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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
Copyright:Attribution Non-commercial


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Severe acute respiratory syndrome (SARS) \u2014 a contagious and sometimes fatal
respiratory illness \u2014 first appeared in China in November 2002. Within six weeks,
SARS had spread worldwide, carried around the globe by unsuspecting travelers.
Eventually, 8,000 people were infected and 800 died of the disease.

The rapid and unexpected spread of SARS alarmed both health officials and the
public. SARS \u2014 the first newly emerged, serious and contagious illness of the 21st
century \u2014 illustrated just how quickly infection can spread in a highly mobile and
interconnected world. On the other hand, concerted international cooperation allowed
health experts to contain SARS just months after its emergence. What's more,
scientists now believe that some cases originally diagnosed as SARS may actually
have been avian influenza (bird flu), potentially a far more deadly disease.


SARS begins with a fever \u2014 a temperature of 100.4 F (38.0 C) or higher \u2014 that
usually occurs two to seven days after you've been infected, although it may not
appear for up to 10 days. Chills, muscle soreness, headache and a general feeling of
discomfort also are common. Two to seven days after the initial signs and symptoms,
you're likely to develop a dry cough. In some people, SARS may progress to severe
pneumonia, leading to an insufficient amount of oxygen in the blood (hypoxemia).

You're probably most contagious while you have active signs and symptoms. As a
precaution, the Centers for Disease Control and Prevention (CDC) recommends that
people who have recovered from SARS avoid going out in public for 10 days after
symptoms go away.


SARS is caused by a new strain of coronavirus, the same family of viruses that cause
the common cold. Until now, these viruses have never been particularly virulent in
humans, although they can cause severe disease in animals. For that reason, scientists
originally thought that the SARS virus might have crossed from animals to humans. It
now seems likely, however, that it evolved from one or more animal viruses into a
completely new strain.

How SARS spreads

Most respiratory illnesses, including SARS, spread through droplets that enter the air
when someone with the disease coughs, sneezes or talks. This type of transmission
can occur in two ways:

Droplets. In droplet transmission, the infected particles are large and can
travel only about three feet. To inhale them, you must be face to face with
someone who's sick.
Airborne particles. Because airborne particles are much smaller than

droplets, they travel farther and linger longer in the air. As a result, you can become infected even after the person who coughed or sneezed has left the room.

Most experts think SARS spreads mainly through face-to-face contact, but the virus
also may be spread on contaminated objects, including doorknobs, telephones and
elevator buttons.

Risk factors

In general, people at greatest risk of SARS have had direct, close contact with
someone who's infected, such as a roommate or family member. Doctors and hospital
workers who treated people with SARS before the disease was identified were some
of the first SARS casualties.

Researchers also have identified a variation in an immune system gene that may make
people with the variation much more vulnerable to the SARS virus. The genetic
variation is common among people of Southeast Asian descent but is rare in other
populations. This may help explain why most SARS cases have occurred in China and

Southeast Asia.
Tests and diagnosis

When SARS first surfaced, no specific tests were available to help doctors diagnose the disease. Now several laboratory tests can help detect the virus, although all have some limitations. These tests include:

DNA test (reverse transcription polymerase chain reaction test).U s ing
secretions from your nose or a blood or stool sample, scientists look for the
DNA of a suspected pathogen.
Blood test (serologic test). This checks a sample of your blood for the
presence of antibodies to SARS-associated coronavirus. Antibodies are
substances that your immune system produces to fight a specific infection.
Virus test (viral culture). In this test, a small sample of tissue or fluid is
placed on a special medium (culture) that's incubated for a period of time and
then checked for the presence of the SARS virus.

Between 10 percent and 20 percent of people with SARS become progressively worse
and develop breathing problems so severe that they need the help of a mechanical
respirator. SARS is fatal in some cases, often due to respiratory failure. Other possible

complications include heart and liver failure.
Treatments and drugs

In spite of a concerted global effort, scientists have yet to find an effective treatment
for SARS. A combination of antiviral drugs normally used to treat AIDS \u2014 lopinavir-
ritonavir along with ribavirin \u2014 has been shown in clinical studies to prevent serious
complications and deaths from SARS. However, further testing is needed.


Researchers are working on several types of vaccines for SARS, but until an effective
vaccine is developed, the World Health Organization (WHO) and the CDC have
established a number of guidelines aimed at stopping transmission of the disease.

Protecting yourself
If you're caring for someone at home with SARS, these measures can help you stay
Wash your hands frequently with soap and hot water or use an alcohol-based
hand rub containing at least 60 percent alcohol.
Instead of touching your face with your hands, use a disposable tissue to rub
your eyes or nose.

Wear disposable gloves if you have contact with the patient's body fluids or
feces. Throw the gloves away immediately after use and wash your hands

Wear a surgical mask when you're in the same room as a person with SARS.
Wearing glasses also may offer some protection.
Use soap and hot water to wash the utensils, towels, bedding and clothing of
someone with SARS. Don't use these items yourself until they're clean.

Use a household disinfectant to clean any surfaces that may have been
contaminated with sweat, saliva, mucus, vomit, stool or urine. Wear
disposable gloves while you clean and throw the gloves away when you're

Follow all precautions for at least 10 days after the person's signs and
symptoms have disappeared.

Keep children home from school if they develop a fever or respiratory
symptoms within 10 days of being exposed to someone with SARS. They can
return to school if symptoms go away after three days.

Protecting others
If you've been diagnosed with SARS, the following measures can help prevent the
infection from spreading:
Wash your hands carefully and frequently with soap and hot water or an
alcohol-based hand rub containing at least 60 percent alcohol.
Cover your mouth and nose with a tissue when you cough or sneeze, and if
possible, wear a surgical mask when you're in close contact with other people.
Don't share your silverware, towels or bedding with anyone in your home until
these items have been thoroughly washed with soap and hot water.

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