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Cited by 4,344

The DOI matches its Crossref record.

A Novel Coronavirus Associated with Severe Acute Respiratory Syndrome

Ksiazek, Thomas G., Erdman, Dean, Goldsmith, Cynthia S., Zaki, Sherif R., Peret, Teresa, Emery, Shannon, Tong, Suxiang, Urbani, Carlo, Comer, James A., Lim, Wilina, Rollin, Pierre E., Dowell, Scott F., Ling, Ai-Ee, Humphrey, Charles D., Shieh, Wun-Ju, Guarner, Jeannette, Paddock, Christopher D., Rota, Paul, Fields, Barry, DeRisi, Joseph, Yang, Jyh-Yuan, Cox, Nancy, Hughes, James M., LeDuc, James W., Bellini, William J., Anderson, Larry J., the SARS Working Group·2003·New England Journal of Medicine
DOI 10.1056/nejmoa030781
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Abstract

BACKGROUND: A worldwide outbreak of severe acute respiratory syndrome (SARS) has been associated with exposures originating from a single ill health care worker from Guangdong Province, China. We conducted studies to identify the etiologic agent of this outbreak. METHODS: We received clinical specimens from patients in seven countries and tested them, using virus-isolation techniques, electron-microscopical and histologic studies, and molecular and serologic assays, in an attempt to identify a wide range of potential pathogens. RESULTS: None of the previously described respiratory pathogens were consistently identified. However, a novel coronavirus was isolated from patients who met the case definition of SARS. Cytopathological features were noted in Vero E6 cells inoculated with a throat-swab specimen. Electron-microscopical examination revealed ultrastructural features characteristic of coronaviruses. Immunohistochemical and immunofluorescence staining revealed reactivity with group I coronavirus polyclonal antibodies. Consensus coronavirus primers designed to amplify a fragment of the polymerase gene by reverse transcription-polymerase chain reaction (RT-PCR) were used to obtain a sequence that clearly identified the isolate as a unique coronavirus only distantly related to previously sequenced coronaviruses. With specific diagnostic RT-PCR primers we identified several identical nucleotide sequences in 12 patients from several locations, a finding consistent with a point-source outbreak. Indirect fluorescence antibody tests and enzyme-linked immunosorbent assays made with the new isolate have been used to demonstrate a virus-specific serologic response. This virus may never before have circulated in the U.S. population. CONCLUSIONS: A novel coronavirus is associated with this outbreak, and the evidence indicates that this virus has an etiologic role in SARS. Because of the death of Dr. Carlo Urbani, we propose that our first isolate be named the Urbani strain of SARS-associated coronavirus.

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Authors
Ksiazek, T. G., Erdman, D., Goldsmith, C. S., Zaki, S. R., Peret, T., Emery, S., Tong, S., Urbani, C., Comer, J. A., Lim, W., Rollin, P. E., Dowell, S. F., Ling, A.-E., Humphrey, C. D., Shieh, W.-J., Guarner, J., Paddock, C. D., Rota, P., Fields, B., DeRisi, J., Yang, J.-Y., Cox, N., Hughes, J. M., LeDuc, J. W., Bellini, W. J., Anderson, L. J., & the SARS Working Group
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2003-05-15
Volume
348
Issue
20
Pages
1953-1966
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa030781
OpenAlex
W2104548316
Cited by
4,344
References
0
FWCI
258.29
Type
journal article
Language
en
Open access
closed

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