Severe acute respiratory syndrome (SARS) is a life-threatening viral respiratory illness caused by a coronavirus

known as SARS-associated coronavirus (SARS-CoV). SARS is associated with a flu-likesyndrome,

which may progress into pneumonia, respiratory failure, and sometimes death. The SARS virus is
believed to have originated in the Guangdong Province in southern China and has subsequently spread
around the world. China and its surrounding countries have witnessed the greatest numbers of SARS-
related cases and death. SARS was first reported in 2002 in Asia and cases were reported until mid-year
2003. According to the World Health Organization (WHO), as of July 2003, a total of 8437 people
worldwide became ill with SARS and 813 died during the outbreak. Illness was reported in more than 30
countries and on 5 continents. Only 8 people in the United States acquired SARS infection, and all of
these people had traveled outside of the United States. No deaths due to SARS occurred in the United
States.

SARS CausesThe SARS virus is spread by close person-to-person contact. Transmission may occur by
droplets produced when an infected person sneezes or coughs. Droplet spread can occur when airborne
droplets, produced by a cough or sneeze, are deposited on the mucous membranes of the mouth, nose,
or eyes of a person up to 3 feet away. The virus can also be spread when a person touches a surface
contaminated with the droplets. Oral-fecal transmission of SARS may also occur. Unprotected health
care workers were at significant risk of acquiring the infection during the outbreak.

SARS SymptomsSymptoms of SARS can be similar to those of other viral infections. The first symptoms begin 2-
7 days after exposure and may include the following:

Fever (temperature of more than 100.4F)

Headache
Fatigue (tiredness)
Muscle aches and pain
Malaise (a feeling of general discomfort)
Decreased appetite
Diarrhea

Respiratory symptoms develop 3 or more days after exposure. Respiratory symptoms include the following:

Dry cough

Shortness of breath
Runny nose and sore throat (uncommon)

By day 7-10 of the illness, almost all patients with laboratory evidence ofSARS infection had pneumonia that
could be detected on x-ray films.

Exams and TestsInitial tests for persons thought to have SARS include the following:

Chest x-ray films

Pulse oximetry (a test in which a probe connected to a computer is placed on the finger or ear to measure
oxygen saturation in the blood)
Blood cultures
Sputum (fluid from the respiratory tract) Gram stain and culture
Testing for viral agents such as influenza A, influenza B, and respiratory syncytial virus
Urinary antigen testing for Legionella and pneumococcal species (2 causes of bacterial pneumonia)