Severe Acute Respiratory Syndrome

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					Severe Acute Respiratory
       Syndrome
   Stevan Cordas DO MPH
           Definition
Fever greater than 100.4° f.
Dyspnea.
Headaches.
Coughing.
Malaise.
Chest x-ray abnormalities resembling
atypical pneumonia.
 Criteria –Suspected Case
Suspected case.
 The above mentioned clinical features
 plus.
 Being is close contact with a case of
 suspected or probable SARS during the
 10 days prior to the onset of symptoms.
 Having traveled to Toronto, Hong Kong,
 Hanoi, portions of china and Singapore.
 Residing in these areas.
  Criteria –Probable Case
A chest x-ray compatible with
respiratory distress syndrome or
pneumonia in addition to the
above.
Other causes should be excluded.
Or a death with autopsy findings of
RDS that meets these suspect and
probable criteria.
As of today, (April 26,2003) a cumulative total of 4836 cases
with 293 deaths have occurred in 26 countries. This
represents an increase of 190 new cases and 19 deaths
compared with yesterday. The new deaths occurred in
Canada (3), China (7), Hong Kong SAR (6), the Philippines (1),
and Singapore (2).
The SARS outbreak in Hong Kong SAR has developed an
unusual pattern of transmission. This pattern is different from
what is being seen in the vast majority of other SARS
outbreaks, and is not yet fully understood. The number of
cases is continuing to increase significantly, and there is
evidence that the disease has spread beyond the initial focus
in hospitals.
These developments raise questions related to other routes
of transmission, in addition to well-documented face-to-face
exposure to droplets released when an infected person
coughs or sneezes. Epidemiologists are considering whether
SARS is being transmitted in Hong Kong by some
environmental means for which no satisfactory explanation
has been found.
      World Health Organization Advice
“The World Health Organization (WHO) today began
recommending that persons travelling to Hong Kong
Special Administrative Region of China and
Guangdong Province, China consider postponing all
but essential travel. This updated travel advice
comes as a result of new developments in the multi-
country outbreak of severe acute respiratory
syndrome (SARS).” April 2 2003
WHO Infectious Disease Specialist, Dr Carlo
Urbani, the First WHO Officer to Identify the
Outbreak of This New Disease and Treat the
Earliest Cases in Hanoi, Died of SARS Today
 in Thailand, Accounting for the Additional
  Death. The Number of Cases in Viet Nam
 Remained at 58 for the Sixth Day in a Row,
  Indicating That the Outbreak in Hanoi Is
               Well-controlled.
    No U.S. Deaths As of April 26th 2003.
                       Causation
Today, April 16th 2003, the World Health Organization
announced that a new pathogen, a member of the
coronavirus family never before seen in humans, is the cause
of Severe Acute Respiratory Syndrome (SARS). The speed at
which this virus was identified is the result of the close
international collaboration of 13 laboratories from 10
countries. While many lines of evidence have found strong
associations between this virus and the disease over the last
weeks, final confirmation came today.
                                                   April 14, 2003
                                    Contact: CDC Media Relations:
                                                   404-639-3286

          CDC Lab Sequences Genome of New Coronavirus
The Centers for Disease Control and Prevention (CDC) announced
today that it has sequenced the genome for the coronavirus believed
to be responsible for the global epidemic of severe acute respiratory
syndrome or SARS. The CDC sequence is nearly identical to that
determined by a Canadian laboratory late last week. The significant
difference is that the CDC-determined sequence has 15 additional
nucleotides, which provides the important beginning of the sequence,
CDC scientists said.
          Transmission
Touching the skin or even inaminate
objects infected with droplets and then
touching your nose, mouth etc.
Breathing infected droplets.
Possibly other mechanisms. Being
explored.
                  Tests
PCR testing is now availabe at BS3
laboratories. Specific but not very sensitive.
Your backup lab is: contact person: Prof. Dr.
Schmitz
fax 49 40 42 818 400
centers for disease control & prevention
national centers for infectious diseases
1600 Clifton road, Mailstop G16
bldg 7, room 111
Atlanta, Georgia 30333
united states
           Lab Protection
Label all blood specimens as possible SARS.
Wear face masks, gloves, laboratory coats and
eye protection (lab worker).
Deal in BS2 lab with biological safety cabinet.
N-95 respirator while centrifuging.
Decontaminate surfaces with disinfectant.
Hand washing afterward.
CDC/NIH Biosafety in microbiological and
biomedical laboratories manual (BMBL).
             Treatment
Good nursing care. Symptomatic.
  Contact and respiratory protection N-95
  masks.
  Isolation.
U. S. Military testing hundreds of drugs in
vitro against the SARS virus.
Canadians use combination of antibacterial
and antiviral drugs. Efficacy?

				
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