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Clinical Infectious Diseases [ 1058-4838 ] ; 2003.

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<sec id="sec1">

<title>New Evidence Supports Animals as Original Reservoir for Sars-Cov</title>

<p>17 October (Reuters Health)—Scientists suspect that the coronavirus that causes severe acute respiratory syndrome (SARSCoV) crossed the species barrier between an animal host and humans. This theory is supported by a study in southern China, where a high proportion of animal traders had antibodies to SARS-CoV.</p>

<p>In May of this year, Dr. D. Yu, at Guangdong Center for Disease Control (CDC) in Guangzhou, and colleagues collected blood samples from 508 traders in 3 animal markets. The prevalence of IgG antibody to SARS-CoV in these samples was compared with that in 3 control groups. Of the total 792 individuals tested, none had SARS or atypical pneumonia diagnosed during the large Guangdong Province outbreak.</p>

<p>Their findings are published in the <italic>Morbidity and Mortality Weekly Report</italic>
 (MMWR) for 17 October.</p>

<p>Antibodies were detected in samples from 13.0% of traders, versus 1.2% of healthy adults attending a clinic, 1.6% of Guangdong CDC workers, and 2.9% of hospital workers (P ! .010).</p>

<p>Seroprevalence was 72.7% among traders of masked palm civets. Traders of wild boar (57.1%), muntjac deer (56.3%), and hare (46.2%) also tested positive for antibodies.</p>

<p>“These determinations appear consistent with the hypothesis that an animal reservoir exists for SARS-CoV or an antigenically related virus,” MMWR editors note.</p>

<p>Source: <italic>MMWR Morb Mortal Wkly Rep CDC Surveill Summ</italic>
 2003; 52:986–7.</p>

<p><bold><italic>Editor's comment</italic>
</bold>
. These high incidences of positive serological test results for traders who presumably had not had SARS-like illnesses are very impressive and confirm the observation first reported in a news briefing from Hong Kong in July that “antibodies were found in a number of animal market workers” who had not been ill. It suggests that either (1) asymptomatic infection is not uncommon, or (2) the serological findings are secondary to exposure to nonvirulent SARS-like coronaviruses that were present in the animals in the past and that this resulted in a serological cross-reaction.</p>

<p>The identification of 1.2 to 2.9 percent of otherwise healthy controls with positive antibodies to the SARS-CoV is a curious finding. Is it due to reduced specificity of the ELISA test used for this study? Were these controls really healthy controls or did they have a history of a serious or significant febrile respiratory illness in recent years that may have been sporadic cases of illness associated with the SARS-CoV? Or were they truly asymptomatic infections that occurred during the outbreak in China earlier this year?</p>

<p>A review of the literature to date does not reveal a plethora of articles addressing the sensitivity and specificity of the current serologic tests used to identify antibodies against the SARS-CoV. In an article in the Chinese medical literature (English abstract available on PubMed) (National ResearchProject For SARS Beijing Group [Serum antibodies detection for serological diagnosis of severe acute respiratory syndrome] Zhonghua Jie He He Hu Xi Za Zhi. 2003 Jun; 26(6):339-42), they evaluated the significance of serum specific antibodies against the SARS-CoV in the diagnosis of SARS. Specific IgG antibodies for SARS virus in 267 serum specimens from patients with SARS and 132 from non- SARS patients or healthy persons were assayed with IFA or ELISA. The sensitivity and specificity of measuring IgG on or after the 11th day of illness was 91.1 percent and 97.0 percent, respectively. Similar results could be seen when IgG was detected by ELISA. Hence, the IgG positivity seen in “normal healthy controls” could be false positive results.</p>

<p>During a review of the laboratory presentation at the first Global SARS conference held in Malaysia in Jun 2003, the lack of standardization of laboratory tests was identified as a significant issue (available for review at: http:// www.who.int/csr/sars/conference/ june 2003/materials/presentations/ en/laboratorydiagnosis.pdf).</p>

<p>Two items summarizing the current status of serological testing for SARS will appear in the 15 January issue of Clinical Infectious Diseases (vol. 38, no. 2): a Brief Report by J.-L. Juang and colleagues (S. S. Jiang et al. “Sensitive and Quantitative Detection of Severe Acute Respiratory Syndrome Coronavirus Infection by Real-Time Nested Polymerase Chain Reaction”) and an Editorial Commentary by J. S. M. Peiris and colleagues (L. L. M. Poon et al. “Crouching Tiger, Hidden Dragon: The Laboratory Diagnosis of Severe Acute Respiratory Syndrome”).</p>

</sec>

<sec id="sec2">

<title>World Health Body Seeks Pact on Handling Sars Virus</title>

<p>17 October (Reuters Health)—TheWorld Health Organization (WHO) said it wanted controls on laboratories holding SARS virus samples to prevent a return of the disease, which killed more than 800 people in the past year.</p>

<p>The risk of transmission from laboratories, the only place where SARS is known to still exist, will be high on the agenda when scientists meet at WHO headquarters for a week of meetings aimed at preparing for any fresh outbreak.</p>

<p>“We are trying to ready ourselves and ready the world for what could happen this year if SARS did come back,” Professor John Mackenzie, coordinator of the WHO's scientific advisory committee, told a news conference.</p>

<p>The United Nations health agency declared the outbreak over in July, but there has since been 1 case in Singapore where a research student became infected while working in a laboratory that kept samples of the virus.</p>

<p>Mackenzie said that the WHO hopes scientists will call for countries to keep tight control over allowing laboratories to work with the virus, and to keep close track of stocks.</p>

