Coronavirus linked to respiratory illnesses and Kawasaki disease

February 2005

Researchers at Yale University have found genetic evidence linking a number of respiratory tract illnesses and Kawasaki disease (KD) with a novel human coronavirus.

In the first of two studies, Frank Esper, MD, and other researchers used molecular probes targeting a gene that is common in human and animal coronaviruses to screen specimens for coronavirus genetic material.

Ultimately, two specimens were identified in which the sequence of chemical building blocks of the gene differed from that of known human coronaviruses.

The researchers then used probes specific for the virus to screen respiratory specimens from 895 symptomatic children younger than age 5 who had tested negative for other viral infections. They found 79 children who were positive for the new virus, dubbed HCoV-NH, nine of whom were subsequently found to have evidence of recent infection with another virus as well.

Analysis of the New Haven coronavirus’s genetic structure showed many similarities to that of a coronavirus recently identified by two groups in the Netherlands, suggesting that the virus may have worldwide distribution.

Link with KD

That KD may be associated with infection with the newly identified coronavirus was suggested by findings in the Yale group’s second study, which they initiated when they found evidence of the virus’s genetic structure in respiratory secretions from an infant with classic signs of KD.

The investigators analyzed respiratory secretions from 11 children diagnosed with KD and 22 children without the disease. Eight (73%) of the KD patients but only one (5%) of the comparison group tested positive for the new coronavirus.

Eugene D. Shapiro, MD, one of the study’s authors, cautioned that the findings need to be confirmed by other clinical studies.

“Apparently many children become infected with this virus and do not develop Kawasaki disease, presumably having something to do with their immune response to the virus, or perhaps other viral-specific factors, or a combination,” said Shapiro, who is professor of pediatrics, epidemiology & public health, and investigative medicine at Yale University School of Medicine.

For more information:

• Esper F, Weibel C, Ferguson D, et al. Evidence of a novel human coronavirus that is associated with respiratory tract disease in infants and young children.
• Esper F, Shapiro ED, Weibel C, et al. Association between a novel human coronavirus and Kawasaki disease.
• Both published in J Infect Dis. 2005;191(4):492-502.