May 2003

What is severe acute respiratory syndrome (SARS)?

• SARS is a respiratory illness that has recently been reported in nearly 30 countries. Scientists have determined that SARS is caused by a new member of the coronavirus family.
  
  
• Main symptoms and signs include fever; headache and muscle aches; and cough, shortness of breath, or difficulty breathing.
  
  
• No treatment beyond good intensive and supportive care has been consistently shown to improve prognosis.
  
  
• For current information on the SARS situation, both domestically and internationally, visit the Centers for Disease Control and Prevention (CDC) Web site at http://www.cdc.gov/ncidod/sars/.

What is NIAID doing about SARS?

The prompt recognition that SARS is caused by a new type of coronavirus is a tribute to the knowledge and ability of today’s biologists and public health experts. While the rapid identification of the SARS virus is remarkable, much needs to be done to mount an effective defense against this disease. Research into the basic biology, pathogenesis, and host response of coronavirus infection supported by NIAID is critical to development of SARS prevention and treatment. NIAID’s SARS-fighting accomplishments and initiatives include the following:

Etiology, Surveillance, and Epidemiology

• Detailed an NIAID staff epidemiologist to the World Health Organization headquarters in early weeks of outbreak.
  
  
• Played a critical role in identifying the SARS coronavirus and developing diagnostic tools through a viral surveillance and research project for influenza viruses in Hong Kong (led by Dr. Robert Webster of St. Jude Children's Research Hospital).

Vaccine Development

• Pursue strategies for vaccines against SARS including inactivated vaccines; DNA vaccines; live, attenuated vaccines; recombinant vector-based vaccines; and vaccines based on purified viral proteins.
  
  
• Initiate contracts to support relevant technologies and cell lines.

Drug and Therapeutic Development

• Continue screening antiviral drugs and other compounds for activity against the SARS virus, in conjunction with the United States Army Medical Research Institute of Infectious Diseases and the Southern Research Institute. Thousands of compounds have already been screened, and plans are to screen as many as 100,000.
  
  
• Expand efforts to identify candidate drugs through rational drug discovery. For example, NIAID provided noted coronavirus researcher Kathryn Holmes a supplement grant to support the development of “entry inhibitor” drugs against coronavirus infection.
  
  
• Conduct research and negotiate agreements with industry to produce human monoclonal and polyclonal antibodies against SARS. These antibodies could provide protection via passive immunity to health care workers and others who may be exposed to the SARS virus.

Basic Research

• Significantly expand the portfolio of 18 grants to study coronaviruses. Research into the basic biology, pathogenesis, and host response of coronavirus infection supported by these grants is critical to development of vaccines and therapeutics.
  
  
• Support comparative genomic studies of the SARS virus. These studies could include analyzing genetic variations among different human and animal coronaviruses, as well those isolated from SARS patients, to better understand the pathogenesis of the virus.
  
  
• Carry out immunological research to determine 1) how the immune system responds to the SARS virus, 2) what constitutes a protective immune response to SARS, and 3) what, if any, human genetic variations affect a person’s susceptibility to SARS.

Clinical Research

• Developed a proposed clinical protocol to study and treat a small number of SARS patients, close contacts of SARS patients, and health care workers exposed to SARS patients. This work would be carried out at the NIH Clinical Center. Activities would include evaluating antiviral and immune-based therapies against SARS as well as gaining a better understanding of the course of the disease.
  
  
• In collaboration with St. Jude Children’s Research Hospital and the University of Hong Kong, follow cohorts of SARS patients and health care workers. The goal of this effort will be to define epidemiological trends and routes of transmission.
  
  
• In collaboration with the CDC, study experimental SARS therapies through the Collaborative Antiviral Study Group, a multi-institutional NIAID network that conducts clinical trials to evaluate experimental therapies for viral infections. The network comprises investigators at approximately 50 clinical research institutions nationwide.
  
  
• Pursue clinical research to understand the impact of prior infection with HIV or tuberculosis on the clinical course of SARS infection.

Diagnostic Tests

• Pursue research to develop better diagnostic tools for SARS coronavirus infections.

Infrastructure

• Create a reagent repository and animal models to facilitate testing of potential new SARS vaccines and drugs.
  
  
• Expand containment facilities for clinical and basic research.

Coordination with Pharmaceutical Industry

• Negotiate with leading vaccine manufacturers for production of SARS vaccines.
  
  
• Engage industry in discussions to determine how they may contribute to the acceleration of research and development efforts for SARS vaccines and therapeutics. NIAID has issued an open call for letters of intent from any companies interested in collaborating on SARS research.

NIAID is a component of the National Institutes of Health (NIH), which is an agency of the Department of Health and Human Services. NIAID supports basic and applied research to prevent, diagnose, and treat infectious and immune-mediated illnesses, including HIV/AIDS and other sexually transmitted diseases, illness from potential agents of bioterrorism, tuberculosis, malaria, autoimmune disorders, asthma and allergies.

News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.

Prepared by:
Office of Communications and Public Liaison
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Bethesda, MD 20892

U.S. Department of Health and Human Services