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Canadian Journal of Infectious Diseases and Medical Microbiology
Volume 17, Issue 6, Pages 330-336
Original Articles

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

David M Patrick,1 Martin Petric,1 Danuta M Skowronski,1 Roland Guasparini,2 Timothy F Booth,3 Mel Krajden,1 Patrick McGeer,4 Nathalie Bastien,3 Larry Gustafson,2 Janet Dubord,2 Diane MacDonald,1 Samara T David,3 Leila F Srour,3 Robert Parker,2 Anton Andonov,3 Judith Isaac-Renton,1 Nadine Loewen,2 Gail McNabb,1 Alan McNabb,1 Swee-Han Goh,1 Scott Henwick,5 Caroline Astell,6 Jian Ping Guo,4 Michael Drebot,3 Raymond Tellier,7 Francis Plummer,3 and Robert C Brunham1

1University of British Columbia Centre for Disease Control, Canada
2Fraser Health Authority, Vancouver, British Columbia, Canada
3Public Health Agency of Canada, Winnipeg, Manitoba and Ottawa, Ontario, Canada
4Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, Canada
5Surrey Memorial Hospital, Surrey, Canada
6British Columbia Cancer Agency’s Genome Sciences Centre, British Columbia, Canada
7Hospital for Sick Children, Toronto, Ontario, Canada

Received 4 August 2006; Accepted 22 September 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: 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).

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.