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      Lung pathology of fatal severe acute respiratory syndrome.

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          Abstract

          Severe acute respiratory syndrome (SARS) is a novel infectious disease with global impact. A virus from the family Coronaviridae has been identified as the cause, but the pathogenesis is still unclear.

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          Pathology of fatal human infection associated with avian influenza A H5N1 virus.

          Ka-Fai To, Paul K.S. Chan, Kui-Fat Chan … (2001)
          Eighteen cases of human influenza A H5N1 infection were identified in Hong Kong from May to December 1997. Two of the six fatal cases had undergone a full post-mortem which showed reactive hemophagocytic syndrome as the most prominent feature. Other findings included organizing diffuse alveolar damage with interstitial fibrosis, extensive hepatic central lobular necrosis, acute renal tubular necrosis and lymphoid depletion. Elevation of soluble interleukin-2 receptor, interleukin-6 and interferon-gamma was demonstrated in both patients, whereas secondary bacterial pneumonia was not observed. Virus detection using isolation, reverse transcription-polymerase chain reaction and immunostaining were all negative. It is postulated that in fatal human infections with this avian subtype, initial virus replication in the respiratory tract triggers hypercytokinemia complicated by the reactive hemophagocytic syndrome. These findings suggest that the pathogenesis of influenza A H5N1 infection might be different from that of the usual human subtypes H1-H3.
          Article 0 comments Cited 144 times – based on 0 reviews     Review now
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            Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus

            KY Yuen, PKS Chan, M. Peiris … (1998)
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              Detection of influenza A viruses from different species by PCR amplification of conserved sequences in the matrix gene.

              A Osterhaus, T Bestebroer, S Herfst … (2000)
              The recently raised awareness of the threat of a new influenza pandemic has stimulated interest in the detection of influenza A viruses in human as well as animal secretions. Virus isolation alone is unsatisfactory for this purpose because of its inherent limited sensitivity and the lack of host cells that are universally permissive to all influenza A viruses. Previously described PCR methods are more sensitive but are targeted predominantly at virus strains currently circulating in humans, since the sequences of the primer sets display considerable numbers of mismatches to the sequences of animal influenza A viruses. Therefore, a new set of primers, based on highly conserved regions of the matrix gene, was designed for single-tube reverse transcription-PCR for the detection of influenza A viruses from multiple species. This PCR proved to be fully reactive with a panel of 25 genetically diverse virus isolates that were obtained from birds, humans, pigs, horses, and seals and that included all known subtypes of influenza A virus. It was not reactive with the 11 other RNA viruses tested. Comparative tests with throat swab samples from humans and fecal and cloacal swab samples from birds confirmed that the new PCR is faster and up to 100-fold more sensitive than classical virus isolation procedures.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Lancet
                Title: Lancet (London, England)
                Publisher: Elsevier BV
                ISSN: 0140-6736
                ISSN (Print): 0140-6736
                Publication date (Electronic): May 24 2003
                Volume: 361
                Issue: 9371
                Affiliations
                [1 ] Department of Pathology, University of Hong Kong, Hong Kong Special Administrative Region, China.
                Article
                Publisher Item ID: S0140673603134137
                DOI: 10.1016/s0140-6736(03)13413-7
                PMC ID: 7112492
                PubMed ID: 12781536
                SO-VID: 71e95039-baec-4df9-84cf-71cb1b33c8ce
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