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Pastimes : SARS - what next? -- Ignore unavailable to you. Want to Upgrade?

To: Snowshoe who wrote (572)	6/19/2003 2:32:28 PM
From: Snowshoe	Respond to of 1070

Court order keeping Texas man quarantined in SARS alert... chron.com

To: Snowshoe who wrote (572)	6/19/2003 4:41:24 PM
From: Henry Niman	Respond to of 1070

>>Or MARS? (Mild Acute Respiratory Syndrome) << The PCR test just detects the SARS virus, so its definitely SARS CoV (coronavirus).

To: Snowshoe who wrote (572)	6/19/2003 8:01:00 PM
From: Henry Niman	Respond to of 1070

I suspect that the 120 SARS CoV positive patients were re-tests. They were either re-tested by PCR or tested for antibody. Since most were early cases, I seriously doubt that there are many false positives at this stage of the game. The media reports suggest that contacts are now going to be identified and tested. Thus, the data for transmission or lack thereof of SARS CoV by the mild cases hasn't even been generated yet. My comments were on SARS CoV spread, which I think is significant because these patients were declared to be SARS free and their contacts were not even being identified. What happens to patients after infection by the virus is varied. Younger patients do better than older and the number of mutations in the SARS CoV is increasing. However, some of the mutations may actually improve survivorship. There hasn't been any published data on new Toronto isolates, but at least one of the positive Toronto patients was thought to have acquired the SARS CoV from Singapore. the published data for SARS CoVs originating there are the most extensive and the results are quite varied, especially in the area of mutations. The virus, SIN2500, for the Singapore index case had the 29 nt deletion, all 7 Metropole Hotel mutations and a mutation that has just been found in isolates from patient/physicians who had close contact with the index case. The index case infected dozens, yet she survived, although her mother, father, and priest died. However, her grandmother survived, even though her virus, SIN2774/KYK, had the same set of mutations described above plus a couple additional mutations also found in the virus, Frankfurt 1, from the index case's physician (and the data suggests he was infected by the grandmother while she was asymptomatic). He survived even though he had the mutations mentioned above plus a mutation found in the virus, HKU-39849, from the Metropole Hotel index case's brother-in-law (who died) as well as TWC, the virus from the first fatal case in Taiwan. Thus, there is a whole spectrum of results with viruses with a large array of mutations. Similarly, in Toronto, virus has been found in probable, suspect, and mild cases. Virus hasn't been found in a large number of asymptomatic cases because no one has looked. I expect to hear that virus has been detected in a broad spectrum of contacts of patients who were infected with the virus and the virus will have spread far and wide. The significance of this spread will be tested when flu and cold season return. Until then, the best way to find out what has happened with regard to viral spread is to simply identify contacts and run the tests.