<p>“Not all laboratories should have the right to work with the virus. We do not want it to be too available for accidents,” he added.</p>

<p>Little is known about stocks in laboratories in countries that registered the highest number of cases, such as China, Taiwan, or Vietnam.</p>

<p>He said a benchmark diagnostic test is needed, so that when suspected cases are studied anywhere in the world, the results will be the same.</p>

<p>“We need to make sure that when labs are diagnosing SARS, they are doing so with the most sensitive tests and that when they diagnose it, it really is SARS,” he added.</p>

<p><bold><italic>Editor's comment</italic>
</bold>
. This last comment is particularly germane in view of the editorial comment in the previous news item about SARS, indicating that 3% of serological test results are false positive.</p>

</sec>

<sec id="sec3">

<title>Circumcision Appears Protective Against Hiv-1 Infection</title>

<p>10 October (Reuters Health [Karla Gale])—The risk of being infected with HIV-1 is 8 times higher among uncircumcised men, compared with their circumcised counterparts, according to a “late breaker” presentation at the 41st Annual Meeting of the Infectious Diseases Society of America in San Diego.</p>

<p>Dr. Steven J. Reynolds, of Johns Hopkins University School of Medicine in Baltimore, and colleagues compared subsequent HIV-1 infection rates among 2298 men in Pune, India, whose initial test results between 1993 and 2000 were negative.</p>

<p>Among the 191 men who were circumcised, the incidence of infection was 0.7%; among the 2107 individuals not circumcised, 5.5% became infected. The incidence of other sexually transmitted diseases was slightly higher among those not circumcised, but the difference was not statistically significant.</p>

<p>Examination of the data revealed that demographics, sexual risk behaviors, and condom use were similar between groups. Thus, it appears that differences in behavior do not explain the protective effect of foreskin removal.</p>

<p><bold><italic>Editor's comment</italic>
</bold>
. The differences in the protective effect of circumcision demonstrated in this study are striking. However, one must ask why one group consisted of circumcised men. Despite the statement that the demographic characteristics were the same in both groups, one must question whether there were differences in the numbers of Hindus (for whom circumcision is unusual) and Muslims (for whom circumcision is routine), or whether there were differences in other factors in the 2 groups. If so, there could be HLA tissue-type differences and subtle (or not-so-subtle) differences in social behavior. It is hoped that these questions will be answered in the published study.</p>

</sec>

<sec id="sec4">

<title>Avascular Necrosis Seen in Former Sars Patients</title>

<p>10 October (Reuters Health [Tan Ee Lyn])—Dozens of former SARS patients in Hong Kong have developed avascular necrosis, sources said…, throwing the spotlight back on the controversial combination of drugs used to treat many patients during the epidemic.</p>

<p>“A substantial number of cases have already been proven. We are now trying to ascertain the severity,” said Leung Pingchung, an orthopedics specialist at the Prince of Wales Hospital, where the first wave of SARS infections in Hong Kong were treated.</p>

<p>Almost all SARS patients in Hong Kong were treated with the antiviral drug ribavirin and steroids earlier this year, but many health experts said at the time that the efficacy of the combination was unproven and could lead to serious side effects.</p>

<p>At least 10 former SARS patients from every major public hospital that tended to SARS victims in Hong Kong have been found to have the bone disease, Leung said. At least 8 public hospitals handled SARS patients.</p>

<p>Avascular necrosis has also been observed in some former SARS patients in mainland China, Leung told Reuters.</p>

<p>“It must be a general problem” in places that treated their patients using steroids, Leung said, adding that steroids were used in many of the 30 countries affected by SARS.</p>

<p>In Singapore, where more than 200 people were infected with SARS and 33 of them later died, a hospital spokeswoman said no one was known to be suffering from bone degeneration.</p>

<p>“Now that we see this information from Hong Kong, doctors are on heightened awareness on this matter,” said the spokeswoman at Tan Tock Seng Hospital, Singapore's SARS-designated hospital.</p>

<p>Leung Ka-lau, former head of the Public Doctors' Association in Hong Kong, said the condition could surface later in some people.</p>

<p><bold><italic>Editor's comment</italic>
</bold>
. Detected avascular necrosis or aseptic necrosis of bone due to steroid therapy most often affects the femoral head. It would be very unusual to see cases in patients who have been given steroids for !1 month, so the question must arise, was there prolonged duration of steroid therapy, or were other factors operative? Given the fact that use of steroids for SARS is, at best, controversial, with no evidence of effectiveness, and given that there are some concerns about negative side effects, it is difficult to understand why long-term steroid therapy was administered (if, in fact, it was). A disclaimer about this new SARS treatment, showing a high rate of side effects associated with ribavirin, may be found in Clinical Infectious Diseases (Knowles SR, Phillips EJ, Dresser L, Matukas L. “Common Adverse Events Associated with the Use of Ribavirin for Severe Acute Respiratory Syndrome in Canada.” 2003; 37:1139–42).</p>

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<author></author>
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Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SrasV1/Data/Istex/Corpus

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000143 | SxmlIndent | more

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Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Sante
   |area=    SrasV1
   |flux=    Istex
   |étape=   Corpus
   |type=    RBID
   |clé=     ISTEX:3D21FEDE181D930540AE6478E7A9DA117AB5B41E
   |texte=   News
}}

This area was generated with Dilib version V0.6.33.
Data generation: Tue Apr 28 14:49:16 2020. Site generation: Sat Mar 27 22:06:49 2021

	Serveur d'exploration SRAS
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration SRAS

News

News

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