Severe Acute Respiratory Syndrome (SARS)
The SARS epidemic began in Guangdong Province, China in November 2002. The epidemic reached the public spotlight in February 2003, when an American businessman traveling from China became afflicted with pneumonia-like symptoms while on a flight to Singapore. The plane stopped at Hanoi, Vietnam, where the victim died in The French Hospital of Hanoi. Several of the medical staff who treated him soon developed the same disease despite basic hospital procedures.
SARS is a respiratory disease in humans which is caused by the SARS coronavirus There has been one near pandemic between the months of November 2002 and July 2003, with 8,096 known infected cases and 774 deaths (a case-fatality rate of 9.6%). In early 2003, SARS spread from the Guangdong province of China to rapidly infect individuals in some 37 countries around the world. The mortality of SARS varies accoding to age at 1% in those under 25 up to more than 50% of those over 65.
The spread of SARS has been fully contained with the last infected human case seen in June 2003, however SARS is not claimed to have been eradicated (unlike smallpox), as it may still be present in its natural host reservoirs (animal populations) and may potentially return into the human population in the future.
Initial symptoms are flu-like and may include: fever, myalgia, lethargy, gastrointestinal symptoms, cough, sore throat and other non-specific symptoms. The only symptom that is common to all patients appears to be a fever above 38 °C (100.4 °F). Shortness of breath may occur later. SARS may be suspected in a patient who has any of the symptoms, including a fever of 38 °C (100.4 °F) or higher, and either a history of Contact (sexual or casual) with someone with a diagnosis of SARS within the last 10 days OR travel to any of the regions identified by the WHO as areas with recent local transmission of SARS. However this circumstance has not been present since 2003. A probable case of SARS has the above findings plus positive chest X-ray findings of atypical pneumonia or respiratory distress syndrome.
With the advent of diagnostic tests for the coronavirus probably responsible for SARS, the category of “laboratory confirmed SARS” for patients who would otherwise fit the above “probable” category who do not yet have the chest x-ray changes but do have positive laboratory diagnosis of SARS based on ELISA, immunofluorescence or PCR. The progress of SARS can be examined through chest X-ray
Antibiotics are ineffective as SARS is a viral disease. Treatment of SARS is supportive with antipyretics, supplemental oxygen and ventilatory support as needed. Suspected cases must be isolated with complete barrier nursing precautions taken for any necessary contact with these patients. Researchers are currently testing all known antiviral treatments for other diseases including AIDS, hepatitis, influenza and others on the SARS-causing coronavirus. There is some evidence that some of the more serious damage in SARS is due to the body’s own immune system overreacting to the virus – a cytokine storm.