Update parue sur une liste de soins intensifs. Jean Levasseur
-------- Original Message -------- Subject: PRO/EDR> Severe acute respiratory syndrome - worldwide (16) Date: Sat, 22 Mar 2003 16:07:39 -0500 (EST) From: ProMED-mail <[EMAIL PROTECTED]> Reply-To: [EMAIL PROTECTED] To: [EMAIL PROTECTED] SEVERE ACUTE RESPIRATORY SYNDROME - WORLDWIDE (16) ************************************************** A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> Date: 22 Mar 2003 From: ProMED-mail <[EMAIL PROTECTED]> Source: World Health Organization SARS update 22 Mar 2003 (edited) <http://www.who.int/csr/don/2003_03_22/en/> SARS virus isolated, new diagnostic test producing reliable results ------------------------------------------------------------------- A team of scientists in the department of microbiology, University of Hong Kong, has announced today success in culturing the viral agent that causes severe acute respiratory syndrome (SARS). Further progress in the development of a reliable diagnostic test was simultaneously announced by the same team. Using a special cell line, the Hong Kong scientists isolated the virus from the lung tissue of a patient who developed pneumonia following contact with a professor from Guangdong Province in southern China. Both the professor and the contact have died. Isolation of the virus now lays the solid foundation for very rapid development of a diagnostic test. The Hong Kong scientists have devised a basic test, relying on the technique of neutralizing antibodies. In today's experiments, designed to determine the accuracy of the test, scientists found that it was able to detect tell-tale antibodies in sera taken from 8 SARS patients. The consistency of these findings indicates that the test is reliably identifying cases of SARS infection. This "hand-made" test will now be further developed into a more sophisticated diagnostic test. A rapid and reliable diagnostic test for SARS is needed urgently to assist the many clinicians who need a tool for rapid confirmation of genuine cases. Such a test can also help reassure the many "worried well" who are flooding health facilities as international concern about this disease and its rapid spread to new areas continues to increase. Many common and usually self-healing illnesses mimic the symptoms of SARS in its early stage. With the virus now isolated, scientists in Hong Kong and elsewhere can move forward quickly to characterize the agent, determine its relationship with known viruses, and establish a definitive identity. Results will be shared among 11 leading laboratories in a network set up on Mon 17 Mar 2003 by WHO. The virus responsible for SARS is considered by some research groups to be a member of the well-known Paramyxoviridae family. Yesterday, Canadian researchers released findings suggesting that the metapneumovirus, which belongs to this family, may be the cause. The metapneumovirus was first discovered by Dutch scientists in June 2001 at a laboratory that is also included in the new WHO network. At the time of its discovery, the virus was known to cause respiratory disease in humans, including some cases of pneumonia, but showed a different transmission pattern and was much less severe than the SARS agent. At this point, it cannot be ruled out that an entirely different virus from another family may be responsible for the SARS outbreak. WHO cautions that the race to identify the SARS causative agent is by no means over. Although the virus has now been isolated, its identity remains elusive. Other research groups in the network of collaborating labs are producing hints that the causative agent may belong to another virus family. SARS is an emerging disease, first recognized in Asia in mid-February 2003, that has made over 380 people ill on 3 continents and caused severe pneumonia in a large proportion of patients. A cumulative list of affected countries and numbers of cases and deaths is released each day on the WHO website. Today's data indicate that slightly more than half of currently reported cases have occurred in health care workers and medical students. The remaining cases are in family members and other persons in close contact with patients. A WHO team of 5 experts is now en route to China to investigate the possibility that an outbreak of a disease having similar symptoms and affecting similar