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Coronavirus Biology and Pathogenesis
On the Front Lines
Clinical Spectrum of SARS Infection
Clinical Experience in Toronto
SARS: An Update from China
Panel 2 Discussion
Approaches to Vaccines and Drug Development
Future Perspectives on Emerging Infections
References and Resources
pdf Conference Transcript
pdf Conference Highlights
SARS in the Context of Emerging Infectious Threats SARS in the Context of Emerging Infectious Threats
On the Front Lines
Panel 2 Discussion

 
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Highlights

Assessing Actual Cases and Mortality Rate
• Patients were admitted with flu-like illness and never developed pneumonia; a serological test is needed.
• If suspect SARS cases are excluded from accounting, the mortality rate jumps from 7 to 15 percent.
• We do not yet know what an asymptomatic SARS infection looks like or how frequently it occurs; this also affects the mortality rate.
• The concept of super-spreaders is confounded by infection control; some so-called super-spreaders may be shedding more virus or may be more efficient transmitters.
• Case reporting is further confounded because gastrointestinal and respiratory illness are commonly reported by people returning from travel.

Sequelae with SARS
• A connection between SARS and diabetes has been observed in a number of countries but more data is needed.
• Psychological impacts of fear among recovered patients and communities will need to be addressed.
• Recovered patients are anecdotally reporting low energy, hyperactive airways, and cough.

Site and Extent of Infection
• Initial infection appears to be in the upper respiratory tract but the mode of spread to other tissues is not known.
• Patients appeared viremic but this may have been a result of cytokines.
• In Hong Kong, virus is found in epithelial sheds, though it does not appear to cause CPE there.
• Viral load goes up in the first week, following onset of symptoms, and decreases thereafter.
• There is a six-log range of viral load over the course of illness, possibly explaining super-spreading.

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