Differential virological diagnosis of acute respiratory infections in suspect SARS patients

The NIC in Lyon has been involved in the virological diagnosis of suspect severe acute respiratory syndrome (SARS) patients. In March, the French medical authorities organized a medical surveillance of the medical staff who had returned from the French hospital in Hanoi. Each person presenting or not with respiratory symptoms was sampled systematically by the nearest general practitioner (GP) belonging to the influenza network surveillance in the community called GROG and the samples were sent to the NICs located either in Paris or in Lyon. We also received samples from patients hospitalized in the south of France suffering from acute respiratory infection soon after a journey in Asia. We implemented a PCR diagnosis for the human respiratory viruses: influenza A and B, Parainfluenza (Type 1 to Type 4), Metapneumovirus, RSV, Rhinovirus, Enterovirus, Adenovirus. In April, we set up the PCR detection of the SARS-associated coronavirus Urbani strain. The practitioners performed respiratory samples. From 14 March to 15 May we received and tested 88 respiratory samples, respectively, 19 were realized by GPs from the community network and 69 came from hospitalized patients. We never detected the urbani coronavirus strain. However, we detected respiratory viruses in 24% of the cases: the most frequent virus was influenza A H3N2 (11%) and Parainfluenza type 3 (8%). RSV, influenza A H1N1 and Rhinovirus were also detected 2, 1 and 1 cases, respectively. All the positive samples except the rhinovirus came from hospitalized patients. The patients were sampled once and all of them recovered rapidly.