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SARSA case study in emerging infections$
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Angela McLean, Robert May, John Pattison, and Robin Weiss

Print publication date: 2005

Print ISBN-13: 9780198568193

Published to Oxford Scholarship Online: September 2007

DOI: 10.1093/acprof:oso/9780198568193.001.0001

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The aetiology of SARS: Koch's postulates fulfilled

The aetiology of SARS: Koch's postulates fulfilled

(p.41) CHAPTER 7 The aetiology of SARS: Koch's postulates fulfilled

Albert D. M. E. Osterhaus

Ron A. M. Fouchier

Thijs Kuiken

Oxford University Press

This chapter describes the experimental studies demonstrating that the virus SARS-CoV is the aetiological agent of the disease SARS. Clinical and post-mortem specimens from 436 SARS patients in six countries were tested for infection with SARS-CoV, human metapneumovirus, and other respiratory pathogens. SARS-CoV infection was diagnosed in 75% of patients fitting the case definition of SARS, hMPV was diagnosed in only 12%, and other respiratory pathogens were found only sporadically, suggesting that SARS-CoV was the most likely etiologic agent of SARS. Four SARS-CoV-infected macaques excreted SARS-CoV from nose, mouth, and pharynx and displayed pathological signs very similar to those of humans suffering from SARS. Replication in SARS-CoV-infected macaques of pneumonia comparable to that in SARS, combined with the high prevalence of SARS-CoV infection in SARS patients, fulfills Koch's postulates and proves that SARS-CoV is the primary cause of SARS.

Keywords:   aetiological agent, SARS-CoV, Koch's postulates, human metapneumovirus, respiratory pathogen

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