Severe acute respiratory syndrome (SARS)

• What is Severe Acute Respiratory Syndrome (SARS)
• Statistics on Severe Acute Respiratory Syndrome (SARS)
• Risk Factors for Severe Acute Respiratory Syndrome (SARS)
• Progression of Severe Acute Respiratory Syndrome (SARS)
• Symptoms of Severe Acute Respiratory Syndrome (SARS)
• Clinical Examination of Severe Acute Respiratory Syndrome (SARS)
• How is Severe Acute Respiratory Syndrome (SARS) Diagnosed?
• Prognosis of Severe Acute Respiratory Syndrome (SARS)
• How is Severe Acute Respiratory Syndrome (SARS) Treated?
• Severe Acute Respiratory Syndrome (SARS) References

What is Severe Acute Respiratory Syndrome (SARS)

The lungs – the severe acute respiratory syndrome is caused by an infection with the SARS virus. It is a relatively new disease, being first described in the Guangdong Province of China in November 2002.

Statistics on Severe Acute Respiratory Syndrome (SARS)

The first cases of this highly infectious condition was first described in February 2003, which over a period of three months affected 8,000 people worldwide.

In June 2003, The total number of cases reported in the United States was 372, without any deaths from the condition in this country.

Risk Factors for Severe Acute Respiratory Syndrome (SARS)

The most important risk factor for SARS is contact with a person suffering from SARS infection. Recent travel to countries where the SARS infection is known to exist is a primary risk factor for the SARS infection.

Progression of Severe Acute Respiratory Syndrome (SARS)

The SARS virus infection remains within the body fo 2-10 days before causing any symptoms. The first symptom usually encountered is a high fever, that may be associated with shivers and chills. The infected patient may also develop diarrhoea in 25% of cases.

The patient will develop a dry cough some 2-4 days after the onset of fever, which may progress over days to cause shortness of breath. This may be severe enough to warrant the insertion of a breathing tube the use of mechanical breathing for the patient.
The condition will usually become better, then worsen once more, before resolution of this infection. As the condition causes significant respiratory compromise, patients may not survive the active phase of this condition.

How is Severe Acute Respiratory Syndrome (SARS) Diagnosed?

The diagnosis of SARS requires a number of samples to be taken to detect the presence of SARS virus within the bloodstream.

Samples may be taken from the mouth, nose, stool or blood in order to detect the SARS virus. A number of blood tests may also be taken to exclude the common diagnosis of pneumonia and find other markers of SARS virus infection.

Prognosis of Severe Acute Respiratory Syndrome (SARS)

The prognosis of this infection is fair, provided that the patient is in good health and within the younger age group. It must be stressed that this condition may be fatal in its most severe form, accounting for 3-12% of cases.

A poorer prognosis is found in those with co-existing conditions such as diabetes mellitus, renal failure and other chronic medical conditions. It is a rare event for this disease to occur in children. When presenting in children, the condition is much less severe and has a better prognosis than infection in the elderly population.

How is Severe Acute Respiratory Syndrome (SARS) Treated?

All patients suspected of SARS infection should be admitted to hospital and isolated to prevent further spread of disease. On admission to hospital, all patients hould also recieve antibiotics against pneumonia, as this condition is commonly confused with SARS infection.

There are many treatments available for the management of SARS, but as this condition is relatively new, most are unproven in their effectiveness to treat this condition. Anti-viral agents, steroids and antibiotics have all been used, with variable success between strategies.

Supportive therapy such as oxygen and asthmatic medication is also commonly used.

An important component in the management of SARS infection is the identification of SARS contacts, which are people that have been in contact with a confirmed or probable SARS case in the recent past. These patients should be educated about SARS infection and self-confined to their home to prevent potential further spread of disease. This should occur for a period of 10 days after presentation, with regular visits by health authorities to monitor the patient for symptoms of SARS infection.

Severe Acute Respiratory Syndrome (SARS) References

[1] Lang ZW et al. A clinicopathological study of three cases of severe acute respiratory syndrome (SARS) Pathology. 2003 Dec;35(6):526-31.
[2] Sampathkumar P, Temesgen Z, Smith TF, Thompson RL. SARS: epidemiology, clinical presentation, management, and infection control measures. Mayo Clin Proc. 2003 Jul;78(7):882-90.
[3] The World Health Organisation