Severe acute respiratory syndrome

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 1, 2016
StartDiseasesSevere acute respiratory syndrome

Severe acute respiratory syndrome (SARS) is a viral infection that affects the respiratory system. This disease is extremely contagious and sometimes even fatal, and can be spread quickly without the carrier being aware of their infection. SARS caused a major outbreak in 2002-2003 but was contained. No cases of it have been reported since 2004.

Contents

Definition & Facts

SARS is a respiratory tract infection caused by the SARS-associated coronavirus (SARS-CoV). The first cases were reported at the end of 2002 and the beginning of 2003, most of which were in China. This virus is easily transmitted, and carriers may not show symptoms during the initial phase, allowing the carriers to travel via airplane to other countries.

SARS is most commonly spread from one person to another by close contact, such as when an infected person sneezes or coughs. In addition, a carrier can infect different surfaces with the virus, which can then infect a healthy individual.

Symptoms & Complaints

The symptoms of SARS vary, but many cases reported a similar start: flu-like symptoms. These may include fever or chills, muscle pain and aches, diarrhea, and fatigue. As the virus has time to reproduce and grow, there may be additional signs, such as a fever above 100.4 degrees Fahrenheit / 38 degrees Celsius, dry cough, headaches, full body ache, or difficulty breathing (feeling short of breath).

Many patients develop pneumonia at some point during the infection, as the immune system is weakened and infection occurs more easily in the respiratory system. Although these are the most common symptoms, some individuals complain of less common symptoms, including: dizziness, nausea, vomiting, and sore throats. Any individual that suspects he or she might be infected with SARS should contact a medical professional immediately.

Causes

The SARS virus is part of the coronavirus family, which is the same viral family that causes the common cold. Although uncertain, SARS is believed to have started in late 2002, when the virus was passed from smaller mammals to humans initially in China. SARS spreads easily through infected droplets of a sneeze or cough coming into direct contact with another person's mucous membranes, meaning person-to-person infection.

The virus also survives on surfaces for many hours, making the chance of infection even greater. Although droplet spread is the most common cause of infection, the virus could be spread through airborne transmission or through coming into contact with the waste of someone that is infected, as the virus has been shown to survive in human waste for up to four days. This virus has also been shown to withstand cold temperatures, surviving many months, if not longer, when temperatures are below freezing.

Diagnosis & Tests

Anyone suspected of a SARS infection should be examined by a trained medical professional as soon as possible, since public health officials declared the disease contained and early identification would be critical in averting another public health crisis as well as encouraging an individual patient's treatment success.

As part of the diagnostic process, a medical professional would listen to the respiratory system, wait to hear if the lungs sound normal or abnormal. Additionally, a chest X-ray or chest CT scan could assist in diagnosing this infection. There are a number of tests that could be used to identify the SARS virus, which include:

These tests have all been employed to quickly identify the virus. There are other tests that may be used to support a diagnosis, such as a complete blood count (CBC), blood chemistry tests, arterial blood gas tests and blood clotting tests. The medical team responsible for testing and diagnosis would determine the most important tests to conduct based on the individual. 

Treatment & Therapy

As a viral infection, SARS has shown incredible resistance against traditional antiviral medicines. Treatment plans for an individual infected with the virus would depend on the severity of the case, patient specifics (such as age), and accompanying infections (such as pneumonia). In many cases, pneumonia caused by a bacterial infection would occur in the patient due to the weakened immune and respiratory systems, which then would require antibiotic treatments.

Antipyretics, commonly known as fever-reducing medications, have played a large part in treating SARS. In addition to this, high doses of corticosteroids to help reduce lung swelling as well as breathing support (oxygen therapy, mechanical ventilation, or chest therapy) have been used to help an individual overcome the infection.

Any individual infected with the virus must be isolated, in a negative pressure room if at all possible, with the necessary precautions (complete barrier nursing precautions) taken for anyone interacting with the patient. This would help to reduce the chance of cross-contamination or spread of the virus.

Prevention & Prophylaxis

There have been no reported cases of SARS since 2004, but as of 2015 there is no existing cure or vaccination for the virus that is safe for humans. In 2012, the Centers for Disease Control and Prevention (CDC) declared that the SARS coronavirus is a select agent, meaning it can pose a severe threat to the health and safety of the general public.

Although there is no preventative treatment available that will definitively protect people from another outbreak, there are ways that an individual can limit any exposure risk should another outbreak occur. Avoiding travel to any location that has an outbreak is an important first step. Additionally, avoiding direct contact with those who have the virus for at least 10 days after their fever and symptoms are gone can greatly lower the risk of exposure.

Just like the common cold, hand washing is critical, and alcohol-based sanitizers are effective as well. Individuals that may be infected should cover their mouth and nose when coughing or sneezing, and sharing food, drink or utensils should be avoided at all costs.