Molecular advances in the cell biology of SARS-CoV and current disease prevention strategies

Stark, Caren J; Atreya, CD

The clinical symptoms of SARS are those of a lower respiratory tract infection and are accompanied by damage to the lungs [6, 9, 10] . Gastrointestinal involvement is also common, with more than 20% of patients presenting with watery diarrhea [11] . Fecal samples from SARS patients taken up to 25 days after onset of disease contain viral RNA, which suggests viral shedding through the bowels [5] . Liver dysfunction has also been reported based on observed necrosis in hepatocytes [9, 12] . Post-mortem tissue examination of SARS patients has found the virus presence in lung, bowel, lymph node, liver, heart, kidney, and skeletal muscle samples [13] . The primary mode of SARS-CoV transmission is airborne via droplets [14, 15] . However, there are also reports of the presence of replicating virus in blood cells (peripheral blood mononuclear cells) and in the small and large intestine [11, 16] . Alternative modes of transmission, such as blood-borne or fecaloral are therefore possible.