gms | German Medical Science

International Conference on SARS - one year after the (first) outbreak

08. - 11.05.2004, Lübeck

Laboratory diagnosis for SARS: an overview


Search Medline for

  • corresponding author presenting/speaker Paul K. S. Chan - Centre for Emerging Infectious Diseases & Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR

International Conference on SARS - one year after the (first) outbreak. Lübeck, 08.-11.05.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04sars8.07

The electronic version of this article is the complete one and can be found online at:

Published: May 26, 2004

© 2004 Chan.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



There are three technical approaches to diagnose SARS-CoV infection. Virus isolation can be accomplished by a widely available cell line (Vero), and with obvious cytopathic effects develop within 2-4 days. However, virus isolation lacks sensitivity particularly for stool samples. Recently, a human colonic cell line was also found to be susceptible. Although this may serve as a better in-vitro model, the absence of cytopathic effect makes it less ideal for routine diagnostics. Direct detection of viral RNA requires less strengthen laboratory containment facilities, results available within 1-2 days, and is more sensitive. Conventional reverse-transcription PCR and real-time PCR have been successfully applied in the previous outbreak. Serology remains a useful tool, as it does not have the problem of insensitive as for virus isolation, or cross-contamination as for PCR; and is the only means for retrospective diagnosis. At present, neutralization test is regarded as the gold standard, and immunofluorescence test has proved to be accurate. Western blot assay also has a potential, but the interpretation remains to be established. A number of viral lysate- and synthetic peptide-based assays for IgG detection are now commercially available. In general, these IgG assays are relatively less sensitive and specific. These assays are more appropriate as a screening test for large-scale epidemiological studies, rather than for individual patient diagnosis. In this talk, the performance of different diagnostic assays with reference to specimen type, time course of infection, and different clinical situations will be presented. Newer developments in SARS diagnostics will be discussed.