Dowell Scott F, Ho Mei Shang
International Emerging Infections Program, Thai Ministry of Public Health and the US Centers for Disease Control and Prevention, Nonthaburi, Thailand.
Lancet Infect Dis. 2004 Nov;4(11):704-8. doi: 10.1016/S1473-3099(04)01177-6.
The novel severe acute respiratory syndrome (SARS) coronavirus caused severe disease and heavy economic losses before apparently coming under complete control. Our understanding of the forces driving seasonal disappearance and recurrence of infectious diseases remains fragmentary, thus limiting any predictions about whether, or when, SARS will recur. It is true that most established respiratory pathogens of human beings recur in wintertime, but a new appreciation for the high burden of disease in tropical areas reinforces questions about explanations resting solely on cold air or low humidity. Seasonal variation in host physiology may also contribute. Newly emergent zoonotic diseases such as ebola or pandemic strains of influenza have recurred in unpredictable patterns. Most established coronaviruses exhibit winter seasonality, with a unique ability to establish persistent infections in a minority of infected animals. Because SARS coronavirus RNA can be detected in the stool of some individuals for at least 9 weeks, recurrence of SARS from persistently shedding human or animal reservoirs is biologically plausible.
新型严重急性呼吸综合征（SARS）冠状病毒在明显得到完全控制之前，曾引发严重疾病并造成巨大经济损失。我们对推动传染病季节性消失和复发的因素的理解仍然支离破碎，因此限制了对SARS是否会复发或何时复发的任何预测。诚然，大多数已确定的人类呼吸道病原体在冬季复发，但对热带地区高疾病负担的新认识强化了仅基于冷空气或低湿度的解释的质疑。宿主生理的季节性变化也可能起作用。新出现的人畜共患病，如埃博拉或大流行性流感毒株，以不可预测的模式复发。大多数已确定的冠状病毒表现出冬季季节性，具有在少数受感染动物中建立持续感染的独特能力。由于在一些个体的粪便中至少9周都能检测到SARS冠状病毒RNA，因此SARS从持续排毒的人类或动物宿主中复发在生物学上是合理的。
