WHAT IS THE CAUSE OF SARS? ONE VIRUS, TWO VIRUSES WORKING IN CONCERT, OR A DETERMINANT UNKNOWN

PRO MED - WHO ^ | 03-25-03

[Mother Abigail]

Q. The question about the 2 viruses having been, or 2 families of viruses having been associated with this disease or with this outbreak. You said it was not normal, if I'm not mistaken. Could you give us an idea of whether or not it's possible for a single disease to be caused by 2 viruses or is it more likely that at least one of the samples might not be related to SARS?

A. Dr Klaus Stohr: Speaking as a scientist, we are looking at a very interesting and a fascinating situation. Looking from the point of infectious disease control, we are a bit puzzled because we are not only dealing apparently with one pathogen but with 2.

The reason why we believe that both pathogens should be given equal attention is that there is consistent finding of both pathogens in individual patients or of either of the pathogens in other patients.

What we are seeing actually are 3 hypotheses.

The first hypothesis is that one of the viruses, for instance the corona virus, causes the disease, and that might be a new corona virus.

The second hypothesis is that the paramyxoviruses cause the disease and if that was the case, it's certainly also a new paramyxovirus.

The third hypothesis, very obviously, is that these 2 pathogens have to come together to cause this very severe outbreak. One of the viruses, for instance the coronavirus, is known to live in immune cells, cells which are important for defense against infection. So what one could hypothesize is that this coronavirus destroys or at least diminishes the immunity in the patient so that the second virus has practically an open door to go in and to sicken the patient beyond what this virus would be able to do normally.

Dr David Heymann: Let me just add to that: there could be a fourth hypothesis. It is possible that both are common viruses: one found in all the patients, even though it's not causing disease, and the other will be the disease-causing agent, so they could both be found but not be related in any way, just there by chance. So it's a very complicated issue that's being sorted out.

[Mother Abigail]

The statement "It is not normal that one disease is caused by two viruses" is not strictly true.

Satellite viruses and satellite nucleic acids which may influence virulence and transmissibility have been described for viruses infecting insects and plants, but not for vertebrate viruses with the exception of hepatitis B virus and delta virus.

A more modest and defensible conclusion would be that on the basis of current evidence it is possible that neither of these 2 candidate etiologic agents are determinants of SARS.

Paramyxoviruses and coronaviruses are fairly benign ubiquitous residents of the human respiratory tract that might be detected fortuitously in both symptomatic and asymptomatic patients.

[aristeides]

Comments?

[TheErnFormerlyKnownAsBig]

What does SARS stand for. That might help the rest of us who are not carrying our secret decoder rings this morning.

[Mother Abigail]

Submitted for your consideration

[blam]

Bump.

[CathyRyan]

severe acute respiratory syndrome

[Mother Abigail]

BEIJING — The World Health Organization for the first time has linked a pneumonia outbreak in China to a mystery flu-like illness that has hit other countries on three continents. The global death toll from the combined outbreaks climbed to 52 today.

Chinese authorities said the disease has killed at least 34 people in China since November — 31 in the south and three in Beijing. Hundreds have been infected. Previously, they said only five had died in southern Guangdong province.

World health officials later said the symptoms of the Chinese illness are consistent with those for severe acute respiratory syndrome, or SARS, which has sickened nearly 500 people and killed 18 elsewhere — 10 in Hong Kong, four in Vietnam, three in Canada and one in Singapore.
Singapore announced its fatality today, and ordered all schools shut as a health precaution. More than 700 people in the city-state have been ordered to stay home under quarantine or face fines

[TheErnFormerlyKnownAsBig]

Thanks. Is this something kids are getting/ Asmtha?

[Drammach]

SARS= Severe Acute Respiratory Syndrome

[CygnusXI]

Just a quick nit-pick here....

Why are bad things, medically, labeled "Acute"?

In geometry an acute angle is less than 90°, and an obtuse one is greater than 90°, IIRC..

So shouldn't "bad" medical terms be labeled Obtuse?

Back on topic.
I think this bug has "man made" possibilities.

[TBall]

I suggest you do some reading on SARS. A lot of conflicting reports, but from what I can tell this outbreak is moving throughout the world at a rapid clip.

[Drammach]

Just an uneducated guess..
Is the difficulty with identifying the cause due to the virus(?) still going through a mutational change?

We know the common cold and flu viruses are constantly going through changes, and that is why they are so hard to cure.
Is this possibly the new strategem for this virus as well?

[Mother Abigail]

Severe Acute Respiratory Syndrome

[TheBigB]

I understand that this outbreak is causing concern, but for gosh sakes; I think lots of this is just fear-mongering by the media. First it was AIDS. Then the "flesh-eating bacteria" that was supposed to kill us all. Then West Nile. Now SARS. This isn't Ebola, with a 95% mortality rate. Pretty soon we'll all be scared to walk outside..."Oh no, what if I get in line at the bank with someone who flew to China last week?" "What if someone caughs behind me on the bus?"

[riri]

Paramyxoviruses and coronaviruses are fairly benign ubiquitous residents of the human respiratory tract that might be detected fortuitously in both symptomatic and asymptomatic patients

So, if I am reading this correctly, you think we could be looking at an AIDS type illness. Immune system destroyer and what they are seeing are remnants of opportunist infections? Interesting to note, as in AIDS, it does seem to be the pneumonia that eventually does the victim in.

Do you recall how long it was before they made the breakthrough of finding the HIV virus in early AIDS patients?

[CathyRyan]

This link is for the CDC site that has a FAQ section.

that is dated 3.23.03

http://www.cdc.gov/ncidod/sars/

[Domestic Church]

So you still think these findings are artifacts and a third entity is the actual cause? Do you think these two set the stage for the third entity to be activated? Is the third entity in the immune system itself?

[Mother Abigail]

Paramyxoviruses and coronaviruses are fairly benign residents of the human respiratory tract.

They are being found because they are there. Not because they are the SARS determinant

Unknown pathogen

[CygnusXI]

Aids is spread through blood, and well...you know..

Flesh eating is spread through direct contact of nose/throat mucus. (CDC source)

West Nile. By blood.

Ebola. By blood and body secretions.

This new one however is spread by pure airborn methods. Like when someone at work gets a cold, and a week later everyone on the office is coughing. That's the difference.

If you had a coworker with AIDS, Ebola, Flesh eating, or West Nile, chances are most-- if not everyone in that office would be fine, barring any touching going on (except maybe ebola).

Yes, true. The death/mortality rate is only between 4-5%, but 5% dead in a workplace where 100 people catch this thing is still going to put you at the funerals of 5 people.