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SEVERE ACUTE RESPIRATORY SYNDROME(SARS)

BY: CHELSEA PANGANIBAN

A life-threatening viral respiratory illness caused by a coronavirus known as SARS-associatedcoronavirus (SARS-CoV). SARS is associated with a flu-likesyndrome, which may progress

intopneumonia, respiratory failure, and sometimes death. The SARS virus is believed to haveoriginated in the Guangdong Province in southern China and has subsequently spread aroundthe world. China and its surrounding countries have witnessed the greatest numbers of SARS-

related cases and death.

SARS Causes

The SARS virus is spread by close person-to-person contact. Transmission may occur by

droplets produced when an infected person sneezes or coughs. Droplet spread can occur when

airborne droplets, produced by a cough or sneeze, are deposited on the mucous membranes of 

the mouth, nose, or eyes of a person up to 3 feet away. The virus can also be spread when a

person touches a surface contaminated with the droplets. Oral-fecal transmission of SARS may

also occur. Unprotected health care workers were at significant risk of acquiring the infection

during the outbreak.

SARS Symptoms

Symptoms of SARS can be similar to those of other viral infections. The first symptoms begin 2-7days after exposure and may include the following:Fever (temperature of more than 100.4°F)

Headache, Fatigue (tiredness), Muscle aches and pain, Malaise (a feeling of general discomfort), Decreased appetite, Diarrhea, Respiratory symptoms develop 3 or more days after exposure.Respiratory symptoms include the following:

-Dry cough-Shortness of breath-Runny nose and sore throat (uncommon)

By day 7-10 of the illness, almost all patients with laboratory evidence of SARS infection hadpneumonia that could be detected on x-ray films

Exams and Tests

Initial tests for persons thought to have SARS include the following:

-Chest x-ray films

-Pulse oximetry (a test in which a probe connected to a computer is placed on the finger or ear tomeasure oxygen saturation in the blood)

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-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-Complete blood count (CBC)

-White blood cell (WBC) count may be low.-Lymphocyte count may be low.-Platelet count may be low.

-Sputum (fluid from the respiratory tract) Gram stains and culture-Urinary antigen testing for Legionella and pneumococcal species (2 causes of bacterialpneumonia)

Complications

Respiratory failure

Liver failure

Heart failure

Medical Treatment

Currently, no specific treatment exists for SARS, although various treatments have been triedwith unclear success.

Persons with confirmed or suspected SARS should be isolated and undergo aggressivetreatment in a hospital. Mechanical ventilation (a device that assists in a person's breathing) andcritical care may be necessary.

Medications

In some of the first cases of SARS, antibiotics were used with no success. Once it wasdetermined that SARS was a virus, the antiviral drug ribavirin was used, sometimes incombination with corticosteroids. However, information is limitedon whether or not these drugswill decrease the overall disease severity and death from SARS.

Prevention

Persons in direct, close contact with someone who has had SARS are at greatest risk for infection. Persons with SARS or those at risk for SARS should follow the guidelines outlinedbelow. The WHO and CDC have established guidelines to help in the prevention and spread of SARS.

Limit time outside of the home. Persons with SARS should not go to work, school, childcarefacilities, or any public place until 10 days after their fever has ended and their respiratorysymptoms are improving.

Wash hands frequently with soap and hot water; use an alcohol-based hand rub, or both,especially after being in contact with bodily fluids such as respiratory fluids or urine.

Wear disposable gloves when in contact with bodily fluids from a person with SARS. After use,throw the gloves away immediately and thoroughly wash the hands.