SARS outbreak

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SARS outbreak
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SARS Outbreak

• March 10 7 MDs and 4 nurses reported sick
• March 11 50 staff screened, 23 admitted, ward
  closed
• March 12 Clinical teaching suspended
• March 13 Index case identified
• March 17 Medical school moved back to campus

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156 patients 138 traceable to the index
case 20 doctors 34 nurses 15 allied
health 16 medical students
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SARS a triphasic disease

Max. daily body temperature (oC)
Days after onset of disease
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Treatment Protocol
Broad spectrum antibiotics IV Ribavirin High
dose steroids Convalescent serum Supportive
care
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Response to Rx
Board-spectrum Antimicrobial () N138 Ribavirin Corticosteroid () N138 IV Methyl-prednisolone () N107
Sustained response 0 (0) 16 (11.6) 50 (46.7)
Partial response 0 (0) 9 (6.5) 45 (42.1)
No response 138 (100) 113 (81.9) 12 (11.2)
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All patients in PWH

• N277
• Discharged 147 (53)
• ICU admission 51 (18.4)
• Died 18 (6.5)
• Mortality median age 76 (44-84) years

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Convalescent Plasma
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Convalescent Plasma vs more MP
3 MP CS (n 19) 4 or more MP (n 21) P values
Age 38.7 47.9 0.087
Admission LDH 258.1 247.7 0.7
Discharge rate by 21 days 73.7 19 0.001
No. of deaths 0 5 0.049
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Outcome of patients who received CS before day 16
vs later date
Day 16 (n 36) Day 16 (n 14) P values
Discharge rate by day 21 51.6 0 0.02
Death rate 0 28.6 0.02
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