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SARS, history, It is believed that the disease was initially transferred to humans through civets, a mammal with a cat

-like appearance. The SARS outbreak actually began in November 2002 in the Guangdong province of mainland China. However, to preserve public confidence, the Chinese government did not inform the World Health Organization (WHO) of the outbreak until February 2003. This contagious respiratory infection was first described on Feb. 26, 2003. SARS was identified as a new disease by World Health Organization (WHO) physician Dr. Carlo Urbani. He diagnosed it in a 48-year-old businessman who had traveled from the Guangdong province of China, through Hong Kong, to Hanoi, Vietnam. The businessman died from the illness. Dr.Urbani subsequently died from SARS on March 29, 2003, at the age of 46. In the meantime, SARS was spreading, and within 6 weeks of its discovery, it had infected thousands of people around the world, including people in Asia, Australia, Europe, Africa, and North and South America. Schools had closed throughout Hong Kong and Singapore. National economies were affected. The WHO had identified SARS as a global health threat, and issued an unprecedented travel advisory. Daily WHO updates tracked the spread of SARS seven days a week. It wasn't clear whether SARS would become a global pandemic, or would settle into a less aggressive pattern. The rapid, global public health response helped to stem the spread of the virus, and by June 2003, the epidemic had subsided to the degree that on June 7 the WHO backed off from its daily reports. Nevertheless, even as the number of new cases dwindled, and travel advisories began to be lifted, the sober truth remained: every new case had the potential to spark another outbreak. SARS appears to be here to stay, and to have changed the way that the world responds to infectious diseases in the era of widespread international travel. definition, Severe acute respiratory syndrome (SARS) is an infectious disease first identified in humans in early 2003. SARS is caused by a newly described coronavirus, called SARS-associated coronavirus (SARS-CoV). Previously identified human coronaviruses (named for their spiky, crown-like appearance) were known to cause only mild respiratory infections. SARS is a viral disease that are responsible for many cases of the common cold . Though the exact origins of this relatively new virus are unknown, it is believed that civets, a mammal with a cat-like appearance, may have been the source of transmission to humans. epidemiology, As of June 11, 2003, a cumulative total of 8435 probable SARS cases and 789 deaths have been reported from 29 countries. The total number of people who have recovered from SARS totals 6581. The WHO continues to issue a daily report on cumulative numbers of SARS cases and deaths on Monday through Friday. China is regarded as the epicentre of the SARS outbreak and presently accounts for almost two thirds of all reported cases worldwide. The first cases were detected in China during mid-November of last year. In an earlier report, a WHO assessment team reached this conclusion: If SARS is not brought under control in China, there will be no chance of controlling the global threat of SARS. Achieving control of SARS is a major challenge especially in a country as large and diverse as China. Effective disease control and reporting are the cornerstones of any strategy to do this. On June 12, 2003, China s Executive Vice Minister of Health, Mr GaoQiang, and Dr. David Heymann, WHO s Executive Director for Communicable Diseases, briefed the press on the situation of SARS control in China. Dr.Heymann praised the openness with which the WHO team was welcomed by the Chinese Ministry of Health, and described the measures now in place to control and prevent SARS as excellent. features, The hallmark symptoms are fever greater than 100.4 degrees F (38.0 degrees C) and cough, difficulty breathing, or other respiratory symptoms. Symptoms in the order of how commonly they appeared have included:

Wear a surgical mask. contact. Wash personal items. and airborne precautions Prevention these safety guidelines if you're caring for an infected person: Wash your hands. Treatments similar to atypical pneumonia Antiviral agents y Intravenous steroids Oseltamivir y Steroid and ribavirin combination Ribavirin Oral steroids Steroids and other antimicrobials Intubation Mechanical ventilation . Use soap and hot water to wash the utensils. wear disposable gloves. Always seek professional medical advice about any treatment or change in treatment plans. y y y y y y y y y y     .needed in about 10-20% of cases Isolation Anti-transmission protocols including standard. bedding and clothing of someone with SARS. cover your mouth and nose with a surgical mask.  Do not share personal use articles with others. Blood cultures Sputum Gram's stain and culture y White blood cell count y Absolute lymphocyte count Influenza A tests y Creatine phosphokinase levels Influenza B tests y Hepatic transaminase levels Respiratory syncytial virus tests Complete blood count Treat The list of treatments mentioned in various sources for SARS includes the following list.Fever y Chills and shaking y Muscle aches y Cough y Headache Less common symptoms include (also in order): y y y y y y y Dizziness Productive cough (sputum) Sore throat Runny nose Nausea and vomiting Diarrhea y y y y y y y y y y y y investigations and Rx The list of medical tests mentioned in various sources as used in the diagnosis of SARS includes: No official specific SARS tests available yet Various SARS tests under development Chest imaging . towels. Clean your hands frequently with soap and hot water or use an alcohol-based hand rub containing at least 60 percent alcohol.for identifying pneumonia and related findings Chest x-rays Pulse oximetry. When you're in the same room as a person with SARS. If you have contact with the person's body fluids or feces.  Cover your nose and mouth if you sneeze or cough. Throw the gloves away immediately after use and wash your hands thoroughly.A non-invasive method of estimating the oxygen saturation of the arterial red blood cells. Wearing eye glasses also may offer some protection. Wear disposable gloves.

