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“A GLOBAL ALERT”
The much talked
about ‘SARS’ , has created panic all over the world. It is
hyped by the media who pour voluminous material on SARS
everyday in the newspapers. It is mandatory now for every
clinician, health care providers and common man to know
everything about SARS.
 What is SARS all about?
SARS is an
emerging viral infectious disease. A flu-like illness,
followed by a typical pneumonia and a high case fatality
rate have been its characteristics. It was first reported in
Guangdong province, China, in November 2002. the largest
outbreak to date began in Singapore in mid March 2003 and
was traced to a traveler returning from Hong Kong.
The syndrome needs to be addressed to for multiple reasons
viz;
-
Firstly,
it’s a new entity.
-
It’s a
highly communicable disease with high case fatality and
is manifest as a trans-continental Epidemic.
-
It has
proven a major occupational hazard for health care
providers
-
It has
potential to tax hospital services beyond their
capacity.
Thus its
emergence promoted the WHO to issue the first "GLOBAL HEALTH
ALERT" for over a decade, on March 15th 2003. an emergency
travel advisory was set up. The Director general of WHO, Dr.
Gro Harlem Brund Hand, stated that 'This syndrome is now a
world-wide health threat and the world needs to work
together to find its cause, cure the sick stop its spread”.
More than 7,956 cases have been reported from 28 countries
taking a toll of 666 people. Areas with current documented
or suspected community transmission of SARS include China,
Hong Kong, Singapore, Taiwan, Canada & Vietnam. India was
also an affected country with 3 probable cases including 2
cases in Bangalore. It is believed by some workers in India,
that Indians have some immunity against this virus, thus
preventing widespread transmission. Even though many people
have traveled and returned from these countries, so far no
case is definitely proved to be a case of SARS in India.
'THE CLINICAL PICTURE OF SARS'
1. Definition
SARS is a condition of unknown etiology probably caused by a
corona virus, that has been described in patients in Asia,
Canada & Europe.
2. Etiological
Agent
A novel corona virus, for which CDC recently completed
genome sequencing is believed to be responsible for global
Epidemic of SARS. (This virus is different from the known
bird and pig corona virus.)
3. How SARS
Spreads?
The primary way that SARS appears to spread is by close
person-to- person contact. Most cases of SARS have involved
people who cared for or lived with someone with SARS, or had
direct contact with infectious material (for example,
respiratory secretions) from a person who has SARS.
Potential ways in which SARS can spread include touching the
skin of other people or objects that are contaminated with
infectious droplets and then touching their own eye(s),
nose, or mouth. This can happen when someone who is sick
with SARS coughs or sneezes droplets onto themselves, other
people, or nearby surfaces. It is also possible that SARS
can spread by other ways that are currently not known.
4. Age of
Onset
Identified in
adults aged 25-70 years. Few cases have been reported among
children < 15 years.
5. Clinical
Features
Incubation
period is typically 2-7 days. The illness begins with
prodrome of Fever (>100.4% /38o C). Fever is
often high, sometimes associated with chills & rigors. There
may be other accompanying symptoms like headache, malaise &
myalgia. At the onset of illness, some persons have mild
respiratory symptoms. Typically, rash neurological or
gastrointestinal symptoms are absent; however some patients
have reported diarrhea during the febrile prodrome.
After 3-7 days,
a lower respiratory phase begins with the onset of dry,
nonproductive cough, dyspnoea, which may be accompanied by
or progress to hypoxemia. In 10-20% of cases, respiratory
illness is severe enough to require intubation and
mechanical ventilation.
6. Case Fatality Rate
Defined by WHO
is approx 3%.
7. The latest case definition criteria is as follows
1) Clinical
criteria
2) Lab Criteria
3) Epidemiologic Criteria
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