Severe Acute Respiratory Syndrome (SARS)
The world pandemic coronavirus or COVID 19 battle of 2020 which has shut down many countries is not a strange virus. It has been in existence since the early 2000s. Wondering how? Read and find out below.
Origin of SARS
Severe acute respiratory syndrome (SARS) which has been described by World Health Organization (WHO) as a viral respiratory disease is said to have been of zoonotic origin and had surfaced in the early 2000s caused by the first-identified strain of the SARS coronavirus (SARS-CoV or SARS-CoV-1). In late 2017, Chinese scientists traced the virus through the intermediary of civets to cave-dwelling horseshoe bats in Yunnan province. Since 2004, no cases of the first SARS-CoV have been reported worldwide.
Mode of Transmission
An epidemic of SARS affected 26 countries and resulted in more than 8000 cases in 2003. Since then, a small number of cases have occurred as a result of laboratory accidents or, possibly, through animal-to-human transmission (Guangdong, China).
Transmission of SARS-CoV is primarily from person to person. It appears to have occurred mainly during the second week of illness, which corresponds to the peak of virus excretion in respiratory secretions and stool, and when cases with severe disease start to deteriorate clinically. Most cases of human-to-human transmission occurred in the health care setting, in the absence of adequate infection control precautions. Implementation of appropriate infection control practices brought the global outbreak to an end.
Nature of the disease
Symptoms are influenza-like and include fever, malaise, myalgia, headache, diarrhoea, and shivering (rigors). No individual symptom or cluster of symptoms has proved to be specific for a diagnosis of SARS. Although fever is the most frequently reported symptom, it is sometimes absent on initial measurement, especially in elderly and immunosuppressed patients.
Cough (initially dry), shortness of breath, and diarrhoea are present in the first and/or second week of illness. Severe cases often evolve rapidly, progressing to respiratory distress and requiring intensive care.
The distribution is based on the 2002–2003 epidemic. The disease appeared in November 2002 in the Guangdong province of southern China. This area is considered as a potential zone of re-emergence of SARS-CoV.
Other countries/areas in which chains of human-to-human transmission occurred after early importation of cases were Toronto in Canada, Hong Kong Special Administrative Region of China, Chinese Taipei, Singapore, and Hanoi in Viet Nam.
Risk for travellers
Currently, no areas of the world are reporting transmission of SARS. Since the end of the global epidemic in July 2003, SARS has reappeared four times – three times from laboratory accidents (Singapore and Chinese Taipei), and once in southern China where the source of infection remains undetermined although there is circumstantial evidence of animal-to-human transmission.
Should SARS re-emerge in epidemic form, WHO will provide guidance on the risk of travel to affected areas. Travellers should stay informed about current travel recommendations. However, even during the height of the 2003 epidemic, the overall risk of SARS-CoV transmission to travellers was low.
Symptoms of SARS
SARS has flu-like symptoms that usually begin 2 to 7 days after infection. Sometimes, the time between coming into contact with the virus and the start of symptoms (incubation period) can be up to 10 days.
The symptoms of SARS include:
- a high temperature (fever)
- extreme tiredness (fatigue)
- muscle pain
- loss of appetite
After these symptoms, the infection will begin to affect your lungs and airways (respiratory system), leading to additional symptoms, such as:
- a dry cough
- breathing difficulties
- an increasing lack of oxygen in the blood, which can be fatal in the most severe cases
Treatment for SARS
There’s currently no cure for SARS, but research to find a vaccine is ongoing.
A person suspected of having SARS should be admitted to hospital immediately and kept in isolation under close observation.
Treatment is mainly supportive, and may include:
- assisting with breathing using a ventilator to deliver oxygen
- Use of antibiotics to treat bacteria that cause pneumonia
- antiviral medicines
- high doses of steroids to reduce swelling in the lungs
There’s not much scientific evidence to show that these treatments are effective. The antiviral medicine ribavirin is known to be ineffective at treating SARS.
There is no vaccine for SARS. However, clinical isolation and quarantine and remain the most effective means to prevent the spread of SARS. Other preventive measures include:
- Hand-washing with soap and water or alcohol and hydrogen peroxide based hand sanitizer
- Disinfection of surfaces for fomities
- Avoiding contact with bodily fluids
- Washing the personal items of someone with SARS in hot, soapy water (eating utensils, dishes, bedding, etc.)
- Keeping children with symptoms home from school
- Simple hygiene measures
- Isolating oneself as much as possible to minimize the chances of transmission of the virus
Many public health interventions were made to try to control the spread of the disease, which is mainly spread through respiratory droplets in the air. These interventions included earlier detection of the disease; isolation of people who are infected; droplet and contact precautions; and the use of personal protective equipment (PPE), including masks and isolation gowns. Studies done during the outbreak found that for medical professionals, wearing any type of mask compared to none could reduce chances of getting sick by about 80%. A screening process was also put in place at airports to monitor air travel to and from affected countries.
SARS-CoV is most infectious in severely ill patients, which usually occurs during the second week of illness. This delayed infectious period meant that quarantine was highly effective; people who were isolated before day five of their illness rarely transmitted the disease to others.
Although no cases have been identified since 2004, the CDC was still working to make federal and local rapid response guidelines and recommendations in the event of a reappearance of the virus as of 2017.
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