SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

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SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

• Quek Boon Har
• UMMC

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What are the signs and symptoms of SARS ?

• begins generally with a prodrome of fever (gt 38
  oC), chills, headache, myalgia, and malaise
• followed later by a respiratory phase
  characterised by a dry, unproductive cough and
  difficulty in breathing
• may also complains of headache, sore throat, loss
  of appetite, confusion, rash, diarrhoea
• lab abnormalities lymphopenia, leukopenia, mild
  thrombocytopenia, and elevations in serum CK
  and/or transaminase
• chest X-ray may be normal initially, but may show
  lobar consolidation or interstitial filtration
  later on

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What is the cause of SARS ?

• preliminary findings coronavirus, a group of
  viruses which have a halo or crown like (corona)
  appearance when viewed under microscope
• common cause of mild to moderate URTI in humans
• associated with respiratory, gastrointestinal,
  liver and neurologic diseases in animals

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How contagious is SARS ?

• close contact with an infected person (e.g.
  health care workers and family members)
• examples of close contact include having care
  for, lived with, or had direct contact with
  aerosolized (exhaled) droplets and bodily
  secretions from an infected person
• may also spread by indirect contact such as
  touching the skin of other people or objects that
  are contaminated with infectious droplets and
  then touching ones eye(s), nose, or mouth
• coronavirus can survive on environmental surfaces
  for up to 3 hours

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How fast does SARS spread ?

• less infectious than influenza
• short incubation period, usually 2 to 7 days (3-5
  days being most common, in some cases up to 10
  days)
• rapid spread due to speed of international travel
• risk of nosocomial transmission

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Prevention of transmission of SARS

• For all contacts with suspects or probable SARS
  patients, careful hand hygiene is urged,
  including hand washing with soap and water. If
  hands are not visibly soiled, alcohol-based hand
  rubs may be used as an alternative to hand washing

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Prevention of transmission of SARS

• If one has
• traveled to a known SARS area in the last 10
  days, or have had close contact with a co-worker
  or family member with suspected or probable SARS
• AND
• developed fever (gt38oC) or respiratory symptoms
  (e.g. cough or difficulty breathing)
• should not go to work, or other public area
• seek evaluation by a healthcare provider
• immediately

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Prevention of transmission of SARS

• For suspect or probable SARS case
• wear a surgical mask in the presence of others
• wash hands often and well, especially after
  blowing nose
• if ongoing respiratory symptoms are present,
  should sleep in separate room, use own eating
  utensils and not share any linen or towels with
  others
• should limit interactions outside home until 10
  days after resolution of fever and respiratory
  symptoms

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Prevention of transmission of SARS

• For household contact living with a case
• disposable gloves should be used for any direct
  contact with body fluids of a SARS patient
  gloves should be immediately removed and
  discarded after the activity and hands should be
  cleaned
• environmental surfaces soiled by body fluids
  should be cleaned with warm water and detergent,
  followed by wiping with a household disinfectant,
  e.g. dilute bleach gloves should be worn during
  this activity
• need to monitor health for 10 days take
  temperature daily
• pursue normal activities but should isolate
  oneself from others quickly if develop fever or
  unwell and seek medical attention

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Prevention of transmission of SARS

• In an outpatient setting
• separate assessment area
• surgical mask should be placed on the suspect
  patient
• health care personnel should wear N-95
  respirators while evaluating, taking care of and
  transporting suspect patient
• if N-95 respirators are not available, surgical
  masks should be worn

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Air travel

• Those at risk of acquiring SARS from another
  passenger could be
• directly within inhalation distance of droplets
  released by coughing or sneezing (within
  approximately one metre)
• in contact with surfaces that the passenger may
  have contaminated by coughing or sneezing and
  enabling self inoculation of the virus by
  transfer of the object via hands to mouth or eyes

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Air travel

• If you must travel
• assemble a travel health kit containing basic
  first aid and medical supplies, including a
  thermometer, household disinfectant, surgical
  masks, disposable gloves and alcohol-based hand
  rubs
• monitor own health for 10 days after returning
  from the affected area

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References

• CDC website
• WHO website
• Interim Australian Infection Control Approach to
  SARS by the Department of Health and Ageing in
  conjunction with the Communicable Disease Network
  of Australia
• Infection Watch by the Infectious Disease Control
  Team, UMMC

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Check out the CDC and WHO SARS websites for more
information

• ..The end..