Severe Acute Respiratory Syndrome

Severe Acute Respiratory Syndrome(SARS) : 

Severe Acute Respiratory Syndrome(SARS) By Dr.V.Sudhakaram M.B.B.S,PGDPHM

Objectives : 

Objectives Epidemiology Clinical manifestations Laboratory Diagnosis Management Surveillance prevention

EPIDIMEOLOGY : 

EPIDIMEOLOGY New epidemic emerged in 2003 WHO identifies SARS as Global Health Threat The rapid Global public health response helped to stem the spread of virus and by June 7th 2003 The WHO backed Off from its daily reports By July 2003 there are >8000 SARS cases and > 780 deaths reported from 29 countries across The World

The Indian Scenario : 

The Indian Scenario The first confirmed case of SARS was reported from GOA in a marine engineer who had H/O of Hong Kong travel

Agent Factors : 

Agent Factors SARS caused by Mutated Corona Virus

Contd… : 

Contd… Mode of Transmission: Droplet Infection, Air borne Infection, Virus is present in stools of the SARS patients Virus can live months or years when the temperature is below freezing Re-Infection is very common Incubation Period : between 2 and 10 days Case Fatality Rate was 10% As per CDC (3% according to CD Alert) So Far No reservoir was found

Clinical Manifestations : 

Clinical Manifestations Hall Mark Symptoms:- Fever > 100.4 F(38.0Degrees C) Cough Difficulty in Breathing Other Minor Symptoms:- Chills and shaking Muscle aches Headache Dizziness Diarrhea Sore Throat Productive Cough

Diagnosis : 

Diagnosis Atypical Pneumonia in CXR

Contd….. : 

Contd….. Swabs from Nose and Throat to identify virus ELISA (detects Abs only after 21 days of onset of symptoms) Immunoflourescence assay (Detects Abs after 10 days of onset of symptoms) PCR (very Specific but not very sensitive)

Management : 

Management Antibiotics High dose steroid therapy Antiviral drugs shows some activity against SARS Mechanical ventilation Oxygen therapy Chest physiotherapy Isolation of cases

prevention : 

prevention Reduce International traveling Screening at Air ports Hand Hygiene is most Imp. Part of SARS prevention (CDC) Cover the mouth and nose when sneezing and coughing (masks)

surveillance : 

surveillance Suspect case 1.   A person presenting after 1 November 2002 with history of: -  high fever (>38 °C) -   cough or breathing difficulty one or more of the following exposures during the 10 days prior to onset of symptoms: close contact2 with a person who is a suspect or probable case of SARS; -  history of travel, to an area with recent local transmission of SARS -  residing in an area with recent local transmission of SARS

Contd…. : 

Contd…. Probable case 1.  A suspect case with radiographic evidence of infiltrates consistent with pneumonia or respiratory distress syndrome (RDS) on chest X-ray (CXR). 2.   A suspect case of SARS that is positive for SARS coronavirus by one or more assays. See Use of laboratory methods for SARS diagnosis.3.   A suspect case with autopsy findings consistent with the pathology of RDS without an identifiable cause.

Thank you : 

Thank you