groups -- health care workers and close contacts of patients -- may be linked to the current SARS outbreak. As of today, Hong Kong remains the most seriously affected area. Authorities there have reported a total of 222 cases in health care workers, medical students, and family members and hospital visitors who have been in close contact with patients. Of these, 217 have developed symptoms of pneumonia, and many are in serious condition. -- ProMED-mail <[EMAIL PROTECTED]> [We join in praising the international collaboration whose work has led to such rapid promising results. Until larger numbers of cases and healthy controls are studied, it is still prudent to maintain a state of cautious optimism that the putative etiologic agent -- a member of the paramyxovirus family -- is in fact the causative agent of SARS. The rapid development of a diagnostic test, perhaps considered somewhat "basic" is yet another step in the process of learning more about the etiology and epidemiology of this emerging disease. - Mod.MPP] [The important fact to emphasize is the successful propagation of an infectious agent from SARS patients in cultured cells; in other respects the situation remains confused. Several laboratories in the WHO Collaborating Network, on the basis of electron microscopy (not the method of choice), have suggested that the etiologic agent is a "paramyxovirus". Subsequently some Canadian virologists have suggested that the agent is a "metapneumovirus", although others had claimed to have excluded from consideration the recently discovered human metapneumovirus (and its distant relative human respiratory syncytial virus). Now apparently "other research groups in the WHO network of collaborating labs are producing hints that the causative agent may belong to another virus family". It is to be hoped that WHO will take the lead in resolving this confusion by distributing clinical material and susceptible cell cultures to all the participating laboratories as quickly as feasible. - Mod.CP] [see also: Severe acute respiratory syndrome - worldwide (15) 20030322.0707 Severe acute respiratory syndrome - worldwide (14) 20030321.0704 Severe acute respiratory syndrome - worldwide (13) 20030321.0703 Severe acute respiratory syndrome - worldwide (12) 20030321.0702 Severe acute respiratory syndrome - worldwide (11) 20030320.0698 Severe acute respiratory syndrome - worldwide (10) 20030319.0689 Severe acute respiratory syndrome - worldwide (09) 20030319.0688 Severe acute respiratory syndrome - worldwide (08) 20030318.0679 Severe acute respiratory syndrome - worldwide (07) 20030318.0678 Severe acute respiratory syndrome - worldwide (06) 20030318.0677 Severe acute respiratory syndrome - Worldwide (05) 20030317.0669 Severe acute respiratory syndrome - Worldwide (04):comment 20030317.0664 Severe acute respiratory syndrome - Worldwide: alert (03) 20030316.0660 Severe acute respiratory syndrome - Worldwide (02):alert 20030315.0649 Severe Acute Respiratory Syndrome - Worldwide 20030315.0637 Acute respiratory syndrome - Canada (Ontario) 20030314.0631 Acute respiratory syndrome - East Asia 20030314.0630 Acute respiratory syndrome - China (HK), VietNam (03) 20030313.0624 Acute respiratory syndrome - China (HK), VietNam (02) 20030313.0623 Acute respiratory syndrome - China (HK), VietNam 20030312.0602 Undiagnosed illness - Vietnam (Hanoi): RFI 20030311.0595 Influenza, H5N1 human case - China (Hong Kong) (05) 20030228.0500 Pneumonia - China (Guangdong) (07) 20030221.0452 Pneumonia - China (Guangdong) (06) 20030220.0447 Pneumonia - China (Guangdong) (05) 20030220.0446 Pneumonia - China (Guangdong) (04) 20030219.0427 Pneumonia - China (Guangdong) (03) 20030214.0390 Pneumonia - China (Guangdong) (02) 20030211.0369 Pneumonia - China (Guangdong): RFI 20030210.0357 2002 --- Metapneumovirus, children - Finland 20021106.5731 Human metapneumovirus - Australia (02) 20020305.3691 Human metapneumovirus - Australia 20020302.3663 2001 --- Paramyxoviruses, new human pathogen - Netherlands 20010603.1094] .......................mpp/cp/sh *##########################################################* ProMED-mail makes every effort to verify the reports that are posted, but the accuracy and completeness of the information, and of any statements or opinions based thereon, are not guaranteed. 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