This study will investigate immune responses, transmission and nucleotide polymorphisms in families with severe acute respiratory syndrome (SARS) virus infections. Study objectives are to: develop an immune response profile to SARS coronavirus (SARS CoV) among SARS survivors; ascertain whether there was spread of SARS CoV within the family and whether significant disease resulted; and determine whether 1 or more nucleotide polymorphisms relate to occurrence and severity of SARS CoV disease or immunologic responses. Up to 1,000 persons residing in Beijing, China, will participate in this study and will include the following groups: 200 adult (greater than or equal to18 years of age) subjects, previously experiencing SARS caused by SARS Coronavirus; their household/family members, including children ages 4 and up (male or female); and an additional 200 adults matched for characteristics (age, gender, health status and housing/work location) of the 200 SARS survivors. As much as possible (for DNA tests), these controls will be persons involved in health care with a possible SARS exposure during the epidemic. Blood will be obtained from all subjects and used for SARS CoV antibody assays. Additional studies will be performed with blood specimens from selected subjects. Tests for serum antibodies will be used to identify infected persons in each family. For any who possess specific antibodies, a review of their health and clinic/hospital visit records for the SARS epidemic period will be conducted to identify any illness, its type and severity. A control for interpretation can be illnesses during the study period in uninfected family members. Data will be analyzed by age, gender, and health status of family members, the severity of SARS illness in the index case and the time of return to the home environment. The illness data will be obtained from medical records and not from subject memory. To assess health status, subjects for this study will have a chest x-ray performed and 15 mL of blood obtained for complete blood counts, liver function, to include ALT, and creatinine. For study purposes, 30 to 100 mL of blood will be collected from SARS survivors and from 50 matched controls (age, gender and health status). Illnesses from medical records will be characterized for severity and will include extent of x-ray changes, need for oxygen therapy, medical care in the intensive care unit and extent of leukocyte changes. Microarray chips that contain human genes determining immune responses, production of cytokines and chemokines and a number of other potential responses to illness have been constructed. PureGene kits will be provided for isolation of DNA from blood specimens for testing for polymorphisms. These analyses will be performed on the 200 SARS survivors, the 200 matched controls and on family members. The DNA samples will be shipped to laboratories at Baylor College of Medicine for analysis using the microarray chips.
