Epidemiological and genetic correlates of severe acute respiratory syndrome coronavirus infection in the hospital with the highest nosocomial infection rate in Taiwan in 2003.
Taiwan experienced a series of outbreaks of nosocomial severe acute respiratory syndrome (SARS) infections in 2003. Two months after the final outbreak, we recruited 658 employees from the hospital that suffered the first and most severe SARS infections to help us investigate epidemiological and genetic factors associated with the SARS coronavirus (SARS-CoV). SARS-CoV infections were detected by using enzyme immunoassays and confirmed by a combination of Western blot assays, neutralizing antibody tests, and commercial SARS tests. Risk factors were analyzed via questionnaire responses and sequence-specific oligonucleotide probes of human leukocyte antigen (HLA) alleles. Our results indicate that 3% (20/658) of the study participants were seropositive, with one female nurse identified as a subclinical case. Identified SARS-CoV infection risk factors include working in the same building as the hospital's emergency room and infection ward, providing direct care to SARS patients, and carrying a Cw*0801 HLA allele. The odds ratio for contracting a SARS-CoV infection among persons with either a homozygous or a heterozygous Cw*0801 genotype was 4.4 (95% confidence interval, 1.5 to 12.9; P = 0.007).
Chen
Yi-Ming Arthur
YM
Institute of Public Health, National Yang-Ming University, Li-Noun Street, Section 2, Taipei, Taiwan. arthur@ym.edu.tw
Liang
Shu-Yuan
SY
Shih
Yi-Ping
YP
Chen
Chia-Yen
CY
Lee
Yuan-Ming
YM
Chang
Ling
L
Jung
Shiao-Ying
SY
Ho
Mei-Shang
MS
Liang
Kung-Yee
KY
Chen
Hour-Young
HY
Chan
Yu-Jiun
YJ
Chu
Da-Chen
DC
D000328:Adult; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood; D015153:Blotting, Western; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015236:HLA-C Antigens / Q000235:genetics*; D006650:Histocompatibility Testing; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D051379:Mice; D008875:Middle Aged; D009500:Neutralization Tests; D012307:Risk Factors; D045473:Severe acute respiratory syndrome-related coronavirus / Q000276:immunology*; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000235:genetics* / Q000821:virology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology
D000914:Antibodies, Viral; D015236:HLA-C Antigens