Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It is caused by a virus that was first identified in 2003. SARS is caused by a member of the corona virus family. Infection with the SARS virus causes acute respiratory distress (severe breathing difficulty) and sometimes death. When someone infected with SARS coughs or sneezes, infected droplets spray into the air. The SARS virus may exist on hands, tissues, and other is surfaces for up to 6 hours in these droplets and up to 3 hours after the droplets have dried.
Airborne transmission is a real possibility in some cases. Live virus has even been found in the stool of people with SARS, where it has been shown to live for up to 4 days. The virus may be able to live for months or years when the temperature is below freezing.
Symptoms usually occur about 2 to 10 days after coming in contact with the virus. In some cases, SARS started sooner or later after first contact. People with active symptoms of illness are contagious.
Sign and Symptoms
- Cough.
- Difficulty breathing.
- Fever greater than 100.4°F (38.0°C).
- Other breathing symptoms.
The most common symptoms are:
- Chills and shaking.
- Cough, usually starts 2 to 3 days after other symptoms.
- Fever.
- Headache.
- Muscle aches.
Less common symptoms include:
- Cough that produces phlegm (sputum).
- Diarrhea.
- Dizziness.
- Nausea and vomiting.
- Runny nose.
- Sore throat.
In some people, the lung symptoms get worse during the second week of illness, even after the fever has stopped.
Treatment
People who are thought to have SARS should be checked right away by a provider. If they are suspected of having SARS, they should be kept isolated in the hospital.
Treatment may include:
- Antibiotics to treat bacteria that cause pneumonia (until bacterial pneumonia is ruled Hout or if there is bacterial pneumonia in addition to SARS).
- Antiviral medicines (although how well they work for SARS is unknown).
- High doses of steroids to reduce swelling in the lungs (it is not known how well they work).
- Oxygen, breathing support (mechanical ventilation), or chest
PREVENTION
- Reducing contact with people who have SARS lowers risk for the disease.
- Avoid travel to places where there is an uncontrolled SARS outbreak.
- When possible, please avoid direct contact with people who have SARS until at least 10 days after their fever and other symptoms are gone.
- Hand hygiene is the most important part of SARS prevention. Wash hands or clean them with an alcohol-based instant hand sanitizer.
- To cover mouth and nose when sneeze or cough. Droplets that are released when a person sneezes or coughs are infectious.
- Do not share food, drink, or utensils.
- Clean commonly touched surfaces with an EPA-approved disinfectant.
- Masks and goggles may be useful for preventing the spread of the disease.
Control of SARS
Possible and confirmed cases require hospitalization and isolation in a suitable health facility, which will be determined by the Communicable Diseases Section of the department in consultation with the treating clinician. The receiving hospital will start its SARS protocol to suitably handle such a patient. All suspected, probable and confirmed cases will be excluded from school and work until clearance is obtained from the department. There are no specific treatment recommendations for SARS. The application of intensive supportive therapy and empirical antimicrobial therapy, to cover other infective agents, is the usual approach. Antiviral and pulse steroid therapy have been used in the past in different countries, with varying degree of success.
Control of contacts
Only people who have been close to an infected person with SARS are at any significant risk of acquiring infection. For this reason, only close contacts are required when public health contact tracing measures are implemented to control disease spread. A close contact is a person who has lived, worked or had other dealings with a SARS case that have caused them to be within 1 meter of the case, or a person who has had direct contact with respiratory secretions from a case while not wearing PPE. Contact tracing will be undertaken for close contacts of probable cases of SARS who were exposed after the patient became symptomatic. It should be remembered that one of the most important available measures to prevent the spread of SARS COV is the application of respiratory precautions and thorough hand washing. Contacts should be advised of such and also for the need to seek immediate medical attention if they develop the initial symptoms of SARS. Daily temperature monitoring for 10 days after a break in exposure from the SARS case is advisable.
