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  • Clinical Treatment and Diagnosis for MERS NCOV - lessons from 2002/2003 outbreak

    http://www.ncbi.nlm.nih.gov/pubmed/23594967

    <INPUT id=resultcount type=hidden value=1 name=EntrezSystem2.PEntrez.PubMed.Pubmed_ResultsPa nel.Pubmed_ResultsController.ResultCount sid="1"><INPUT type=hidden name=EntrezSystem2.PEntrez.PubMed.Pubmed_ResultsPa nel.Pubmed_ResultsController.RunLastQuery sid="1">
    Sci Rep. 2013;3:1686. doi: 10.1038/srep01686.
    Inhibition of novel β coronavirus replication by a combination of interferon-α2b and ribavirin.

    Falzarano D<SUP>1</SUP>, de Wit E, Martellaro C, Callison J, Munster VJ, Feldmann H.
    Author information

    • <SUP>1</SUP>Disease Modeling and Transmission Unit, Hamilton, MT, USA.


    Abstract

    The identification of a novel β coronavirus, nCoV, as the causative agent of severe respiratory illness in humans originating in Saudi Arabia, Qatar and Jordan has raised concerns about the possibility of a coronavirus pandemic similar to that of SARS-CoV. As a definitive treatment regimen has never been thoroughly evaluated for coronavirus infections, there is an urgent need to rapidly identify potential therapeutics to address future cases of nCoV. To determine an intervention strategy, the effect of interferon-α2b and ribavirin on nCoV isolate hCoV-EMC/2012 replication in Vero and LLC-MK2 cells was evaluated. hCoV-EMC/2012 was sensitive to both interferon-α2b and ribavirin alone in Vero and LLC-MK2 cells, but only at relatively high concentrations; however, when combined, lower concentrations of interferon-α2b and ribavirin achieved comparable endpoints. Thus, a combination of interferon-α2b and ribavirin, which are already commonly used in the clinic, may be useful for patient management in the event of future nCoV infections.


    <DL class=rprtid> <DT>PMID: <DD>23594967 <DD>[PubMed - indexed for MEDLINE] <DD> <DT>PMCID: <DD>PMC3629412 <DD></DD></DL>Free PMC Article


    <INPUT id=img_strip_Closed type=hidden name=EntrezSystem2.PEntrez.PubMed.Pubmed_ResultsPa nel.Pubmed_RVAbstract.img_strip_Closed sid="1"> Images from this publication.See all images (4)Free text
    Figure 1 Interferon-α2b and/or ribavirin treatment of hCoV-EMC/2012-infected Vero cells.

    Vero cells were infected with hCoV-EMC/2012 at an MOI of 0.001 for 1 h and subsequently treated with interferon-α2b (IFN-α2b) and/or ribavirin at the indicated concentration. On day 5 post-infection cells were photographed and cytopathic effect was assessed (A). Cell lysates were collected and subjected to western blotting with serum from a rabbit immunized with whole inactivated hCoV-EMC/2012 (B). β-actin was used as loading control (actin).

    Inhibition of novel ? coronavirus replication by a combination of interferon-?2b and ribavirin
    Sci Rep. 2013;3:1686.



    Figure 2 Replication of novel human coronavirus hCoV-EMC/2012 in response to interferon-α2b or ribavirin treatment in Vero cells.

    Vero cells were infected with hCoV-EMC/2012 at an MOI of 0.001 for 1 h and subsequently treated with interferon-α2b (IFN-α2b) or ribavirin at the indicated concentration. At 1 and 3 days post-infection, supernatants were removed and subsequently analyzed for viral load by real time quantitative RT-PCR (A,B) and infectious virus titers by 50% tissue culture infectious dose (TCID<SUB>50</SUB>) assay (C, D). Viral loads are shown as TCID<SUB>50</SUB> equivalents/ml ±SD, in response to increasing concentrations of IFN-α2b (A) or ribavirin (B). Viral titers are TCID<SUB>50</SUB>/ml ±SD in response to increasing concentrations of IFN-α2b (C) or ribavirin (D).

    Inhibition of novel ? coronavirus replication by a combination of interferon-?2b and ribavirin
    Sci Rep. 2013;3:1686.



    Figure 3 Replication of novel human coronavirus hCoV-EMC/2012 in response to interferon-α2b or ribavirin treatment in LLC-MK2 cells.

