Severe acute respiratory syndrome (SARS)

Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It is caused by a virus that was first identified in 2003. Infection with the SARS virus causes  acute respiratory distress (severe breathing difficulty) and sometimes death.  
SARS is a dramatic example of how quickly world travel can spread a disease. It is also an example of how quickly a connected health system can respond to a new health threat.


World Health Organization (WHO) physician Dr. Carlo Urbani identified SARS as a new disease in 2003. He diagnosed it in a 48-year-old businessman who had traveled from the Guangdong province of China, through Hong Kong, to Hanoi, Vietnam. The businessman and the doctor who first diagnosed SARS both died from the illness.
In the meantime, SARS was spreading. Quickly it infected thousands of people around the world, including people in Asia, Australia, Europe, Africa, and North and South America. Schools closed throughout Hong Kong and Singapore. National economies were affected.
The WHO identified SARS as a global health threat, and issued a travel advisory. WHO updates closely tracked the spread of SARS. It wasn't clear whether SARS would become a global pandemic.
The fast global public health response helped to stem the spread of the virus. By June 2003, the number of new cases was down enough that on June 7, the WHO stopped its daily reports. But even though the number of new cases dwindled and travel advisories began to be lifted, every new case had the potential to spark another outbreak.
SARS appears to be here to stay. It has changed the way that the world responds to infectious diseases during a time of widespread international travel. The 2003 outbreak had an estimated 8,000 cases and 750 deaths. Deaths occurred mainly in older patients. 

The hallmark symptoms are:

• Cough
• Difficulty breathing
• Fever greater than 100.4 degrees F (38.0 degrees C)
• Other breathing symptoms

The most common symptoms are:

• Chills and shaking
• Cough -- usually starts 2-3 days after other symptoms
• Fever
• Headache
• Muscle aches

Less common symptoms include:

• Cough that produces phlegm (sputum)
• Diarrhea
• Dizziness
• Nausea and vomiting
• Runny nose
• Sore throat

In some people, the lung symptoms get worse during the second week of illness, even after the fever has stopped.

People who are thought to have SARS should be checked right away by a health care provider. If they are suspected of having SARS, they should be kept isolated in the hospital.
Treatment may include:

• Antibiotics to treat bacteria that cause pneumonia
• Antiviral medications (although how well they work for SARS is unknown)
• High doses of steroids to reduce swelling in the lungs
• Oxygen, breathing support (mechanical ventilation), or chest therapy

In some serious cases, the liquid part of blood from people who have already recovered from SARS has been given as a treatment.
There is no strong evidence that these treatments work well. There is evidence that the antiviral medication, ribavirin, does not work.
The death rate from SARS was 9 to 12% of those diagnosed. In people over age 65, the death rate was higher than 50%. The illness was milder in younger patients.
Many more people became sick enough to need breathing assistance. And even more people had to go to hospital intensive care units.
Public health policies have been effective at controlling outbreaks. Many nations have stopped the epidemic in their own countries. All countries must continue to be careful to keep this disease under control. Viruses in the coronavirus family are known for their ability to change (mutate) in order to spread among humans.

 possible complications

• Respiratory failure
• Liver failure
• Heart failure