Avian influenza. That is why the presence of an H5 or H7 virus in poultry is always cause for concern even when initial signs of infection are mild. continuously caused massive outbreaks in poultry. the viruses can mutate. is an infectious disease of birds caused by type A strains of the influenza virus. This type of HPAI has been referred to as bird flu. the highly pathogenic H5N1 strain found in poultry has infected and killed humans and has been referred to as bird flu. as of September 24. The wild birds carry the virus in their intestines. All influenza viruses affecting domestic animals (horses. In 1955. Currently. vomit. including domestic chickens. originally known as Fowl Plague. millions of chickens. . Avian influenza outbreaks occur sporadically throughout the world. Millions of birds have also died or been culled to prevent further spread of the virus. avian influenza can make some domesticated birds. If allowed to circulate in the flocks. Most avian influenza viruses are LPAI viruses. are considered to be the natural reservoirs for influenza viruses. ducks. a highly pathogenic strain of H5N1 which kills poultry has infected and killed some humans. Avian influenza viruses in poultry occur in two main forms. also known as avian flu or bird flu. y The highly pathogenic form (HPAI) spreads rapidly through poultry flocks and can cause severe illness and high mortality. there is scientific evidence that the mutated virus can then infect and kill wild waterfowl. when highly pathogenic avian influenza (HPAI) H5N1 was discovered in humans in Hong Kong. pigs. Wild waterfowl. the virus (also known as bird flu) has received unprecedented publicity. This disease has been very disruptive to the poultry industry. once the avian influenza virus has mutated in domestic poultry. 2009. Public health officials are concerned that HPAI H5N1 could mutate into a form that could spread from human to human. very sick and kill them. The avian influenza outbreak has since spread to 14 countries in Asia. and C. usually within a few months. etc. it was discovered that the virus causing Fowl Plague was an influenza virus. such as ducks and geese. Influenza types B and C affect only humans. Although the number of people infected with avian influenza is relatively few compared to seasonal human flu. mucus. There are three types of influenza virus: A. Only some viruses of the H5 and H7 subtypes have been known to mutate into a highly pathogenic form of the disease. Africa. and turkeys. y The low pathogenic form (LPAI) may go undetected because it usually causes only mild illness such as ruffled feathers and a drop in egg production. Avian influenza. Two hundred sixty-two of those infected people died. human outbreaks and deaths have resulted mainly from direct contact with infected birds. epidemiology. infected 442 people. B. poultry. the percentage of people who die from HPAI H5N1 is very high (approximately 60%). into the highly pathogenic form. but do not usually show any signs of illness. and turkeys have been destroyed to prevent further spread of the disease Starting in 1997. including two outbreaks in the United States (1924 and 1929). In some cases. geese. Wear disposable gloves while you clean and throw the gloves away when you're done. definition. Avian influenza was first recorded in Italy in 1878. However. Current research has shown that H5 and H7 viruses are introduced to poultry flocks in their low pathogenic form. Use a household disinfectant to clean any surfaces that may have been contaminated with sweat.) belong to type A. stool or urine. In rare cases. saliva. The disease. which is the most common virus type producing serious epidemics in humans. and. In recent years.  Disinfect surfaces. history. and the Middle East.

