Final: SARS

Question 1

What foes SARS stand for?

Answer 1

Severe Acute Respiratory Syndrome

Question 2

What was the index city for SARS origin?

Answer 2

Fushan, China

Question 3

What was the index city for the global distribution of SARS?

Answer 3

Hong Kong, China

Question 4

What countries were directly affected by movement from the global distribution city?

Answer 4

Vietnam, Singapore, United States, Canada, Ireland

Question 5

Rank the countries affected by SARs from most cases to least:

Answer 5

1. China
2. Canada
3. Singapore
4. Vietnam
5. United States
6. Philippines

Question 6

What are super spreader events (SSE)?

Answer 6

a large cluster of infection in which one or more individuals infect many more other individuals than an average SARS

Question 7

What % of infections were attributed to SSE in Hong Kong?

Answer 7

71.1%

Question 8

What % of infections were attributed to SSE in Singapore?

Answer 8

74.8%

Question 9

What was the suspect case criteria?

Answer 9

1) High fever (>100.4 F, >38 C)
2) Cough or difficulty breathing
3) close contact suspect or probable case -travel area recent local transmission -residence area recent local transmission
OR
1) person with an unexplained acute respiratory illness resulting in death after 1 November 2002, but on whom no autopsy has been performed + one or more of preceding criteria

Question 10

What was the probable case criteria?

Answer 10

1) radiographic evidence (Chest X-ray) consistent with pneumonia or respiratory distress syndrome (RDS)
2) SARS CoV positive by one or more assays
OR:
1) autopsy findings RDS pathology - no identifiable cause

Question 11

What was the global total of probable SARs cases?

Answer 11

8,455

Question 12

What was the global total of SARs deaths?

Answer 12

790

Question 13

What was the average case fatality rate for all probable cases of SARS?

Answer 13

9.3%

Question 14

How many SARs related deaths occurred in the United States?

Answer 14

0

Question 15

What enzyme is present of the host cell surface that is essential for attachment of SARs CoV?

Answer 15

Angiotensin-converting-enzyme 2 (ACE-2) Receptor

Question 16

What are the stages of replication for SARs?

Answer 16

1) Binding to cell receptors and penetration of host cell. (ACE-2)
2) Uncoating of protein coat.
3) Gene expression and transcription
4) Genome replication (occurs in cytoplasm)
5) Assembly and release of new visions
6) Replication occurs in ~12 hours

Question 17

What organs is SARs CoV found in? (besides lungs)

Answer 17

1) the intestinal tract
2) kidney
3) sweat glands

Question 18

What is the most common/efficient transmission of SARs CoV?

Answer 18

• close contact < 3 feet away, cough droplets
• fomites
• Sewage, feces, food, water and air possible

Question 19

Why is SARs CoV considered a novel virus?

Answer 19

• Never been seen before in humans
• Neither a mutated or reasserted version of known CoV
• First member of new group of CoVs

Question 20

What was the original host of SARs CoV?

Answer 20

Wild Chinese horseshoe bats

Question 21

What are some assumptions of SARs CoV in relation to the future of SARs CoV and SARs?

Answer 21

1) SARS is a respiratory disease
2) Global public health response was responsible for control / elimination of SARS
3) SARS is an acute disease
4) If SARS-CoV reemerges it will be a “seasonal” disease
5) SARS-CoV will adapt and become less virulent
6) SARS-CoV will adapt and become more virulent
7) The barriers for trans-species movement of coronaviruses are high
8) Immune response equals recovery and protection
9) Response of animals correlates with protection in humans