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Updated: Dec 27, 2025

Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses

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Published on: November 10, 2023

Potential Factors Influencing Repeated SARS Outbreaks in China.

Zhong Sun¹, Karuppiah Thilakavathy^1,2, S Suresh Kumar^2,3

¹Department of Biomedical Sciences, Faculty of Medicine & Health Sciences, University Putra Malaysia, UPM Serdang 43400, Selangor, Malaysia.

International Journal of Environmental Research and Public Health

|March 7, 2020

Summary

Two SARS epidemics, caused by coronaviruses (CoVs), share patterns in pathogenesis and spread. Environmental and social factors, including cold weather and holiday gatherings, likely influenced these severe acute respiratory syndrome outbreaks.

Keywords:

2019-nCoV ACE2 COVID-19 CoV SARS SARS-CoV Wuhan pneumonia angiotensin-converting enzyme 2 bat coronavirus drought epidemic epidemiology exposure green light host infection outbreak red light risk severe acute respiratory syndrome wildlife

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Area of Science:

Epidemiology
Virology
Environmental Science

Background:

Two severe acute respiratory syndrome (SARS) epidemics, caused by SARS-associated coronaviruses (CoVs) like SARS-CoV and SARS-CoV-2, have occurred in China.
Both viruses use the angiotensin-converting enzyme 2 (ACE2) receptor to infect human cells.

Purpose of the Study:

To analyze patterns in the pathogenesis and epidemiology of SARS-CoV and SARS-CoV-2 outbreaks.
To explore potential environmental and social factors influencing SARS outbreaks.

Main Methods:

Review of epidemiological data from past SARS outbreaks.
Analysis of viral receptor usage and environmental conditions during outbreaks.
Consideration of social factors such as holiday travel and gatherings.

Main Results:

Both SARS epidemics occurred during cold, dry winter seasons coinciding with major holidays.
Outbreaks originated in regions with a cultural practice of consuming wildlife.
Environmental conditions (cold, low humidity) may favor viral survival and transmission.
Social factors like increased gatherings and travel facilitated disease spread.

Conclusions:

Environmental and social factors play a significant role in the epidemiology of SARS.
Cold temperatures and low humidity may enhance viral persistence and human vulnerability.
Social behaviors during holidays contribute to widespread transmission.
Further research is needed to fully understand unique factors contributing to SARS origination, particularly in Wuhan.