S

ARS
 WHAT IS SARS?
 Severe acute respiratory syndrome
(SARS)
--is a serious form of pneumonia, caused
by a virus isolated in 2003. Infection
with the SARS virus results in acute
respiratory distress (severe breathing
difficulty) and sometimes death.
Itis a dramatic example of how
quickly world travel can spread
a disease. It is also an example
of how quickly a networked
health system can respond to
an emerging threat.
 This contagious respiratory infection was
first described on Feb. 26, 2003. SARS
was identified as a new disease by World
Health Organization (WHO) physician
Dr. Carlo Urbani. He diagnosed it in a
48-year-old businessman who had
traveled from the Guangdong province of
China, through Hong Kong, to Hanoi,
Vietnam.
How does the virus
spread?
 SARS is clearly spread by droplet
contact
 Airborne transmission is possible
 Virus found in stool of SARS victims

*could live up to 4 days

*virus can live for months and years
when temp is below freezing
History of SARS
 History of SARS
 March 2003- WHO received
reports of an outbreak of acute
respiratory illness from Vietnam
and South East Asia. The
outbreak continued to grow
nearly 6000 cases in 30 different
countries.
And 90% of
this is from
mainland
China or
Hong Kong.
So far, so far less than 1 % of
cases have been reported in
Europe, with no European
country reporting more than 10
possible cases and many having
none.
 The illness is a bit like Influenza
and has no unique features. It
begins with fever which after an
interval of a few days progresses to
cough and breathlessness. A chest
radiograph will usually show signs
of pneumonia.
 The continued increase in cases is
now mainly occurring in China. In
many places SARS appears to be
under control, and Viet Nam,
where it was first reported, has now
been declared free of SARS. Much
remains to be learnt about the
infection.
Symptoms:
 Common Symptoms
 fever greater than 100.4 degrees F
(38.0 degrees C)
 Difficulty in breathing
 other respiratory symptoms but other
routes of infection may also be
involved, such as fecal contamination
 Fever – 94%
 Influenza-like symptoms:
*Muscle aches, Cough, headache,
loss of appetite, malaise, myalgia
 Gastrointestinal symptoms :Vomiting
– 14%, Diarrhea – 27%, abdominal
pain- 13%
 6-4 days incubation period
Sars victim:
 Less common symptoms
Dizziness
Productive cough (sputum)
Sore throat
Runny nose
Nausea and vomiting
Diarrhea
What causes SARS!?
CORONAVIRUS, the killer virus..
 Corona virus:

Corona virus particles are

irregularly-shaped, ~60-220nm in
diameter, with an outer envelope
bearing distinctive, 'club-shaped'
peplomers. This 'crown-like'
appearance (Latin, corona) gives the
family its name.
 Pathogenesis:
 These viruses infect a variety of mammals
& birds. The exact number of human
isolates are not known as many cannot be
grown in culture.
 They are transmitted by:

*aerosols of respiratory secretions,

* by faecal-oral route,
* by mechanical transmission
 Most coronavirus occurs in the
epithelial cells
*occasionally, it grows in the
liver,kidneys, heart or eyes may
be infected, as well as other cell
types such as macrophages.
 The incidence of
infection is strongly
seasonal, with the
greatest incidence in
children in winter.
Adult infections are
less common.
 Might SARS
coronavirus
recombine with
other human
coronaviruses to
produce an even
more deadly virus?
 Fortunately,the coronaviruses of
which we are aware indicate that
recombination has not occurred
between viruses of different
groups, only within a group, so
recombination does not seem likely
given the distance between the SARS
virus and HCoV.
Signs and tests for
SARS
 Health care provider
may hear:
abnormal lung sounds while
listening to the chest with a
stethoscope
worsening chest X-ray
changes, or chest CT changes
 The general tests used in the
diagnosis of SARS might include
the following:
 Blood clotting tests
 Blood chemistries
*ALT and CPK are
sometimes elevated.
*LDH levels are often
elevated.
*Sodium and potassium are
sometimes low.
 Chest X-ray or chest CT scan
 Completeblood count (CBC)
* White blood cell (WBC)

count may be low.

* Lymphocyte count may
be low.
*Platelet count may be low.
Treatment
 People suspected of having
SARS should be:
 evaluated immediately by a physician
 hospitalized under isolation
 Antibiotics are sometimes given in an
attempt to treat bacterial causes of
atypical pneumonia
 . Antiviral medications have also been
used.
 High doses of steroids to reduce lung
inflammation
 serum from people who have already
recovered from SARS (convalescent
serum) be given.
 supplemental oxygen
 mechanical ventilation
Complications
 Common complications:

Respiratory Liver failure

failure

Heart
failure
 Prevention:
Health Care Concerns
 Minimizing contact to people with
SARS
 minimizing travel to locations where
there is an uncontrolled outbreak
 Hand hygiene as the most important
part of SARS prevention. cover the
mouth and nose when sneezing or
coughing.
 Respiratory secretions should be
considered infectious, which
means no sharing of food, drink,
or utensils. Commonly touched
surfaces can be cleaned with an
EPA approved disinfectant.
THE FIRST
OUTBREAK
According to WHO

Death
Cases
of
SARS
The outbreak is believed to have
originated in February 2003 in
the Guangdong province of
China, where 300 people
became ill, and at least five died.
Countries affected:
Where the virus came from
and what will happen in the
future is not known, but we
have already learnt a great
deal about the condition in a
very short space of time…
God has a much
brighter plan for
mankind…

----END----