SARS Cases Worldwide Reported to WHO as of June 6, 2003

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SARS Cases Worldwide Reported to WHO as of June
6, 2003
Europe 8 countries (38)
Canada (219)
U.S. (68)
China (5329)
Hong Kong (1750)
Vietnam (63)
Taiwan (676)
SA (2)
Singapore (206)
Thailand (8)
AustraliaNZ (6)
Total 8404 cases 779 deaths (10case fatality)
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Masked shop owner in Amoy Gardens complex
photo by Christian Keenan
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Coronaviruses

• Single Strand RNA, nonsegmented, enveloped,
  31,000 bps
• Order Nidovirales
• Family Coronaviridae
• Torovirus and Coronavirus Grp I, Grp II, Grp
  III
• 229E and OC43 in humans cause 1/3 of common
  colds , reinfections common
• May remain viable for several hours after drying
  on surfaces

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Relative Size of Coronaviruses Compared to Other
Microbes
NY Times 4/27/03
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Structure of Coronavirus Virion
-
The spike glycoproteins create corona, bind and
fuse with host cell membranes
Holmes, NEJM 2003348 1948
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nucleus
M Denison, Vanderbilt
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Genome Organization
A
E
1a
29,727 nt
S
1b
N
M
1
5,000
10,000
15,000
20,000
25,000
30,000
B
20,001
30,000
25,000
X1
X3
E
N
M
X2
X4
S
X5
8.3 kb
RNA 2
4.5 kb
RNA 3
3.4 kb
RNA 4
RNA 5
2.5 kb
1.7 kb
RNA 6
- Replicases (1a/1b) structural genes
(S,E,M,N) - Multiple small genes (X1-X5)-these
vary in number, location, and sequence in
different coronaviruses
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• SARS-CoV is similar in general genome
  organization
• to other coronaviruses
• SARS-CoV is genetically distinct from other known
  coronaviruses
• Structural proteins are lt 40 identical
• Replicase proteins are lt 70 identical
• SARS-CoV nsps are not homologous to known
  proteins
• Specific RT-PCR assays will allow the rapid and
  sensitive
• detection of the virus, aiding in control

CDC Enterovirus Reference Laboratory
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• - Distinct from other known coronaviruses
• Neither a mutant nor recombinant
• Previously unknown, probably from a nonhuman
  host, has acquired the ability to infect humans.
  

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Evidence that Urbani Coronavirus is the Etiology
of SARS

• Culture of novel coronavirus from SARS patients
  in multiple sites worldwide
• Identical Sequence
• EMs from BAL and lung showing coronavirus
• PCR finding novel coronavirus nucleic acid
• Antibody response specific to novel coronavirus,
  sera from other human coronaviruses show no
  reaction
• Infection re-produced in primate animal model

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CIVET CAT

• Nocturnal
  Animal
• Related To Mongoose
• Delicacy in Southern
  China

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NY Times 4/27/03
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Probable SARS cases by reported source of
infection, --- Singapore February 25--April 30,
2003 MMWR 200352405

• MMWR 200352405

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