Biosafety Risk Assessment of the Severe Acute Respiratory Syndrome (SARS) Coronavirus and Containment Measures for the Diagnostic and Research Laboratories

At the end of 2002, an outbreak of a new viral respiratory illness, called SARS (Severe Acute Respiratory Syndrome virus), occurred in China. The disease spread over Asia, North America, Europe, and Africa. In response to the SARS outbreak, the World Health Organization (WHO) coordinated an international collaboration that included clinical, epidemiologic, and laboratory investigations, and initiated efforts to control the spread of SARS. As in other countries, Belgium has been decided to establish biosafety guidelines and recommendations with particular emphasis on handling clinical specimens associated with SARS for research, production, and clinical laboratories. Taking into account that there is so far no SARS case reported in Belgium as well as in other countries in the world, and based on a scientific risk assessment related to the contained use of biological agents, the SARS-CoV was classified as a Risk Group 3 agent. In relation to the reported biosafety assessment, the SARS-CoV should be handled in appropriate biosafety containment levels to avoid laboratory-acquired infections and spread of the disease in the human population and the environment. Therefore, diagnostic activities with inactivated clinical specimens associated with SARS cases and with specimens originating in countries where SARS is documented but not associated with SARS cases should be performed under Biosafety Level 2 (BSL-2) conditions. Diagnostic activities involving non inactivated clinical specimens associated with SARS should be carried out under BSL-2 containment with BSL-3 safety equipment and work practices. Culture of SARS-CoV and all research activities involving SARS-CoV require a BSL-3 containment.