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SARS outbreak. SARS Outbreak. March 107 MDs and 4 nurses reported sick March 1150 staff screened, 23 admitted, ward closed March 12Clinical teaching suspended March 13 Index case identified March 17Medical school moved back to campus. 156 patients 138 traceable to the index case - PowerPoint PPT Presentation
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SARS Outbreak
March 10 7 MDs and 4 nurses reported sick
March 11 50 staff screened, 23 admitted, ward closed
March 12 Clinical teaching suspended
March 13 Index case identified
March 17 Medical school moved back to campus
SARS: a triphasic disease
Max. daily body temperature (oC)
Days after onset of disease
36
37
38
39
40
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Viral replicative phase Immune hyperactive
phasePulmonary-destruction phase
Treatment Protocol
Broad spectrum antibiotics
IV Ribavirin
High dose steroids
Convalescent serum
Supportive care
Response to Rx
Board-spectrumAntimicrobial* (%)
N=138
Ribavirin + Corticosteroid# (%)
N=138
IV Methyl-prednisolone+ (%)
N=107
Sustained response 0 (0) 16 (11.6) 50 (46.7)
Partial response 0 (0) 9 (6.5) 45 (42.1)
No response 138 (100) 113 (81.9) 12 (11.2)
All patients in PWH
• N=277
• Discharged: 147 (53%)
• ICU admission: 51 (18.4%)
• Died: 18 (6.5%)
• Mortality : median age 76 (44-84) years
Convalescent Plasma vs more MP
3 MP + CS
(n = 19)
4 or more MP
(n = 21)
P values
Age 38.7 47.9 0.087
Admission LDH 258.1 247.7 0.7
Discharge rate by 21 days
73.7% 19% 0.001
No. of deaths 0 5 0.049
Outcome of patients who received CS before day 16 vs later date
≤ Day 16
(n = 36)
Day 16
(n = 14)
P values
Discharge rate by day 21
51.6% 0% 0.02
Death rate 0% 28.6% 0.02