    LLC-MK2 cells were infected with hCoV-EMC/2012 at an MOI of 0.001 for 1 h and subsequently treated with interferon-α2b (IFN-α2b) or ribavirin at the indicated concentration. At 1 and 3 days post-infection, supernatants were removed and subsequently analyzed for viral load by real time quantitative RT-PCR (A,B) and infectious virus titers by 50% tissue culture infectious dose (TCID<SUB>50</SUB>) assay (C, D). Viral loads are shown as TCID<SUB>50</SUB> equivalents/ml ±SD, in response to increasing concentrations of IFN-α2b (A) or ribavirin (B). Viral titers are TCID<SUB>50</SUB>/ml ±SD in response to increasing concentrations of IFN-α2b (C) or ribavirin (D).

    Inhibition of novel ? coronavirus replication by a combination of interferon-?2b and ribavirin
    Sci Rep. 2013;3:1686.



    Figure 4 Replication of novel human coronavirus hCoV-EMC/2012 in response to combined treatment with interferon-α2b and ribavirin in Vero cells.

    Vero cells were infected with hCoV-EMC/2012 at an MOI of 0.001 for 1 h and subsequently treated with interferon-α2b (IFN-α2b) and/or ribavirin at the indicated concentration. At 3 days post-infection, supernatants were removed and subsequently analyzed for infectious virus titers by 50% tissue culture infectious dose (TCID<SUB>50</SUB>) assay. Viral titers are shown as TCID<SUB>50</SUB>/ml ±SE in response to increasing concentrations of IFN-α2b, ribavirin or the combination of both.

    Inhibition of novel ? coronavirus replication by a combination of interferon-?2b and ribavirin
    Sci Rep. 2013;3:1686.






    Publication Types, MeSH Terms, Substances
    Please do not ask me for medical advice, I am not a medical doctor.

    Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
    Thank you,
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  • #2
    Re: linical Treatment and Diagnosis for MERS NCOV

    http://www.cidrap.umn.edu/news-persp...susceptibility


    Connect with Us
    Mar 27, 2013 (CIDRAP News) – Experiments by Hong Kong researchers to gauge the susceptibility of several human and animal cell lines to novel coronavirus (NCoV) found signs that it can infect a broad range of tissues, which might shed light on the disease's seemingly high mortality rate.
    Though many questions remain about the source of the new virus and how it spreads, health officials know that it can cause severe clinical illness in some patients, including severe pneumonia and renal failure, the group wrote. They added that until more is known about the disease, lab studies could help provide clues.
    The tests they conducted with NCoV and the cell lines are surrogates of virus growth in the tissues. They measured viral load in the cultures, nucleoprotein expression, and cytopathic effect. They published their findings yesterday in an early online edition of the Journal of Infectious Diseases (JID).
    The group used an autopsy NCoV virus sample obtained from the first known case-patient, a Saudi Arabian man who died from the disease in June. They used 27 cell lines from different tissues and organs in their susceptibility tests, 14 from humans and 13 from animals.
    Tests suggested that NCoV can infect human respiratory, kidney, and liver cells, as well as histiocytes. The impact on neuronal cells and monocytes was much less.
    Researchers suggested that the range of human tissues that are susceptible to infection appears to be broader than all other human coronaviruses, including the SARS (severe acute respiratory syndrome) virus. The team said this finding might help explain the disease's pathogenesis and high mortality
    Please do not ask me for medical advice, I am not a medical doctor.

    Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
    Thank you,
    Shannon Bennett

    Comment


    • #3
      Re: Clinical Treatment and Diagnosis for MERS NCOV

      <LI class=firstcrumb>Home > Volume 59, Issue 3
      <LI class=lastcrumb>> Article
      Thoraxthorax.bmj.com
      <CITE><ABBR title=Thorax class=slug-jnl-abbrev><?xml:namespace prefix = "nlm" /><nlm:abbrev-journal-title xmlns:nlm="http://schema.highwire.org/NLM/Journal" abbrev-type="publisher">Thorax</nlm:abbrev-journal-title></ABBR> 2004;59:252-256 doi:10.1136/thorax.2003.012658 </CITE>
      • Respiratory infection
      Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings

      1. C M Chu2,
      2. V C C Cheng1,
      3. I F N ****1,
      4. M M L Wong3,
      5. K H Chan1,
      6. K S Chan2,
      7. R Y T Kao1,
      8. L L M Poon1,
      9. C L P Wong1,
      10. Y Guan1,
      11. J S M Peiris1,
      12. K Y Yuen1,
      13. on behalf of the HKU/UCH SARS Study Group*
      + Author Affiliations
      1. <ADDRESS><SUP>1</SUP>Department of Microbiology and Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong </ADDRESS>
      2. <ADDRESS><SUP>2</SUP>Department of Medicine, United Christian Hospital, Hong Kong </ADDRESS>
      3. <ADDRESS><SUP>3</SUP>Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong </ADDRESS>
      1. Correspondence to:
        Professor K Y Yuen
        Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong Special Administrative Region, China; kyyuen@hkucc.hku.hk
      • Received 8 July 2003
      • Accepted 8 October 2003

      Abstract

      Background: The clinical response of patients with severe acute respiratory syndrome (SARS) to a combination of lopinavir/ritonavir and ribavirin was examined after establishing the in vitro antiviral susceptibility of the SARS associated coronavirus to a panel of antiviral agents.
      Methods: The in vitro susceptibility of the prototype of SARS associated coronavirus to a panel of nucleoside analogues and protease inhibitors currently licensed for clinical use was studied. Forty one patients with SARS followed for 3 weeks were treated with a combination of lopinavir/ritonavir and ribavirin. The clinical progress and virological outcomes were monitored and compared with 111 patients treated with ribavirin only who served as historical controls.
      Results: In vitro antiviral activity against SARS associated coronavirus was demonstrated for lopinavir and ribavirin at concentrations of 4 µg/ml and 50 µg/ml, respectively, only at 48 hours. The adverse clinical outcome (ARDS or death) was significantly lower in the treatment group than in the historical controls (2.4% v 28.8%, p<0.001) at day 21 after the onset of symptoms. The adverse outcome remained significantly lower in the treatment group than in the controls—both those diagnosed early (p<0.001) and those diagnosed later in the course of the epidemic (p = 0.002)—but there was no significant difference in adverse outcome rates between the two time periods (p = 0.548). No time related difference in outcome was observed in the control groups. A reduction in steroid usage and nosocomial infections was seen in patients initially treated with lopinavir/ritonavir, and these patients had a decreasing viral load and rising peripheral lymphocyte count. Multivariate analysis showed that age, hepatitis B carrier status, and lack of treatment with this antiviral combination were independent predictors of an adverse outcome. Lopinavir/ritonavir treatment was associated with a better outcome even when adjusted for baseline lactate dehydrogenase level.
      Conclusions: The apparent favourable clinical response with lopinavir/ritonavir and ribavirin supports further randomised placebo controlled trials in patients with SARS.







      http://thorax.bmj.com/content/59/3/252.short
      Please do not ask me for medical advice, I am not a medical doctor.

      Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
      Thank you,
      Shannon Bennett

      Comment


      • #4
        Re: Clinical Treatment and Diagnosis for MERS NCOV

        <NOSCRIPT></NOSCRIPT>
        <!--?xml version="1.0" encoding="UTF-8"?--> Volume 362, Issue 9380, 26 July 2003, Pages 293–294


        <NOSCRIPT></NOSCRIPT>

        Fast track — Research Letters

        Treatment of SARS with human interferons


        <LI class=external> PDF (326 K)
        <!--FRAGMENTEND-->
        <!--VALIDHTML--> <HR id=abs_author1 class=artHeader> Summary

        Effective antiviral agents are needed to treat severe acute respiratory syndrome-associated coronavirus (SARS-CoV) infection. We assessed the antiviral potential of recombinant interferons against two clinical isolates of SARS-CoV—FFM-1, from Frankfurt patients, and Hong Kong—replicated in Vero and Caco2 cells. Interferon β was five to ten times more effective in Caco2 cells. Interferon α effectively inhibited SARS-CoV replication, but with a selectivity index 50–90 times lower than that for interferon β. Interferon γ was slightly better than interferon α in Vero cell cultures, but was completely ineffective in Caco2 cell cultures. Interferon β could be useful alone or in combination with other antiviral drugs for the treatment of SARS.

        <!--VALIDHTML-->
        <!--VALIDHTML--> <DL id=cor1 class=correspondence> <DT class="label topPadd"><SUP><NOSCRIPT></NOSCRIPT></SUP></DT> <DD>Correspondence to: Prof J Cinatl</DD></DL><!--footerNotes-->
        <!--VALIDHTML--> Copyright © 2003 Elsevier Ltd. All rights reserved.




        http://www.sciencedirect.com/science...40673603139736
        Please do not ask me for medical advice, I am not a medical doctor.

        Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
        Thank you,
        Shannon Bennett

        Comment


        • #5
          Re: Clinical Treatment and Diagnosis for MERS NCOV

          <TABLE cellSpacing=0 cellPadding=0 width=760 border=0> <TBODY> <TR> <TD width=15></TD> <TD vAlign=top width=470> <TABLE cellSpacing=0 cellPadding=0 width=470 border=0> <TBODY> <TR xmlns=""> <TD height=21 vAlign=top></TD></TR> <TR xmlns=""> <TD height=22 vAlign=top>Article</TD></TR> <TR xmlns=""> <TD></TD></TR> <TR xmlns=""> <TD height=14></TD></TR> <TR> <TD>Nature Medicine 11, 944 - 951 (2005)
          Published online: 21 August 2005; | doi:10.1038/nm1280 Using siRNA in prophylactic and therapeutic regimens against SARS coronavirus in Rhesus macaque

          Bao-jian Li<SUP>1, </SUP><SUP>2, </SUP><SUP>7</SUP>, Qingquan Tang<SUP>3, </SUP><SUP>7</SUP>, Du Cheng<SUP>2, </SUP><SUP>7</SUP>, Chuan Qin<SUP>4, </SUP><SUP>7</SUP>, Frank Y Xie<SUP>2, </SUP><SUP>3</SUP>, Qiang Wei<SUP>4</SUP>, Jun Xu<SUP>3</SUP>, Yijia Liu<SUP>3</SUP>, Bo-jian Zheng<SUP>5</SUP>, Martin C Woodle<SUP>3</SUP>, Nanshan Zhong<SUP>6</SUP> & Patrick Y Lu<SUP>3</SUP> <SUP>1</SUP> Biotechnology Research Center of Sun Yatsen University, and Key Laboratory of Gene Engineering of Ministry of Education of the State, Guangzhou, China.
          <SUP>2</SUP> Guangzhou Top Genomics, Ltd., Guangzhou, China.
          <SUP>3</SUP> Intradigm Corporation, 12115 K Parklawn Drive, Rockville, Maryland 20852, USA.
          <SUP>4</SUP> Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
          <SUP>5</SUP> Department of Pathology, University of Hong Kong, Hong Kong, China.
          <SUP>6</SUP> Guangzhou Institute of Respiratory Diseases, Guangzhou, China.
          <SUP>7</SUP> These authors contributed equally to this work.
          Correspondence should be addressed to Patrick Y Lu patricklu@intradigm.com or Nanshan Zhong nanshan@vip.163.com
          <TABLE cellSpacing=0 cellPadding=0 width=450 border=0 xmlns=""> <TBODY> <TR> <TD height=20></TD></TR> <TR> <TD height=1></TD></TR> <TR> <TD height=20></TD></TR></TBODY></TABLE>Development of therapeutic agents for severe acute respiratory syndrome (SARS) viral infection using short interfering RNA (siRNA) inhibitors exemplifies a powerful new means to combat emerging infectious diseases. Potent siRNA inhibitors of SARS coronavirus (SCV) in vitro were further evaluated for efficacy and safety in a rhesus macaque (Macaca mulatta) SARS model using clinically viable delivery while comparing three dosing regimens. Observations of SARS-like symptoms, measurements of SCV RNA presence and lung histopathology and immunohistochemistry consistently showed siRNA-mediated anti-SARS efficacy by either prophylactic or therapeutic regimens. The siRNAs used provided relief from SCV infection–induced fever, diminished SCV viral levels and reduced acute diffuse alveoli damage. The 10–40 mg/kg accumulated dosages of siRNA did not show any sign of siRNA-induced toxicity. These results suggest that a clinical investigation is warranted and illustrate the prospects for siRNA to enable a massive reduction in development time for new targeted therapeutic agents. <TABLE cellSpacing=0 cellPadding=0 width=450 border=0 xmlns=""> <TBODY> <TR> <TD height=20></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>




          http://www.nature.com/nm/journal/v11/n9/abs/nm1280.html
          Please do not ask me for medical advice, I am not a medical doctor.

          Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
          Thank you,
          Shannon Bennett

          Comment


          • #6
            Re: Clinical Treatment and Diagnosis for MERS NCOV

            CMAJ May 13, 2003 vol. 168 no. 10
            • Practice
              • practice
            Ribavirin in the treatment of SARS: A new trick for an old drug?