a little over 60% of those who became ill have died. which might include: y Cough (dry or productive) y y Diarrhea y y Difficulty breathing y y Fever greater than 100. Doctors recommend that people get an influenza (flu) shot to reduce the chance of an avian flu virus mixing with a human flu virus. kidneys. have a higher risk for getting the bird flu. features. Older tests took 2 to 3 days. The more the avian flu virus spreads. Africa. Farmers and other people working with poultry. There is a tremendous concern that H5N1 poses an enormous pandemic threat. Symptoms of avian flu infection in humans depend on the strain of causes more classic flu-like symptoms. Infection may be spread simply by touching contaminated surfaces. which would create a new virus that may easily spread. treatment with the antiviral medication oseltamivir (Tamiflu) or zanamivir (Relenza) may make the disease less severe -. Europe and the near East. Around 400 people have become sick with this virus. The virus that causes human avian flu appears to be resistant to the antiviral medicines amantadine and rimantadine.4°F (38°C) y y Headache virus. Tests to identify the avian flu exist but are not widely available. Human cases of avian influenza A (H5N1) have now been reported in Asia. Handling an infected bird can cause infection. Food and Drug Administration has approved a vaccine to protect humans from the avian flu. A test for diagnosing strains of bird flu in people suspected of having the virus gives preliminary results within 4 hours. the greater the chances of a worldwide outbreak. The avian flu virus (H5N1) has been shown to survive in the environment for long periods of time. Experts say the vaccine could be used if the current H5N1 virus starts spreading between people. People with severe infection may need to be placed on a breathing machine. Experts recommend that persons diagnosed with avian flu be put in isolation. In general. However. the Pacific. as well as travelers visiting affected countries. . People who eat raw or undercooked poultry meat. eggs. prevention. Oseltamivir may also be prescribed for persons who live in the same house as those diagnosed with avian flu. Infection with the H5N1 virus in humans Malaise Muscle aches Runny nose Sore throat investigations and Rx . Birds who recover from the flu can continue to shed the virus in their feces and saliva for as long as 10 days. Health care workers and household contacts of patients with avian influenza may also be at an increased risk of the bird flu. or blood from these birds are also at an increased risk for avian influenza. Therefore these medications should not be used if an H5N1 outbreak occurs. Your doctor might also perform the following tests: Auscultation (to detect abnormal breath sounds) y Chest x-ray y Nasopharyngeal culture y White blood cell differential y Other tests may be done to look at the functions of your heart. during an avian flu epidemic on the island.S. and Vietnam. This outbreak was linked to chickens and classified as avian influenza A (H5N1). The U. and liver.The first avian influenza virus to infect humans directly occurred in Hong Kong in 1997. Indonesia.if you start taking the medicine within 48 hours after your symptoms start.

Additionally. over 1. A total of 265 persons were infected and required hospitalization. Adult males. Henipavirus is a genus of the family Paramyxoviridae.At this time. People who work with birds who might be infected should use protective clothing and special breathing masks. The 1998-1999 outbreak of Nipah virus in Malaysia occurred in three clusters. Serological surveillance of farms and random testing of pigs at abattoirs is currently being performed. Additionally. human cases of febrile encephalitis with high mortality were reported by the Malaysian Ministry of Health. The 1998-1999 outbreak of Nipah virus in Malaysia occurred in three clusters. closely related to Hendra virus. epidemiology. The pig population in Malaysia prior to the outbreak was 2.5:1. travelers should avoid visits to live-bird markets in areas with an avian flu outbreak. in particular pig farmers.5:1. The henipaviruses are naturally harboured by Pteropid fruit bats (flying foxes) and are characterised by a large genome. The male to female ratio was 4. Serological surveillance of farms and random testing of pigs at abattoirs is currently being performed. Some pigs also demonstrated neurological signs. the U. a similar type of outbreak occurred in Singapore. Severe respiratory disease was rapidly spread by movement of infected pigs from farm to farm.4 million animals. order Mononegavirales containing two members. and a trainer at a training complex in Hendra. Australia. a wide host range and their recent emergence as zoonotic pathogens capable of causing illness and death in domestic animals and humans. were the majority affected. Many required mechanical ventilation. Nipah virus was named after the village (Sungai Nipah) where the first cases were