Coronavirus: Severe acute respiratory syndrome (sars) Hearing Before U.S. Congress 2003 Contains very important information About Corona Virus

Dr. Gerberding. We are really talking about two different things.One is, at what point do we determine that people are not going to develop the disease SARS and that incubation period is ten days. So if you were exposed, you would wait 10 days, and if nothing happened to you in those 10 days, you would be assured that you are not going to develop the illness SARS.The 21 days comes in as an antibody test. If you have SARS, it takes 21 days for your antibody test to become positive. So if we want to diagnose someone or we want to see whether or not they actually have the coronavirus infection, when we test them at the beginning of their illness it is usually negative because the antibodies take time to develop. But we repeat the test after 21 days. It will be positive then. And that will tell us for sure, yes, there was coronavirus infection or, no, there was no coronavirus infection.So you are asking both questions with your patients. One is, are the healthcare workers who are exposed safe, and if it has gone 10 days without infection, they are safe. But if you are asking, does the patient have the infection or did they develop an asymptomatic infection, you would have to test them 21 days after exposure to be absolutely sure. Senator Specter. So it is a determination that a patient with a 21-day test as opposed to the 10-day incubation period?Dr. Gerberding. Correct.Senator Specter. But there is no possibility of transmission between the 10th day and the 21st day? Dr. Gerberding. We have not seen any evidence of transmission after 10 days here, but obviously, we are still new in this and we have probably looked at 56 probable cases here, so we do have an open mind and we are not abandoning the follow-up of individuals who have been exposed. Senator Specter. In some of the commentaries, there is an issue raised as to recurrence. What is the scientific thinking that SARS can recur in an individual even after there is some judgment that he or she is safe to be around others, Dr. Gerberding?Dr. Gerberding. I spoke with Dr. Heyman from the World Health Organization about this yesterday, we have more than 5,000 probable cases of SARS internationally, and so just this week there were no reports of recurrence in any country. The only country that is reporting recurrence right now in Hong Kong, in 12 patients.What is unique in Hong Kong is that when the patients are in the hospital with severe pneumonia, they get started on steroids to cut down their inflammation. What they think they are seeing is that the steroids are artificially disguising the inflammation in the lungs, and when they stop the steroids, the patients get sick again. So it may not be an infection recurrence. It may be unmasking of the problem that was really there and that the steroids were artificially covering it up, 13 and also the steroids were preventing the sick person from developing immunity to the infection and it was delaying their recovery. That is just speculation right now, but that is the kind of question that is being asked there. We can answer the questions with some laboratory testing and some better clinical observation of the patients. We do not treat our patients here, typically, with steroids, in part because most of them have not been that ill, and in part, because we have no evidence that steroids are particularly effective.U.S. Congress Senate Committee on Appropriations SEVERE ACUTE RESPIRATORY SYNDROME (SARS) Date(s) Held: 2003-05-02 108th Congress, 1st Session Superintendents of Documents ID: Y 4.AP 6/2The opening statement of Senator Arlen Specter 1Statement of Julie Gerberding, M.D., M.P.H., Director, Centers for DiseaseControl and Prevention, Department of Health and Human Services 2Statement of Luther V. Rhodes, M.D., chief, Division of Infectious Disease,Department of Medicine, Lehigh Valley Hospital and Health Network 7Statement of Anthony S. Fauci, M.D., Director, National Institute of Allergyand Infectious Diseases, National Institutes of Health, Department of Health and Human Services 16Statement of Dr. John Combes, Senior Medical Adviser, Hospital and HealthSystem Association of Pennsylvania 23Questions submitted by Senator Arlen Specter 32Publication Date: 2003