JOURNAL ARTICLE

An Outbreak of Human Coronavirus OC43 Infection and Serological Cross-reactivity with SARS Coronavirus

David M Patrick, Martin Petric, Danuta M Skowronski, Roland Guasparini, Timothy F Booth, Mel Krajden, Patrick McGeer, Nathalie Bastien, Larry Gustafson, Janet Dubord, Diane Macdonald, Samara T David, Leila F Srour, Robert Parker, Anton Andonov, Judith Isaac-Renton, Nadine Loewen, Gail McNabb, Alan McNabb, Swee-Han Goh, Scott Henwick, Caroline Astell, Jian Ping Guo, Michael Drebot, Raymond Tellier, Francis Plummer, Robert C Brunham
Canadian Journal of Infectious Diseases & Medical Microbiology 2006, 17 (6): 330-6
18382647

BACKGROUND: In summer 2003, a respiratory outbreak was investigated in British Columbia, during which nucleic acid tests and serology unexpectedly indicated reactivity for severe acute respiratory syndrome coronavirus (SARS-CoV).

METHODS: Cases at a care facility were epidemiologically characterized and sequentially investigated for conventional agents of respiratory infection, SARS-CoV and other human CoVs. Serological cross-reactivity between SARS-CoV and human CoV-OC43 (HCoV-OC43) was investigated by peptide spot assay.

RESULTS: Ninety-five of 142 residents (67%) and 53 of 160 staff members (33%) experienced symptoms of respiratory infection. Symptomatic residents experienced cough (66%), fever (21%) and pneumonia (12%). Eight residents died, six with pneumonia. No staff members developed pneumonia. Findings on reverse transcriptase-polymerase chain reaction assays for SARS-CoV at a national reference laboratory were suspected to represent false positives, but this was confounded by concurrent identification of antibody to N protein on serology. Subsequent testing by reverse transcriptase-polymerase chain reaction confirmed HCoV-OC43 infection. Convalescent serology ruled out SARS. Notably, sera demonstrated cross-reactivity against nucleocapsid peptide sequences common to HCoV-OC43 and SARS-CoV.

CONCLUSIONS: These findings underscore the virulence of human CoV-OC43 in elderly populations and confirm that cross-reactivity to antibody against nucleocapsid proteins from these viruses must be considered when interpreting serological tests for SARS-CoV.

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