementText elementTextId="8897">
                <text>severe acute respiratory syndrome, healthcare workers, environmental contamination, real-time reverse transcriptase–polymerase chain reaction, Taiwan</text>
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            </elementTextContainer>
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          <element elementId="43">
            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
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              <elementText elementTextId="8898">
                <text>DOI: 10.3201/eid1005.030579</text>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="8899">
                <text>Emerging Infectious Diseases</text>
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            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
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              <elementText elementTextId="8900">
                <text>Centers for Disease Control and Prevention</text>
              </elementText>
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          </element>
          <element elementId="38">
            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
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              <elementText elementTextId="8901">
                <text>Infectious and parasitic diseases, Medicine</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
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              <elementText elementTextId="8902">
                <text>EN</text>
              </elementText>
            </elementTextContainer>
          </element>
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