Severe Acute Respiratory Syndrome (SARS) Associated Coronavirus (SARS-CoV)

Characteristics

Morphology Family Coronaviridae. Genus Coronavirus, 80-140 nm in diameter, single-stranded, linear, non-segmented, positive-sense RNA Virus.
Growth Conditions

SARS-CoV has been cultured in vitro using human airway epithelial cells

Health Hazards

Host Range

Humans, raccoon dog, and Chinese ferret badgers. Experimental hosts include non-human primates, ferrets, hamsters, guinea pigs, mice, rats. Bats may be a potential reservoir.

Modes of Transmission

Close person-to-person contact by inhalation of infected respiratory droplets; mucous membrane splash to eye(s), nose or mouth; contaminated surface –tomouth/ nose/ eye. 

Signs and Symptoms

High fever (>100.4°F), chills, rigors, headache, malaise, myalgia, mild respiratory symptoms. Most patients develop pneumonia. 10% to 20% of individuals develop diarrhea.

Infectious Dose Unknown
Incubation Period Generally 2-7 days, can be up to 10 days

Medical Precautions/Treatment

Prophylaxis None available
Vaccines None available
Treatment

Supportive care

Surveillance

Monitor and report symptoms. Laboratory confirmation is done via detection of any of the following by a validated test, with confirmation in a reference laboratory: Serum antibodies to SARS-CoV in a single serum specimen or a fourfold rise in neutralizing antibody titer taken upon admission and 28 days afterward. RT-PCR-based and ELISA based methods are also available for detection of viral RNA.

Emory Requirements If possible, before working with either live SARS-CoV or clinical specimens known to contain SARS-CoV, laboratory personnel should have a baseline serum sample. Report all incidents.

Laboratory Hazards

Laboratory Acquired Infections (LAIs)

Accidental infection has occurred in laboratory personnel while performing viral propagation. No LAI has been reported in personnel performing diagnostic assays. There have not been any known cases of SARS reported anywhere in the world since 2004.

Sources Unknown

Supplemental References

Containment

BSL-2 BSL2 facilities with BSL2 practices should be used for handling respiratory secretions, stool, or tissues for procedures performed in microbiology or pathology labs.
BSL-3/ABSL-3 Biosafety Level 3 facilities, equipment, and operational practices are recommended for SARS-CoV propagation in cell culture and initial characterization of viral agents recovered in cultures of SARS specimens. Inoculation of animals for potential recovery of SARS-CoV from samples, research studies involving animal inoculation for characterization of putative SARS agents must be performed in ABSL-3 facilities.

Spill Procedures

Small Notify others working in the lab. Allow aerosols to settle. Don appropriate PPE. Cover area of the spill with paper towels and apply an EPA approved disinfectant, working from the perimeter towards the center. Allow 30 minutes of contact time before disposal and cleanup of spill materials.
Large

Contact Emory’s Biosafety Officer (404-727-8863),
the EHSO Office (404-727-5922), or
The Spill Response Team (404-727-2888).

Exposure Procedures

Mucous membrane Flush eyes, mouth or nose for 15 minutes at eyewash station.
Other Exposures Wash area with soap and water for 15 minutes.
Reporting Immediately report incident to supervisor, complete an employee incident report in PeopleSoft.
Medical Followup 

7am-4pm (OIM): EUH (404-686-7941) EUHM (404-686-7106) WW (404-728-6431)

After Hours: OIM NP On Call 404-686-5500 PIC# 50464

Needle Stick (OIM): EUH (404-686-8587) EUHM (404-686-2352)

Yerkes: Maureen Thompson Office (404-727-8012) Cell (404-275-0963)

Viability

Disinfection

Household bleach, ice-cold acetone, 70% ethanol, paraformaldehyde, and glutaraldehyde

Inactivation Heat (60°C for 30 minutes), UV radiation
Survival Outside Host 4 days in stool samples with an alkaline pH, > 7 days in respiratory secretions at room temperature, for at least 4 days in undiluted urine and human serum at room temperature, up to 9 days in suspension, 60 hours in soil/water, more than a day on hard surfaces such as glass and metal and 6 days in dried state.

Personal Protective Equipment (PPE)

Minimum PPE Requirements At minimum, personnel are required to don gloves, closed toed shoes, lab coat, and appropriate face and eye protection prior to working with SARS-CoV. Risk assessment may dictate the additional use of respiratory protection (N95 mask).
Additional Precautions All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited. Additional precautions should be considered with work involving animals or large scale activities.

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