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    Friday, May 02, 2003

    SARS Developments: Still trying to elucidate the natural history of the disease:

    Researchers in Hong Kong reported that they had detected evidence of the virus in some people who have not gotten sick and in some who were thought to have recovered and, therefore, were no longer infectious.

    "Some studies show people do continue to secrete the virus in feces and tears," said David L. Heymann of the World Health Organization, who was attending a scientific meeting on severe acute respiratory syndrome in Toronto. "Some cases actually recover and relapse. There are many more issues to be clarified."

    But there have been no documented chains of transmission from SARS patients who have been released from hospitals, which indicates they may not be spreading the disease.

    "We have to look at this," said Julie L. Gerberding, director of the Centers for Disease Control and Prevention in Atlanta. "The focus still needs to be on the people who are sick."


    It isn’t uncommon for a virus to continue to be excreted in body fluids long after the illness is over. The virus that causes infectious mononucleosis is excreted for months, sometimes years, in body fluids, but only appears to be contagious during the early phase of the illness.

    Then, there’s this fascinating observation:

    Guangzhou authorities divided the floor of People's Hospital No. 8 in half, putting SARS patients on one side of the elevator bank and AIDS patients on the other. Health care workers walked back and forth between the two sides, and some of those doctors and nurses contracted SARS.

    Yet not one of the several dozen AIDS patients or their visitors, some of whom were also HIV positive, developed the disease. "I am wondering why there was no SARS virus co-infection in the AIDS cases," Dr. Zhang Fujie, director of AIDS treatment and care for China, said yesterday in an interview. "We are exchanging information with Hong Kong on this. We will continue to try to understand that."
    Dr. Cheng Feng of the China/UK HIV/AIDS Project said he, too, was aware of the phenomenon. He wondered whether the drugs the AIDS patients were receiving for HIV control might be blocking a SARS infection. A similar notion was mentioned by Dr. Yuen Kowk-yung of the University of Hong Kong. With New York's Dr. David Ho, of the Aaron Diamond AIDS Research Laboratory, Yuen is exploring the AIDS apothecary for an effective SARS treatment.


    It could be the drugs, or as Andrew Sullivan points out, it could be that the immune system’s response to the virus is the primary cause of the illness. That would help explain why so many of the victims are young and healthy, and why steroids, which suppress the immune system seem to help.
     

    posted by Sydney on 5/02/2003 08:18:00 AM 0 comments

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