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                <text>Severe acute respiratory syndrome (SARS)–related risk perceptions, knowledge, precautionary actions, and information sources were studied in the Netherlands during the 2003 SARS outbreak. Although respondents were highly aware of the SARS outbreak, the outbreak did not result in unnecessary precautionary actions or fears.</text>
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                <text>DOI: 10.3201/eid1008.040283</text>
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                <text>Teppei Imai, Ken Takahashi, Tsutomu Hoshuyama, Naoki Hasegawa, Meng-Kin Lim, David Koh</text>
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                <text>In coping with severe acute respiratory syndrome (SARS), infection control measures are a key aspect of protecting healthcare workers. We conducted a survey concerning perception of risk and countermeasures for SARS in 7 tertiary hospitals in Japan from July through September 2003, immediately after the SARS epidemic in neighboring countries. Based on 7,282 respondents out of 9,978 questionnaires administered, we found the perception of risk to be relatively high and the perception of countermeasures at the institutional level to be relatively low. Knowledge of preventive measures, concept of (opinions regarding) institutional measures, and perception of risk differed substantially among the 3 job categories, notably between physicians and nurses. The concept of institutional measures was the most important predictor of individual perception of risk. In view of the potential for future epidemics, planning and implementing institutional measures should be given a high priority.</text>
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                <text>DOI: 10.3201/eid1103.040631</text>
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                <text>Anthony E. Fiore, Stephanie J. Schrag, John T. Brooks, Ali S Khan, Cynthia G Whitney, Larry J. Anderson, Chris Van Beneden, Victor G. Coronado, Brian D. Plikaytis, Umesh D Parashar, Thomas G. Ksiazek, Joseph F. Perz, Dean D. Erdman, Alexander Klimov, Teresa C.T. Peret, William J. Bellini, Patricia M. Griffin, William A. Bower, Clare A. Dykewicz, Daniel R. Feikin, Jacquelyn S. Sampson, Deborah A. Levy, Tracee A. Treadwell, Allen W. Hightower, Rima F. Khabbaz, Maria L. Tondella, Deborah F. Talkington, Nancy E. Rosenstein, Mary E. Chamberland, Annemarie Wasley, Robert F. Benson, W. Lanier Thacker, Dale F. Nordenberg, Tonji M. Durant, Joy L. Herndon, Barbara W. Kilbourn, Joanna Buffington</text>
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                <text>In response to the emergence of severe acute respiratory syndrome (SARS), the United States established national surveillance using a sensitive case definition incorporating clinical, epidemiologic, and laboratory criteria. Of 1,460 unexplained respiratory illnesses reported by state and local health departments to the Centers for Disease Control and Prevention from March 17 to July 30, 2003, a total of 398 (27%) met clinical and epidemiologic SARS case criteria. Of these, 72 (18%) were probable cases with radiographic evidence of pneumonia. Eight (2%) were laboratory-confirmed SARS-coronavirus (SARS-CoV) infections, 206 (52%) were SARS-CoV negative, and 184 (46%) had undetermined SARS-CoV status because of missing convalescent-phase serum specimens. Thirty-one percent (124/398) of case-patients were hospitalized; none died. Travel was the most common epidemiologic link (329/398, 83%), and mainland China was the affected area most commonly visited. One case of possible household transmission was reported, and no laboratory-confirmed infections occurred among healthcare workers. Successes and limitations of this emergency surveillance can guide preparations for future outbreaks of SARS or respiratory diseases of unknown etiology.</text>
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                <text>DOI: 10.3201/eid1002.030752</text>
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                <text>Joseph T. F. Lau, Kitty S. Fung, Tze-wai Wong, Jean H. Kim, Eric Wong, Sydney Chung, Deborah Ho, Louis Y. Chan, S.F. Lui, Augustine Cheng</text>
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                <text>Despite infection control measures, breakthrough transmission of severe acute respiratory syndrome (SARS) occurred for many hospital workers in Hong Kong. We conducted a case-control study of 72 hospital workers with SARS and 144 matched controls. Inconsistent use of goggles, gowns, gloves, and caps was associated with a higher risk for SARS infection (unadjusted odds ratio 2.42 to 20.54, p &lt; 0.05). The likelihood of SARS infection was strongly associated with the amount of personal protection equipment perceived to be inadequate, having</text>
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                <text>DOI: 10.3201/eid1008.040093</text>
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                <text>Gowri Gopalakrishna, Philip Choo, Yee Sin Leo, Boon Keng Tay, Yean Teng Lim, Ali S Khan, Chorh Chuan Tan</text>
