Knudsen T B, Kledal T N, Andersen O, Eugen-Olsen J, Kristiansen T B
Department of Infectious Diseases, and Clinical Research Unit, Copenhagen University Hospitals Hvidovre, Copenhagen, Denmark.
Scand J Immunol. 2003 Sep;58(3):277-84. doi: 10.1046/j.1365-3083.2003.01302.x.
The recent identification of a novel clinical entity, the severe acute respiratory syndrome (SARS), the rapid subsequent spread and case fatality rates of 14-15% have prompted a massive international collaborative investigation facilitated by a network of laboratories established by the World Health Organization (WHO). As SARS has the potential of becoming the first pandemic of the new millennium, a global warning by the WHO was issued on 12 March 2003. The disease, which is believed to have its origin in the Chinese Guangdong province, spread from Hong Kong via international airports to its current worldwide distribution. The concerted efforts of a globally united scientific community have led to the independent isolation and identification of a novel coronavirus from SARS patients by several groups. The extraordinarily rapid isolation of a causative agent of this newly emerged infectious disease constitutes an unprecedented scientific achievement. The main scope of the article is to provide the clinician with an overview of the natural history, epidemiology and clinical characteristics of SARS. On the basis of the recently published viral genome and structural features common to the members of the coronavirus family, a model for host cell-virus interaction and possible targets for antiviral drugs are presented. The epidemiological consequences of introducing a novel pathogen in a previously unexposed population and the origin and evolution of a new and more pathogenic strain of coronavirus are discussed.
近期一种新型临床疾病——严重急性呼吸综合征（SARS）的发现，以及随后该病迅速传播且病死率达14% - 15%，促使在世界卫生组织（WHO）建立的实验室网络推动下展开了大规模国际合作调查。鉴于SARS有可能成为新千年的首例大流行病，WHO于2003年3月12日发布了全球警告。这种疾病据信起源于中国广东省，从香港经国际机场传播至目前在全球的分布范围。全球科学界齐心协力，多个团队已从SARS患者中独立分离并鉴定出一种新型冠状病毒。如此迅速地分离出这种新出现的传染病病原体堪称一项前所未有的科学成就。本文的主要目的是向临床医生概述SARS的自然史、流行病学和临床特征。基于最近公布的病毒基因组以及冠状病毒家族成员共有的结构特征，提出了宿主细胞 - 病毒相互作用模型以及抗病毒药物的可能靶点。文中还讨论了在先前未接触过该病原体的人群中引入新型病原体的流行病学后果，以及新型且致病性更强的冠状病毒株的起源和演变。
