Back to Search
Start Over
Colonization of Severe Acute Respiratory Syndrome-Associated Coronavirus Among Health-Care Workers Screened by Nasopharyngeal Swab
- Source :
- Chest
- Publication Year :
- 2006
- Publisher :
- Elsevier BV, 2006.
-
Abstract
- Study objectives To report the efficacy and findings of a large-scale preventive screening program for severe acute respiratory syndrome-associated coronavirus (SARS-CoV) using amplification of the virus from a nasopharyngeal swab (NPS) obtained from the health-care workers (HCWs). Design A prospective observational study. Setting A medical center in Taiwan. Participants Two hundred thirty HCWs. Intervention NPS examination for the presence of SARS-CoV by two nested reverse transcription-polymerase chain reaction (RT-PCR) assays. Measurements and results During the outbreak of severe acute respiratory syndrome (SARS), NPS polymerase chain reaction screening of HCWs for SARS-CoV was performed. SARS-CoV was examined by two nested RT-PCRs and a quantitative RT-PCR. Serum-specific antibodies were assessed by enzyme immunoassay and indirect immunofluorescence. We monitored 230 HCWs, including 217 first-line HCWs and 13 non–first-line HCWs. One hundred ninety first-line HCWs and 13 non–first-line HCWs had negative results in both nested RT-PCR assays. Two first-line HCWs who were positive on both nested RT-PCR assays had SARS. They had 16,900 ± 7,920 copies (mean ± SD) of RNA per milliliter in the NPS and had detectable anti-SARS antibodies. The remaining 25 first-line HCWs were negative for the first nested RT-PCR but positive for the second nested RT-PCR. Their corresponding titers were 338 ± 227 copies of RNA per milliliter; antibodies developed in none of these 25 HCWs. The expression and function of angiotensin-converting enzyme-2 were not different among these HCWs. This study shows that colonization of SARS-CoV occurred in 25 of 217 well-protected first-line HCWs on a SARS-associated service, but they remained seronegative. Conclusion With the second RT-PCR assay more sensitive than the first RT-PCR assay, we are able to show that approximately 11.5% of well-protected HCWs exposed to SARS patients or specimens may have colonization without seroconversion. Only those with significant clinical symptoms or disease would have active immunity. Thus, regular NPS screening for nested RT-PCR assays in conjunction with a daily recording of body temperature in all first-line HCWs may provide an effective way of early detection.
- Subjects :
- Male
health care facilities, manpower, and services
Antibodies, Viral
Severe Acute Respiratory Syndrome
Critical Care and Intensive Care Medicine
medicine.disease_cause
Serology
IIFT, indirect immunofluorescence test
Immunoenzyme Techniques
Nasopharynx
Coronaviridae
Fluorescent Antibody Technique, Indirect
SARS-CoV, severe acute respiratory syndrome-associated coronavirus
Coronavirus
Cross Infection
EIA, enzyme immunoassay
biology
medicine.diagnostic_test
Reverse Transcriptase Polymerase Chain Reaction
virus diseases
Titer
Severe acute respiratory syndrome-related coronavirus
nosocomial infection
RNA, Viral
Female
Viral disease
Cardiology and Cardiovascular Medicine
bp, base-pair
Adult
Pulmonary and Respiratory Medicine
HCW, health-care worker
PBMC, peripheral blood mononuclear cell
Infectious Disease Transmission, Patient-to-Professional
ACE, angiotensin-converting enzyme
RT-PCR, reverse transcription-polymerase chain reaction
Health Personnel
education
Taiwan
Article
medicine
Humans
SARS, severe acute respiratory syndrome
Seroconversion
Retrospective Studies
business.industry
Outbreak
biology.organism_classification
viral disease
Virology
immunology infection
Immunoassay
NPS, nasopharyngeal swab
business
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 129
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi.dedup.....7c626d8916893d28d8cb5093336258b4