            1. Gideon Koren,
            2. Susan King,
            3. Sandra Knowles,
            4. Elizabeth Phillips
            + Author Affiliations
            1. <ADDRESS>From the Divisions of Clinical Pharmacology/Toxicology (Koren) and of Infectious Diseases (King), The Hospital for Sick Children, Toronto, Ont.; and the Divisions of Clinical Pharmacology (Knowles, Phillips), Infectious Diseases (Phillips) and Pharmacy (Knowles), Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ont. </ADDRESS>
            1. Correspondence to:
              Dr. Gideon Koren, Division of Clinical Pharmacology/Toxicology, The Hospital for Sick Children, 555 University Ave., Toronto ON M5G 1X8; fax 416 813-7562; gkoren@sickkids.ca


            Next Section
            The dramatic outbreak of severe acute respiratory syndrome (SARS) has led to the use of high-dose intravenous and oral ribavirin in patients affected with this disorder. Ribavirin, a nucleoside analogue with broad antiviral activity, was discovered in 1970 by ICN Pharmaceuticals. In Canada, ribavirin is licensed for the treatment of respiratory syncytial virus (RSV) infection in infants and, in combination with interferon α2b, hepatitis C. In view of the limited circumstances in which it is prescribed, most physicians are not familiar with its pharmacology, dosing and safety. In this article we summarize this information for the benefit of health care professionals who may be involved with patients receiving ribavirin for treatment or prevention of SARS. We also review emerging data on the potential efficacy of ribavirin against the SARS virus, a new mutant of coronavirus.

            Full article available at link.



            http://www.cmaj.ca/content/168/10/1289.short
            Please do not ask me for medical advice, I am not a medical doctor.

            Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
            Thank you,
            Shannon Bennett

            Comment


            • #7
              Re: Clinical Treatment and Diagnosis for MERS NCOV

              <!--?xml version="1.0" encoding="UTF-8"?--> Journal of Infection
              Volume 49, Issue 4, November 2004, Pages 262–273

              <NOSCRIPT></NOSCRIPT>


              Medical treatment of viral pneumonia including SARS in immunocompetent adult

              <!--VALIDHTML-->
              • <SUP>a</SUP> Centre of Infection, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, China
              • <SUP>b</SUP> Department of Medicine, United Christian Hospital, Hong Kong Special Administrative Region, China
              <!--VALIDHTML--><!--VALIDHTML--> <DL class="articleDates smh" style="DISPLAY: none"> <DD>Accepted 15 July 2004, Available online 11 September 2004</DD></DL><!--VALIDHTML--> <DL class=citation></DL>
              <!--VALIDHTML--> Choose an option to locate/access this article:
              Check if you have access through your login credentials or your institution











              <DL id=referredToBy class=documentThread><!--Referred To By--></DL>
              <!--FRAGMENTEND-->

              <!--VALIDHTML--> <HR id=abs_author1 class=artHeader> Abstract

              Since no randomized controlled trials have been conducted on the treatment of viral pneumonia by antivirals or immunomodulators in immunocompetent adults, a review of such anecdotal experience are needed for the more rational use of such agents. Case reports (single or case series) with details on their treatment and outcome in the English literature can be reviewed for pneumonia caused by human or avian influenza A virus (50 patients), varicella zoster virus (120), adenovirus (29), hantavirus (100) and SARS coronavirus (SARS-CoV) (841). Even with steroid therapy alone, the mortality rate appeared to be lower when compared with conservative treatment for pneumonia caused by human influenza virus (12.5% vs. 42.1%) and hantavirus (13.3% vs. 63.4%). Combination of an effective antiviral, acyclovir, with steroid in the treatment of varicella zoster virus may be associated with a lower mortality than acyclovir alone (0% vs. 10.3%). Combination of interferon alfacon-1 plus steroid, or lopinavir/ritonavir, ribavirin plus steroid were associated with a better outcome than ribavirin plus steroid (0% vs. 2.3% vs. 7.7%, respectively). Combination of lopinavir/ritonavir plus ribavirin significantly reduced the virus load of SARS-CoV in nasopharyngeal, serum, stool and urine specimens taken between day 10 and 15 after symptom onset when compared with the historical control group treated with ribavirin. It appears that the combination of an effective antiviral and steroid was associated with a better outcome. Randomized therapeutic trial should be conducted to ascertain the relative usefulness of antiviral alone or in combination with steroid.



              http://www.sciencedirect.com/science...63445304001653
              Please do not ask me for medical advice, I am not a medical doctor.

              Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
              Thank you,
              Shannon Bennett

              Comment


              • #8
                Re: Clinical Treatment and Diagnosis for MERS NCOV - lessons from 2002/2003 outbreak

                This is an open access article. It is a timeline of the SARS outbreak. It also a teaching instrument for future emerging disease outbreaks. I found it to be a worthwhile read. Wouldn't it be nice if we actually learned something from SARS so we don't have to make the same errors again this time?
                Follow the link at the bottom of the page for the full text.
                Editors' Summary

                Background

                Every now and then, a new infectious disease appears in a human population or an old disease becomes much more common or more geographically widespread. Recently, several such “emerging infectious diseases” have become major public health problems. For example, HIV/AIDS, hepatitis C, and severe acute respiratory syndrome (SARS) have all emerged in the past three decades and spread rapidly round the world. When an outbreak (epidemic) of an emerging infectious disease occurs, epidemiologists (scientists who study the causes, distribution, and control of diseases in populations) swing into action, collecting and analyzing data on the new threat to human health. Epidemiological studies are rapidly launched to identify the causative agent of the new disease, to investigate how the disease spreads, to define diagnostic criteria for the disease, to evaluate potential treatments, and to devise ways to control the disease's spread. Public health officials then use the results of these studies to bring the epidemic under control.
                Why Was This Study Done?

                Clearly, epidemics of emerging infectious diseases can only be controlled rapidly and effectively if the results of epidemiological studies are made widely available in a timely manner. Public health bulletins (for example, the Morbidity and Mortality Weekly Report from the US Centers from Disease Control and Prevention) are an important way of disseminating information as is the publication of original research in peer-reviewed academic journals. But how timely is this second dissemination route? Submission, peer-review, revision, re-review, acceptance, and publication of a piece of academic research can be a long process, the speed of which is affected by the responses of both authors and journals. In this study, the researchers analyze how the results of academic epidemiological research are submitted and published in journals during and after an emerging infectious disease epidemic using the 2003 SARS epidemic as an example. The first case of SARS was identified in Asia in February 2003 and rapidly spread around the world. 8,098 people became ill with SARS and 774 died before the epidemic was halted in July 2003.
                What Did the Researchers Do and Find?

                The researchers identified more than 300 journal articles covering epidemiological research into the SARS outbreak in Hong Kong, China, and Toronto, Canada (two cities strongly affected by the epidemic) that were published online or in print between January 1, 2003 and July 31, 2007. The researchers' analysis of these articles shows that more than half them were descriptive epidemiological studies, investigations that focused on describing the distribution of SARS; a third were analytical epidemiological studies that tried to discover the cause of SARS. Overall, 22% of the journal articles were submitted for publication during the epidemic. Only 8% of the articles were accepted for publication and only 7% were actually published during the epidemic. The median (average) submission-to-acceptance and acceptance-to-publication intervals for SARS articles submitted during the epidemic were 55 and 77.5 days, respectively, much shorter intervals than those for non-SARS articles published in the same journal issues. After the epidemic was over, the submission-to-acceptance and acceptance-to-publication intervals for SARS articles was similar to that of non-SARS articles.
                What Do These Findings Mean?

                These findings show that, although the academic response to the SARS epidemic was rapid, most articles on the epidemiology of SARS were published after the epidemic was over even though SARS was a major threat to public health. Possible reasons for this publication delay include the time taken by authors to prepare and undertake their studies, to write and submit their papers, and, possibly, their tendency to first submit their results to high profile journals. The time then taken by journals to review the studies, make decisions about publication, and complete the publication process might also have delayed matters. To minimize future delays in the publication of epidemiological research on emerging infectious diseases, epidemiologists could adopt common, predefined protocols and ready-to-use instruments, which would improve timeliness and ensure comparability across studies, suggest the researchers. Journals, in turn, could improve their fast-track procedures and could consider setting up online sections that could be activated when an emerging infectious disease outbreak occurred. Finally, journals could consider altering their review system to speed up the publication process provided the quality of the final published articles was not compromised.
                Additional Information

                Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1​000272.
                • The US National Institute of Allergy and Infectious Diseases provides information on emerging infectious diseases
                • The US Centers for Control and Prevention of Diseases also provides information about emerging infectious diseases, including links to other resources, and information on SARS
                • Wikipedia has a page on epidemiology (note that Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
                • The World Health Organization has information on SARS (in several languages





                http://www.plosmedicine.org/article/...d-1000272-g006
                Please do not ask me for medical advice, I am not a medical doctor.

                Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
                Thank you,
                Shannon Bennett

                Comment

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