SARS-associated Coronavirus Transmission, United States

Isakbaeva, Elmira T.; Khetsuriani, Nino; Beard, R. Suzanne; Peck, Angela; Erdman, Dean; Monroe, Stephan S.; Tong, Suxiang; Ksiazek, Thomas G.; Lowther, Sara; Smith, Indra Pandya; Anderson, Larry J.; Lingappa, Jairam; Widdowson, Marc-Alain

To better assess the risk for transmission of the severe acute respiratory syndrome–associated coronavirus (SARS-CoV), we obtained serial specimens and clinical and exposure data from seven confirmed U.S. SARS patients and their 10 household contacts. SARS-CoV was detected in a day-14 sputum specimen from one case-patient and in five stool specimens from two case-patients. In one case-patient, SARS-CoV persisted in stool for at least 26 days after symptom onset. The highest amounts of virus were in the day-14 sputum sample and a day-14 stool sample. Residual respiratory symptoms were still present in recovered SARS case-patients 2 months after illness onset. Possible transmission of SARS-CoV occurred in one household contact, but this person had also traveled to a SARS-affected area. The data suggest that SARS-CoV is not always transmitted efficiently. Laboratory diagnosis of SARS-CoV infection is difficult; thus, sputum and stool specimens should be included in the diagnostic work-up for SARS-CoV infection.