2. SARS Cases Worldwide Reported to WHO as of June 6, 2003 China (5329) Singapore (206) Hong Kong (1750) Vietnam (63) Canada (219) U.S. (68) Europe: 8 countries (38) Thailand (8) Taiwan (676) Total: 8404 cases; 779 deaths (~10%case fatality) Australia&NZ (6) SA (2)

3. Masked shop owner in Amoy Gardens complex photo by Christian Keenan

6. Coronaviruses Single Strand RNA, nonsegmented, enveloped, ~31,000 bps Order: Nidovirales Family: Coronaviridae Torovirus and Coronavirus :Grp I, Grp II, Grp III 229E and OC43 in humans cause ~1/3 of common colds, reinfections common May remain viable for several hours after drying on surfaces

7. Relative Size of Coronaviruses Compared to Other Microbes NY Times 4/27/03

8. Holmes, NEJM 2003;348: 1948 - Structure of Coronavirus Virion The spike glycoproteins create corona, bind and fuse with host cell membranes

9. nucleus attachment maturation assembly translation replication mRNA synthesis release entry M Denison, Vanderbilt

10. CDC X1 X2 X3 X4 X5 NM E 20,00130,00025,000 S RNA 6 RNA 5 RNA 4 RNA 3 RNA 2 8.3 kb 4.5 kb 3.4 kb 2.5 kb 1.7 kb S1b 1a NM E A B 1 5,00010,00015,00020,00025,00030,000 29,727 nt Genome Organization - Replicases (1a/1b) & structural genes (S,E,M,N) - Multiple small genes (X1-X5)-these vary in number, location, and sequence in different coronaviruses

11. SARS-CoV is similar in general genome organization to other coronaviruses SARS-CoV is genetically distinct from other known coronaviruses – Structural proteins are < 40% identical – Replicase proteins are < 70% identical – SARS-CoV nsps are not homologous to known proteins Specific RT-PCR assays will allow the rapid and sensitive detection of the virus, aiding in control CDC Enterovirus Reference Laboratory

12. - Distinct from other known coronaviruses - Neither a mutant nor recombinant - Previously unknown, probably from a nonhuman host, has acquired the ability to infect humans.

13. Evidence that Urbani Coronavirus is the Etiology of SARS Culture of novel coronavirus from SARS patients in multiple sites worldwide Identical Sequence EM ’ s from BAL and lung showing coronavirus PCR finding novel coronavirus nucleic acid Antibody response specific to novel coronavirus, sera from other human coronaviruses show no reaction Infection re-produced in primate animal model

14. CIVET CAT Nocturnal Animal Related To Mongoose Delicacy in Southern China

15. NY Times 4/27/03

16. Probable SARS cases by reported source of infection,* --- Singapore February 25--April 30, 2003 MMWR 2003;52:405 MMWR 2003;52:405