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Severe acute respiratory syndrome: Treatment, symptoms, advice & help

About severe acute respiratory syndrome

SARS, or Severe acute respiratory syndrome, is an infectious disease causing headache, and fever, followed in 2–10 days by cough, dyspnea, and pneumonia.

Severe acute respiratory syndrome: Incidence, age and sex

There has been one outbreak to date, between November 2002 and July 2003.Within weeks in early 2003, SARS spread from the Guangdong province of China to rapidly infect individuals in some 37 countries around the world. Though all age groups were affected, the mortality was more in those above 65 yrs. As of today, the spread of SARS has been fully contained, with the last infected human case seen in June 2003.

Signs & symptoms of severe acute respiratory syndrome: Diagnosis

The clinical manifestations are nonspecific; high-temperature, cough, malaise, coryza, chills or rigours, headache, and myalgia. Diarrhoea and nausea or vomiting, occur in up to 1/3 of cases. Wheezing is rare if it occurs at all, and crackles are relatively uncommon. The clinical course of SARS-CoV infection varies with age. Adults are most severely affected and classically have a triphasic clinical pattern. Following an initial improvement towards the end of the 1st week, there is recurrence of fever and development of respiratory distress with dyspnoea, hypoxemia, and diarrhoea. Approximately 20% progress into the 3rd phase, characterized by acute respiratory distress syndrome (ARDS) and respiratory failure. Children less than 12 years of age have a relatively mild non-specific illness, with only a minority developing significant lower respiratory tract disease. The laboratory abnormalities and radiographic findings observed in SARS-CoV infected children are non-specific and cannot be differentiated from those associated with other commonly encountered viral illnesses.

The diagnosis of SARS-Co V infection can be confirmed by serological testing, detection of viral RNA using RT-PCR, or though isolation of the virus in cell culture. Antibody is not detectable until 10 days after the onset of symptoms, the mainstay of early diagnosis is RT-PCR. Nasopharyngeal aspirates, plasma or serum and stool are the preferred samples, for pathological diagnosis.

Causes and prevention of severe acute respiratory syndrome

The causative agent of SARS is a novel coronavirus, referred to as the SARS – associated coronavirus (SARS-CoV) that was discovered in Asia in 2002 and spread rapidly. The primary mode of SARS-CoV transmission is through direct or indirect contact of mucous membranes with infectious droplets or fomites.

Prevention: A vaccine is not yet available. Quarantine of all potential contacts and adherence to appropriate infection control precautions are effective in controlling the spread of SARS-CoV.

Severe acute respiratory syndrome: Complications

Respiratory distress and hypoxemia are observed in 10-20%, and 1/3 of these require ventilatory support. The case fatality rate from SARS-CoV infection during the 2003 outbreak was 10-17%. The estimated case fatality rate according to age varies from less than1% for those less than20 years of age to greater than50% for those greater than 65 year of age.

Severe acute respiratory syndrome: Treatment

Treatment of SARS-CoV infection is primarily supportive. Oxygen should be provided to hypoxemia persons. Empiric antibiotic therapy directed at common bacterial causes of community-acquired pneumonia should be considered on an individual basis.