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

• Published in: The Canadian journal of infectious diseases & medical microbiology Vol. 17; no. 6; pp. 330 - 336
• Main Authors: Patrick, David M, Petric, Martin, Skowronski, Danuta M, Guasparini, Roland, Booth, Timothy F, Krajden, Mel, McGeer, Patrick, Bastien, Nathalie, Gustafson, Larry, Dubord, Janet, Macdonald, Diane, David, Samara T, Srour, Leila F, Parker, Robert, Andonov, Anton, Isaac-Renton, Judith, Loewen, Nadine, McNabb, Gail, McNabb, Alan, Goh, Swee-Han, Henwick, Scott, Astell, Caroline, Guo, Jian Ping, Drebot, Michael, Tellier, Raymond, Plummer, Francis, Brunham, Robert C
• Format: Journal Article
• Language: English
• Published: Egypt Pulsus Group Inc 2006; Wiley
• Subjects: Original; Coronavirus; Outbreak; SARS coronavirus; Human coronavirus OC43; Respiratory infection; Severe acute respiratory syndrome; SARS-CoV
• ISSN: 1712-9532; 1918-1493
• DOI: 10.1155/2006/152612

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). 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. 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. 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.