Tears and conjunctival scrapings for coronavirus in patients with SARS.

LETTERS If you have a burning desire to respond to a paper published in BJO, why not make use of our ''rapid response'' option? Log onto our website (www.bjophthalmol. com), find the paper that interests you, and send your response via email by clicking on the ''eLetters'' option in the box at the top right hand corner. Providing it isn't libellous or obscene, it will be posted within seven days. You can retrieve it by clicking on ''read eLetters'' on our homepage. The editors will decide as before whether to also publish it in a future paper issue. Severe acute respiratory syndrome (SARS) was first recognised in Guangdong Province in China and later in Hong Kong in March 2003. 1 Within a matter of weeks, the outbreak has evolved to become a global health threat and almost 30 countries have been afflicted with the novel coronavirus strain (SARS-CoV). 2 SARS is a highly contagious potentially lethal disease. The main route of transmission is by respiratory droplets, though the virus has also been isolated in stool and in urine. Tears, being one of the body fluids, may potentially harbour the coronavirus. The presence of viruses in these body fluids may affect our precaution practices and sites of sampling for diagnostic tests. A prospective interventional case series study was conducted on the identification of the SARS-CoV virus in tear secretions and con-junctival cells of patients with confirmed SARS. Approval was obtained from the ethics committee of the Chinese University of Hong Kong. Consecutive patients with probable SARS in the Prince of Wales Hospital, Hong Kong, during the epidemic period from April to May 2003 were recruited. Other than the routine samples of nasopharyngeal, mouthwash and stool, tear swab and conjunctival scraping were taken randomly from one eye of all recruited patients. The tear swab was taken by putting a sterile cottonwool stick into the deep lower fornix of each patient's eye after a single drop of topical anaesthetic agent (1% amethocaine eye drops) was applied. Conjunctival scraping was performed at the lower palpebral con-junctiva with a bent tip of a sterile 23 gauge needle. All ocular samples were collected by a single ophthalmologist with personal protective equipment recommended by the infection control unit of the hospital. Particular care was taken not to contaminate the samples. The samples were analysed by virus culture and RT-PCR. The SARS-CoV specific primers COR-1 (sense) 59 CAC …