SARS-associated coronavirus transmission, United States

Abstract

To better assess the risk for transmission of the severe acute respiratory syndrome-associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S. SARS patients and their 10 household contacts. SARS-CoV was detected in a day-14 sputum specimen from one case-patient and in five stool specimens from two case-patients. In one case-patient, SARS-CoV persisted in stool for at least 26 days after symptom onset. The highest amounts of virus were in the day-14 sputum sample and a day-14 stool sample. Residual respiratory symptoms were still present in recovered SARS case-patients 2 months after illness onset. Possible transmission of SARS-CoV occurred in one household contact, but this person had also traveled to a SARS-affected area. The data suggest that SARS-CoV is not always transmitted efficiently. Routine collection and testing of stool and sputum specimens of probable SARS case-patients may help the early detection of SARS-CoV infection.

Figure

Detecting severe acute respiratory syndrome–associated coronavirus (SARS-CoV) RNA by reverse transcriptase–polymerase chain reaction (RT-PCR) and SARS-CoV antibodies by enzyme-linked immunosorbent assay (ELISA) in clinical specimens from seven confirmed SARS case-patients, United States, 2003. Circle within circle: blood specimens (same symbol represents both whole blood and serum when both specimens are collected and results are entirely concordant. s, serum; wb, whole blood (symbols are labeled s or wb if either blood or serum was collected). Blocked symbols denote SARS-CoV–positive specimens by ELISA. ∆: respiratory specimens (include np, nasopharyngeal swab; nw, nasal wash; a, nasal aspirate; op, oropharyngeal swab; sp, sputum). □: stool. ◊: urine. Blocked symbols denote SARS-CoV–positive specimens by RT-PCR.