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                <text>An outbreak of severe acute respiratory syndrome (SARS) was detected in Singapore at the beginning of March 2003. The outbreak, initiated by a traveler to Hong Kong in late February 2003, led to sequential spread of SARS to three major acute care hospitals in Singapore. The critical factor in containing this outbreak was early detection and complete assessment of movements and follow-up of patients, healthcare workers, and visitors who were contacts. Visitor records were important in helping identify exposed persons who could carry the infection into the community. In the three hospital outbreaks, three different containment strategies were used to contain spread of infection: closing an entire hospital, removing all potentially infected persons to a dedicated SARS hospital, and managing exposed persons in place. On the basis of this experience, if a nosocomial outbreak is detected late, a hospital may need to be closed in order to contain spread of the disease. Outbreaks detected early can be managed by either removing all exposed persons to a designated location or isolating and managing them in place.</text>
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                <text>DOI: 10.3201/eid1003.030650</text>
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                <text>Emerging Infectious Diseases</text>
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                <text>Infectious and parasitic diseases, Medicine</text>
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                  <text>Coronavirus</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>SARS transmission pattern in Singapore reassessed by viral sequence variation analysis.</text>
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              <elementText elementTextId="12175">
                <text>Jianjun Liu, Siew Lan Lim, Yijun Ruan, Ai Ee Ling, Lisa F. P. Ng, Christian Drosten, Edison T. Liu, Lawrence W. Stanton, Martin L. Hibberd</text>
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                <text>BACKGROUND: Epidemiological investigations of infectious disease are mainly dependent on indirect contact information and only occasionally assisted by characterization of pathogen sequence variation from clinical isolates. Direct sequence analysis of the pathogen, particularly at a population level, is generally thought to be too cumbersome, technically difficult, and expensive. We present here a novel application of mass spectrometry (MS)-based technology in characterizing viral sequence variations that overcomes these problems, and we apply it retrospectively to the severe acute respiratory syndrome (SARS) outbreak in Singapore. METHODS AND FINDINGS: The success rate of the MS-based analysis for detecting SARS coronavirus (SARS-CoV) sequence variations was determined to be 95% with 75 copies of viral RNA per reaction, which is sufficient to directly analyze both clinical and cultured samples. Analysis of 13 SARS-CoV isolates from the different stages of the Singapore outbreak identified nine sequence variations that could define the molecular relationship between them and pointed to a new, previously unidentified, primary route of introduction of SARS-CoV into the Singapore population. Our direct determination of viral sequence variation from a clinical sample also clarified an unresolved epidemiological link regarding the acquisition of SARS in a German patient. We were also able to detect heterogeneous viral sequences in primary lung tissues, suggesting a possible coevolution of quasispecies of virus within a single host. CONCLUSION: This study has further demonstrated the importance of improving clinical and epidemiological studies of pathogen transmission through the use of genetic analysis and has revealed the MS-based analysis to be a sensitive and accurate method for characterizing SARS-CoV genetic variations in clinical samples. We suggest that this approach should be used routinely during outbreaks of a wide variety of agents, in order to allow the most effective control.</text>
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                <text>DOI: 10.1371/journal.pmed.0020043</text>
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                <text>PLoS Medicine</text>
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                <text>Medicine</text>
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              <name>Title</name>
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                  <text>Dominio científico: Coronavirus</text>
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      <name>Text</name>
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                <text>SARS Transmission, Risk Factors, and Prevention in Hong Kong</text>
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                <text>Joseph T. F. Lau, Hi Yi Tsui, Mason Lau, Xilin Yang</text>
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                <text>We analyzed information obtained from 1,192 patients with probable severe acute respiratory syndrome (SARS) reported in Hong Kong. Among them, 26.6% were hospital workers, 16.1% were household members of SARS patients and had probable secondary infections, 14.3% were Amoy Garden residents, 4.9% were inpatients, and 20.1% were contacts of SARS patients who were not family members. The remaining 347 case-patients (29.1%) did not have “known” sources of infection. Excluding those</text>
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                <text>2004</text>
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                <text>SARS, source, Transmission, Hong Kong, Chinese</text>
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                <text>DOI: 10.3201/eid1004.030628</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>Dominio científico: Coronavirus</text>
