New SARS case may be "reactivated" or a mutation Scientists are...

New SARS case may be "reactivated" or a mutation
Scientists are perplexed by the findings so far from laboratory and forensic tests on China's newest SARS victim and one particularly chilling line of inquiry is examining whether the case may be a resurgence of an earlier, undetected bout with the virus.

As New York Times medical writer Lawrence K. Altman put it in a thoughtful article that ran in the International Herald Tribune on Saturday, the scientists "are wrestling with tantalizing but inconclusive test findings that have created a medical mystery and raised a number of diagnostic questions."

While gene sequencing tests have shown that the patient -- identified by China only as a 32-year-old television producer from Guangdong province -- is likely to have SARS, or Severe Acute Respiratory Syndrome, certain key elements of the diagnostic chain appear either to be missing or ambiguous.

First, the man has had no contact with any known transmission vectors, something that may be resolved through on-going examination of his environment and recent past. If not, there is the possibility that a new, previously unseen, vector has emerged.

Second, the man had been ill while SARS was raging in Guangdong Province last winter -- but he had not then been suspected of having SARS. If he did, this case may be a reactivation of the earlier infection, a development with horrific consequences for the thousands that survived the first round of infections -- and for the medical establishments that must try to plan for and contain any future outbreak.

Dr Julie Hall, the World Health Organisation's SARS team leader in Beijing told the Times that reactivated or recurrent SARS "is among the theories we are considering" in the case.

Developments in China today, however, deepened the mystery.

Official news agency Xinhua reported that the case appears to be SARS, but "a virus variation with new sequence" -- a mutation.

The news agency said officials were taking "a prudent approach to the final diagnosis" while awaiting more information about how the man might have come down with the disease -- or even whether it might have reactivated from a dormant state.

4-Jan-2004