Advertising Disclaimer
Published online December 29, 2008
PEDIATRICS Vol. 123 No. 1 January 2009, pp. 97-101 (doi:10.1542/peds.2007-3745)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bitnun, A.
Right arrow Articles by Richardson, S. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bitnun, A.
Right arrow Articles by Richardson, S. E.
Related Collections
Right arrow Infectious Disease & Immunity
Right arrowRelated AAP Red Book topics:
Coronaviruses, Including SARS
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Severe Acute Respiratory Syndrome–Associated Coronavirus Infection in Toronto Children: A Second Look

Ari Bitnun, MD, MSca, Stanley Read, MD, PhDa, Raymond Tellier, MD, MScb, Martin Petric, PhDc, Susan E. Richardson, MDb

a Division of Infectious Diseases, Department of Pediatrics
b Department of Pediatric Laboratory Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
c British Columbia Center for Disease Control, Vancouver, British Columbia, Canada

OBJECTIVES. During the severe acute respiratory syndrome outbreak of 2003, there was an impetus to provide clinical information to the medical community in a timely manner. Accordingly, a preliminary report of our experience of suspected severe acute respiratory syndrome–associated coronavirus infections in children was published without microbiological findings. This report provides an update on pediatric severe acute respiratory syndrome–associated coronavirus infections in Toronto, Ontario, Canada, that includes microbiological findings.

METHODS. All of the children admitted to the Hospital for Sick Children between March 14 and June 15, 2003, with suspect severe acute respiratory syndrome–associated coronavirus infection were included. A proven case was defined as one that fulfilled the clinical criteria for suspect severe acute respiratory syndrome–associated coronavirus infection and demonstrated a serologic response to severe acute respiratory syndrome–associated coronavirus. Serology results, from a neutralizing antibody assay, were considered positive if the sera inhibited the development of a severe acute respiratory syndrome–associated coronavirus-specific cytopathic effect at a dilution of ≥1:8.

RESULTS. Neutralizing antibody to severe acute respiratory syndrome–associated coronavirus was demonstrated in 8 of 25 children admitted with suspect severe acute respiratory syndrome–associated coronavirus infection. In 3 of these 8 children, severe acute respiratory syndrome–associated coronavirus was also detected by reverse-transcription polymerase chain reaction in the stool. All 8 had documented exposure to ≥1 severe acute respiratory syndrome–associated coronavirus-infected adults residing in the same household. Exposure that was limited to visiting a Toronto hospital at which severe acute respiratory syndrome–associated coronavirus-infected patients were admitted or travel from a country in which severe acute respiratory syndrome had been reported did not result in documented infection in any of our cases. On the basis of our clinical case definition, 6 of 8 microbiologically confirmed case had been classified as having probable severe acute respiratory syndrome–associated coronavirus infection. Clinical disease was mild, nonspecific, and self-limited and was indistinguishable from that reported with other common respiratory viruses.

CONCLUSIONS. The factor most strongly associated with severe acute respiratory syndrome–associated coronavirus infection in Toronto children was a history of close contact with an adult severe acute respiratory syndrome–associated coronavirus case. This serves to reinforce the importance of routinely obtaining a thorough epidemiologic travel and exposure history for all subjects with suspected infectious diseases.

Key Words: severe acute respiratory syndrome • SARS • reverse-transcription polymerase chain reaction • probable SARS • suspect SARS

Abbreviations: SARS—severe acute respiratory syndrome • CoV—associated coronavirus • RT-PCR—reverse-transcription polymerase chain reaction

Accepted Mar 25, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?