West Nile Virus (WNV)

 An infectious disease that first appeared in the United States in 1999.

 Infected mosquitoes spread the virus that causes it.
 The symptoms: a fever, headache, body aches, skin rash, and swollen lymph glands.
 Can last a few days to several weeks, and usually go away on their own.
 If West Nile virus enters the brain can be life-threatening. May cause inflammation of
the brain, called (encephalitis), or inflammation of the tissue that surrounds the brain
and spinal cord (meningitis). A physical exam, medical history, and laboratory tests can
diagnose it.
 Older people and those with weakened immune systems are most at risk.
 No specific vaccines or treatment
 Best way to avoid is to prevent mosquito bites:
 Use insect repellent
 Get rid of mosquito breeding sites by emptying standing water from flower pots,
buckets or barrels
 Stay indoors between dusk and dawn, when mosquitoes are most active
 Use screens on windows to keep mosquitoes out

Severe Acute Respiratory Syndrome (SARS)

 A serious form of pneumonia. Infection with the SARS virus causes acute respiratory distress (severe
breathing difficulty) and sometimes death.
 Caused by a member of the coronavirus family of viruses (the same family that can cause the common
cold). 2003 epidemic started when the virus spread from small mammals in China.
 When someone with SARS coughs or sneezes, infected droplets spray into the air and if you breathe in
or touch these particles.
 The SARS virus may live on hands, tissues, and other surfaces for up to several hours in these droplets.
The virus may be able to live for months or years when the temperature is below freezing.
 Reinfection is possible
Symptoms usually occur about 2 to 10 days after coming in contact with the virus. In some cases, SARS started
sooner or later after first contact. People with active symptoms of illness are contagious. But it is not known for
how long a person may be contagious before or after symptoms appear.

Symptoms

The main symptoms are:

Cough

Difficulty breathing

Fever of 100.4°F (38.0°C) or higher

Other breathing symptoms

The most common symptoms are:

Chills and shaking

Cough, usually starts 2 to 3 days after other symptoms

Headache

Muscle aches

Tiredness

Less common symptoms include:

Cough that produces phlegm (sputum)

Diarrhea

Dizziness

Nausea and vomiting

In some people, the lung symptoms get worse during the second week of illness, even after the fever has
stopped.

Exams and Tests

Your health care provider may hear abnormal lung sounds while listening to your chest with a stethoscope. In
most people with SARS, a chest x-ray or chest CT show pneumonia, which is typical with SARS.

Tests used to diagnose SARS might include:

Arterial blood tests

Blood clotting tests

Blood chemistry tests

Chest x-ray or chest CT scan

Complete blood count (CBC)

Tests used to quickly identify the virus that causes SARS include:

Antibody tests for SARS

Direct isolation of the SARS virus

Rapid polymerase chain reaction (PCR) test for SARS virus

All current tests have some limitations. They may not be able to easily identify a SARS case during the first week
of the illness, when it is most important.

Treatment

People who are thought to have SARS should be checked right away by a provider. If they are suspected of
having SARS, they should be kept isolated in the hospital.

Treatment may include:

Antibiotics to treat bacteria that cause pneumonia (until bacterial pneumonia is ruled out or if there is bacterial
pneumonia in addition to SARS)

Antiviral medicines (although how well they work for SARS is unknown)

High doses of steroids to reduce swelling in the lungs (it is not known how well they work)

Oxygen, breathing support (mechanical ventilation), or chest therapy

In some serious cases, the liquid part of blood from people who have already recovered from SARS has been
given as a treatment.

There is no strong evidence that these treatments work well. There is evidence that the antiviral medicine,
ribavirin, does not work.

Outlook (Prognosis)
In the 2003 outbreak, the death rate from SARS was 9% to 12% of those diagnosed. In people over age 65, the
death rate was higher than 50%. The illness was milder in younger people.

In the older population, many more people became sick enough to need breathing assistance. And even more
people had to go to hospital intensive care units.

Public health policies have been effective at controlling outbreaks. Many nations have stopped the epidemic in
their own countries. All countries must continue to be careful to keep this disease under control. Viruses in the
coronavirus family are known for their ability to change (mutate) in order to spread among humans.

Possible Complications

Complications may include:

Respiratory failure

Liver failure

Heart failure

Kidney problems

When to Contact a Medical Professional

Call your provider if you or someone you have been in close contact with SARS.

Prevention

Reducing your contact with people who have SARS lowers your risk for the disease. Avoid travel to places
where there is an uncontrolled SARS outbreak. When possible, avoid direct contact with people who have SARS
until at least 10 days after their fever and other symptoms are gone.

Hand hygiene is the most important part of SARS prevention. Wash your hands or clean them with an alcohol-
based instant hand sanitizer.

Cover your mouth and nose when you sneeze or cough. Droplets that are released when a person sneezes or
coughs are infectious.

DO NOT share food, drink, or utensils.

Clean commonly touched surfaces with an EPA-approved disinfectant.

Masks and goggles may be useful for preventing the spread of the disease. You may use gloves when handling
items that may have touched infected droplets.