SARS

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV) though it is possible that other infectious agents might have a role in some cases of SARS. SARS was recognized as a global threat in March 2003, after first appearing in Southern China in November 2002. 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.


Preliminary studies in some research laboratories suggest that the virus may survive in the environment for several days. The length of time that the virus survives likely depends on a number of factors. These factors could include the type of material or body fluid containing the virus and various environmental conditions such as temperature or humidity. Researchers at CDC and other institutions are designing standardized experiments to measure how long SARS-CoV can survive in situations that simulate natural environmental conditions.


Symptoms and signs
The illness usually begins with a high fever (measured temperature greater than 100.4°F [>38.0°C]). The fever is sometimes associated with chills or other symptoms, including headache, general feeling of discomfort and body aches. Some people also experience mild respiratory symptoms at the outset. Diarrhoea is seen in approximately 10 percent to 20 percent of patients. After 2 to 7 days, SARS patients may develop a dry, non-productive cough that might be accompanied by or progress to a condition in which the oxygen levels in the blood are low (hypoxia). In 10 percent to 20 percent of cases, patients require mechanical ventilation. Most patients develop pneumonia.


Treatment
There is a wide clinical spectrum in SARS. Most patients have recovered with minimal treatment, but for the severely ill, reports from affected countries suggest that anti-viral drugs are probably not beneficial, however other research suggests that interferon may be helpful. It is recommended that patients with SARS receive the same treatment that would be used for a patient with any serious community-acquired atypical pneumonia. In addition, steroids may be effective in some patients though research into this area is continuing. At present, there is no specific treatment but SARS-CoV is being tested against various antiviral drugs to see if an effective treatment can be found.


If there is another outbreak of SARS, how can I protect myself?
If transmission of SARS-CoV recurs, there are some common-sense precautions that you can take that apply to many infectious diseases. The most important is frequent hand washing with soap and water or use of an alcohol-based hand rub. You should also avoid touching your eyes, nose, and mouth with unclean hands and encourage people around you to cover their nose and mouth with a tissue when coughing or sneezing.


Is there a vaccine for this?
No, a vaccine is not available.


What should I do if I am planning to travel and am worried about SARS?
During the first global outbreak of SARS, WHO issued travel recommendations for travelers to postpone travel to areas with local transmission in a bid to interrupt the transmission of the virus internationally. From 5 July 2003, no travel restrictions or recommendations have been imposed as there are no countries on the WHO's list of areas with recent local transmission.


Has SARS gone for good?
There have been four small and rapidly contained outbreaks of SARS in the world between July 2003 and May 2004. Public health systems are continuing to be vigilant and prepared for the possible global re-emergence of SARS as such a possibility remains.