found. Nipah Virus (Encephalitis) history.) In March 1999. Adult males. Hendra virus (originally Equine morbillivirus) was discovered in September 1994 when it caused the deaths of fourteenhorses. Ninety-three percent (93%) of these cases had close contact with infected pigs. Centers for Disease Control and Prevention (CDC) has no recommendations against travel to the countries affected by H5N1 . Many required mechanical v entilation.4 million animals. resulting in 105 human deaths and the culling of one million pigs. in particular pig farmers. (NOTE: Hendra virus is a severe respiratory and encephalitic disease causing virus that affects humans and horses. which resulted in a substantial economic loss for this country (an estimated cost of about US $97 million) and loss of export trade (estimated cost of about US$120 million). Avoiding undercooked or uncooked meat reduces the risk of exposure to avian flu and other foodborne diseases.1 million pigs were culled to prevent the further spread of the disease.S. There were 105 fatalities (40% mortality). Nipah virus was identified in 1999 when it caused an outbreak of neurological and respiratory disease on pig farms in peninsular Malaysia. Initially Japanese encephalitis (JE) was suspected. The male to female ratio was 4. over 1. [The total v alue of annual national output was estimated at about US$ 400 million and total export value at US$100 million. Pigs were also affected during this outbreak. However serological tests and the epidemiology of the disease indicated it was different from JE. However. From September 1998 April 1999. . Some pigs also demonstrated neurological signs. local pork consumption during the outbreak dropped by 80%. which resulted in a substantial economic loss for this country (an estimated cost of about US $97 million) and loss of export trade (estimated cost of about US$120 million).1 million pigs were culled to prevent the further spread of the disease.Hendravirus and Nipahvirus. [The total value of annual national output was estimated at about US$ 400 million and total export value at US$100 million. Pigs were also affected during this outbreak. There were 105 fatalities (40% mortality). A total of 265 persons were infected and required hospitalization. The disease affected abattoir workers that had been exposed to pigs imported from Malaysia for slaughter. local pork consumption during the outbreak dropped by 80%. Ninety-three percent (93%) of these cases had close contact with infected pigs. were the majority affected. The pig population in Malaysia prior to the outbreak was 2. Tissue culture isolation from cases sugge sted a previously unrecognized paramyxovirus. a suburb of Brisbane in Queensland. definition.] During the outbreak. Severe respiratory disease was rapidly spread by movement of infected pigs from farm to farm.] During the outbreak.

spleen. cerebrospinal fluid) y y Virus neutralization Immunohistochemistry (lung. prevention. Upon the discovery of Nipah. although further study is needed y Intensive supportive care is required for infected humans Adding to the mortality rate for Nipah virus infection is that there is no known cure for it. Malaysia and Singapore developed national plans to help eradicate the disease y Phase I: Immediate eradication by mass culling of pigs (this resulted in the loss of over 1 million swine and had a significant impact on the pig industry in Malaysia) y y Phase II: Antibody surveillance of high-risk farms to prevent future epidemics Future actions: Further research into natural hosts. may reduce mortality among patients with encephalitis caused by Nipah virus. Severely ill individuals will be hospitalized and may require the use of a respirator (ventilator). several methods have been used to confirm viral infection: y y History/clinical signs Virus isolation (kidney.features. Encephalitis (may relapse after recovery) Meningitis Disorientation Neurologic deficits (may persist after recovery) Coma Death No standard protocol exists for detecting Nipah virus at this time. Some infected individuals who received the antiviral drug ribavirin early in their illness had less severe symptoms. dogs. y Ribavirin. liver. cats) until the proper authorities are consulted. Treatment is mostly focused on managing fever and the neurological symptoms. heart) y IgG-. IgM-capture enzyme linked immunosorbent assay (ELISA) y Reverse transcriptase polymerase chain reaction (RT-PCr Treatment Effective treatment has not been developed for Nipah infection. Avoid all contact with potentially infected species (pigs. Characteristics: Fever Migraine Vomiting Emphysema Myalgia investigations and Rx . pathogenesis. kidney. However. and epidemiology Other preventive actions included the following: y y y y A ban on transporting pigs within the country A total ban on porcine production (which has since been lifted) Education about contact with pigs Use of personal protective equipment among persons exposed to pigs . an antiviral drug.