Transcript SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

SEVERE ACUTE RESPIRATORY
SYNDROME (SARS)
Quek Boon Har
UMMC
What are the signs and symptoms
of SARS ?
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begins generally with a prodrome of fever (> 38 oC),
chills, headache, myalgia, and malaise
followed later by a respiratory phase characterised by a
dry, unproductive cough and difficulty in breathing
may also complains of headache, sore throat, loss of
appetite, confusion, rash, diarrhoea
lab abnormalities – lymphopenia, leukopenia, mild
thrombocytopenia, and elevations in serum CK and/or
transaminase
chest X-ray may be normal initially, but may show lobar
consolidation or interstitial filtration later on
What is the cause of SARS ?
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preliminary findings – coronavirus, a group of
viruses which have a halo or crown like (corona)
appearance when viewed under microscope
common cause of mild to moderate URTI in
humans
associated with respiratory, gastrointestinal, liver
and neurologic diseases in animals
How contagious is SARS ?
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close contact with an infected person (e.g.
health care workers and family members)
examples of close contact include having care
for, lived with, or had direct contact with
aerosolized (exhaled) droplets and bodily
secretions from an infected person
may also spread by indirect contact such as
touching the skin of other people or objects that
are contaminated with infectious droplets and
then touching one’s eye(s), nose, or mouth
coronavirus can survive on environmental
surfaces for up to 3 hours
How fast does SARS spread ?
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less infectious than influenza
short incubation period, usually 2 to 7 days (3-5
days being most common, in some cases up to
10 days)
rapid spread due to speed of international travel
risk of nosocomial transmission
Prevention of transmission of SARS
For all contacts with suspects or
probable SARS patients, careful
hand hygiene is urged, including
hand washing with soap and
water. If hands are not visibly
soiled, alcohol-based hand rubs
may be used as an alternative to
hand washing
Prevention of transmission of SARS
If one has
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traveled to a known SARS area in the last 10 days, or
have had close contact with a co-worker or family
member with suspected or probable SARS
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developed fever (>38oC) or respiratory symptoms (e.g.
cough or difficulty breathing)
*** should not go to work, or other public area
*** seek evaluation by a healthcare provider
immediately
Prevention of transmission of SARS
For suspect or probable SARS case:
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wear a surgical mask in the presence of others
wash hands often and well, especially after
blowing nose
if ongoing respiratory symptoms are present,
should sleep in separate room, use own eating
utensils and not share any linen or towels with
others
should limit interactions outside home until 10
days after resolution of fever and respiratory
symptoms
Prevention of transmission of SARS
For household contact living with a case:
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disposable gloves should be used for any direct
contact with body fluids of a SARS patient; gloves
should be immediately removed and discarded after
the activity and hands should be cleaned
environmental surfaces soiled by body fluids should be
cleaned with warm water and detergent, followed by
wiping with a household disinfectant, e.g. dilute
bleach; gloves should be worn during this activity
need to monitor health for 10 days – take temperature
daily
pursue normal activities but should isolate oneself
from others quickly if develop fever or unwell and seek
medical attention
Prevention of transmission of SARS
In an outpatient setting
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separate assessment area
surgical mask should be placed on the suspect
patient
health care personnel should wear N-95 respirators
while evaluating, taking care of and transporting
suspect patient
if N-95 respirators are not available, surgical masks
should be worn
Air travel
Those at risk of acquiring SARS from another
passenger could be:
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directly within inhalation distance of droplets
released by coughing or sneezing (within
approximately one metre)
in contact with surfaces that the passenger may
have contaminated by coughing or sneezing and
enabling self inoculation of the virus by transfer of
the object via hands to mouth or eyes
Air travel
If you must travel:
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assemble a travel health kit containing basic first
aid and medical supplies, including a thermometer,
household disinfectant, surgical masks, disposable
gloves and alcohol-based hand rubs
monitor own health for 10 days after returning from
the affected area
References:
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CDC website
WHO website
Interim Australian Infection Control Approach to
SARS by the Department of Health and Ageing
in conjunction with the Communicable Disease
Network of Australia
Infection Watch by the Infectious Disease
Control Team, UMMC
Check out the CDC and WHO
SARS websites for more
information
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