Severe Acute Respiratory Syndrome (SARS)

Severe acute respiratory syndrome (SARS) is a viral respiratory illness. It is caused by a coronavirus called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained. About one in four people with SARS require admission to an intensive care unit.

SYMPTOMS

  • Fever (more than 100.4° F[38° C]).

  • Diarrhea occurs in about 10 to 20 percent of patients.

  • Mild respiratory symptoms (breathing difficulties).

  • Chills and shivering.

  • Headache.

  • Feeling tired.

  • Muscle and body aches.

LOWER RESPIRATORY PHASE

  • After 2 to 7 days, SARS patients may develop a dry cough and difficult breathing (dyspnea).

  • Most patients develop pneumonia.

  • Low oxygen in the blood (hypoxemia) develops.

HOW LONG DOES IT TAKE TO GET THE ILLNESS ONCE YOU HAVE BEEN EXPOSED? (INCUBATION PERIOD)

The infection usually begins 2 to 10 days after exposure. However, it may have an incubation period of up to 2 weeks.

INFECTION CONTROL

  • The infection is spread by respiratory droplets and touching unclean (contaminated) surfaces.

  • The main way that SARS spreads is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily when an infected person coughs or sneezes. Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eyes. It is also possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.

  • Close contact means having cared for or lived with someone with SARS. It is also having direct contact with respiratory secretions or body fluids of a patient with SARS. Examples of close contact include:

  • Kissing or hugging.

  • Sharing eating or drinking utensils.

  • Talking to someone within 3 feet.

  • Touching someone directly.

  • Close contact does not include activities like walking by a person or briefly sitting across a waiting room or office.

  • Strict infection control is extremely important.

RECOMMENDED INFECTION CONTROL MEASURES AT HOME

  • Frequent hand washing with liquid soap (rather than bar soap). Use especially after contact with nose, mouth, and respiratory secretions, such as after sneezing.

  • Family members should practice hand washing frequently. Avoid touching the eyes, nose, and mouth with the hands.

  • Infected people should put on a surgical mask.

  • Infected people should avoid close contact with family members.

  • Avoid sharing food and utensils with family members.

  • Shower immediately after work.

  • Cleanse and disinfect the facilities regularly at least once a day using diluted household bleach (1 part in 99 parts of water). This includes furniture and toilet facilities. Rinse with water and then mop dry.

  • If the facilities are contaminated with vomitus, wash or wipe with diluted domestic bleach (1 part in 49 parts of water) immediately.

  • These precautionary measures should be continued for 1 week from the latest contact with SARS patients.

DIAGNOSIS

SARS is less likely if there is no history of exposure and the patient has one of the following:

  • Elevated white blood cell count (leucocytosis) on admission.

  • Lobar consolidation on CXR. This means on x-ray, the pneumonia is located in a portion of a lung.

  • A known germ that causes something else.

TREATMENT

  • Broad spectrum medicines that kill germs (antibiotics) may be used to cover the usual causes of severe community acquired pneumonia. There are no antibiotic treatments for the virus itself.

  • Steroids and some antiviral medications are sometimes used as methods of treatment.

PROGNOSIS

The prognosis is worse with advancing age or if other health problems are present. Most people recover from this illness.

If you have been seen and are suspected of having been in contact with someone with SARS, follow all directions carefully. If quarantine has been suggested, carry out all suggestions exactly as they were given to you.

Make sure to remain in quarantine for the proper amount of time. Do not allow visitors while you are in quarantine.