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                <text>SARS Unique Domain (SUD) of Severe Acute Respiratory Syndrome Coronavirus Induces NLRP3 Inflammasome-Dependent CXCL10-Mediated Pulmonary Inflammation</text>
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            <description>An entity primarily responsible for making the resource</description>
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                <text>Hsin-Hou Chang, Su-Hua Huang, Cheng-Wen Lin, Jyh-Cherng Ju, Bo-Han Ko, Young-Sheng Chang</text>
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                <text>Severe acute respiratory syndrome–associated coronavirus (SARS-CoV) initiates the cytokine/chemokine storm-mediated lung injury. The SARS-CoV unique domain (SUD) with three macrodomains (N, M, and C), showing the G-quadruplex binding activity, was examined the possible role in SARS pathogenesis in this study. The chemokine profile analysis indicated that SARS-CoV SUD significantly up-regulated the expression of CXCL10, CCL5 and interleukin (IL)-1β in human lung epithelial cells and in the lung tissues of the mice intratracheally instilled with the recombinant plasmids. Among the SUD subdomains, SUD-MC substantially activated AP-1-mediated CXCL10 expression in vitro. In the wild type mice, SARS-CoV SUD-MC triggered the pulmonary infiltration of macrophages and monocytes, inducing CXCL10-mediated inflammatory responses and severe diffuse alveolar damage symptoms. Moreover, SUD-MC actuated NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome-dependent pulmonary inflammation, as confirmed by the NLRP3 inflammasome inhibitor and the NLRP3−/− mouse model. This study demonstrated that SARS-CoV SUD modulated NLRP3 inflammasome-dependent CXCL10-mediated pulmonary inflammation, providing the potential therapeutic targets for developing the antiviral agents.</text>
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                <text>2020</text>
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                <text>NLRP3 inflammasome, pulmonary inflammation, CXCL10, SARS-coronavirus, SARS-CoV unique domain (SUD)</text>
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                <text>DOI: 10.3390/ijms21093179</text>
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                <text>International Journal of Molecular Sciences</text>
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            <name>Publisher</name>
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                <text>MDPI AG</text>
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                <text>Biology (General), Chemistry</text>
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              <name>Title</name>
              <description>A name given to the resource</description>
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                  <text>Coronavirus</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>SARS Unique Domain (SUD) of Severe Acute Respiratory Syndrome Coronavirus Induces NLRP3 Inflammasome-Dependent CXCL10-Mediated Pulmonary Inflammation</text>
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                <text>Young-Sheng Chang, Bo-Han Ko, Jyh-Cherng Ju, Hsin-Hou Chang, Su-Hua Huang, Cheng-Wen Lin</text>
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                <text>Severe acute respiratory syndrome–associated coronavirus (SARS-CoV) initiates the cytokine/chemokine storm-mediated lung injury. The SARS-CoV unique domain (SUD) with three macrodomains (N, M, and C), showing the G-quadruplex binding activity, was examined the possible role in SARS pathogenesis in this study. The chemokine profile analysis indicated that SARS-CoV SUD significantly up-regulated the expression of CXCL10, CCL5 and interleukin (IL)-1β in human lung epithelial cells and in the lung tissues of the mice intratracheally instilled with the recombinant plasmids. Among the SUD subdomains, SUD-MC substantially activated AP-1-mediated CXCL10 expression in vitro. In the wild type mice, SARS-CoV SUD-MC triggered the pulmonary infiltration of macrophages and monocytes, inducing CXCL10-mediated inflammatory responses and severe diffuse alveolar damage symptoms. Moreover, SUD-MC actuated NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome-dependent pulmonary inflammation, as confirmed by the NLRP3 inflammasome inhibitor and the NLRP3−/− mouse model. This study demonstrated that SARS-CoV SUD modulated NLRP3 inflammasome-dependent CXCL10-mediated pulmonary inflammation, providing the potential therapeutic targets for developing the antiviral agents.</text>
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                <text>2020</text>
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                <text>SARS-coronavirus, NLRP3 inflammasome, CXCL10, Pulmonary inflammation, SARS-CoV unique domain (SUD)</text>
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                <text>10.3390/ijms21093179</text>
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                <text>Epidemiology and Health</text>
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            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
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                <text>Korean Society of Epidemiology</text>
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            <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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                <text>Biology (General), Chemistry</text>
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