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Alternative Medicine That Works for Regular Folks

Updated May 2, 2003





Pneumonia... SARS: Severe Acute Respiratory Syndrome
by Brian Benjamin Carter, M.Sci, L.Ac.

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What is SARS?

SARS is a respiratory illness of unknown cause that has recently been reported in Asia, North America and Europe. The disease began in China and has spread to Hong Kong, Vietnam, Singapore, Canada, Germany, Japan, United States, France and Britain.

SARS appears to be caused by a new type of coronavirus.

How Worried Should I Be?

There is no known treatment, and 3% of reported cases have died from it. It spreads like a common cold; by close contact only, most probably via airborne droplets. Most new cases have been reported in healthcare workers and family members of people who have it.

How Many People Have It?

(As of March 27, 2003) Health officials in Singapore have quarantined 861 people with flu-like symptoms and have closed all schools until April 6. Chinese authorities officially reported yesterday a total of 792 severe acute respiratory syndrome (SARS) cases and 31 deaths that occurred in seven cities of Guangdong Province between November 16, 2002, and February 28, 2003.

The U.S. Centers for Disease Control and Prevention (CDC) is now reporting a total of 45 suspected U.S. cases in 20 states, up from 39 cases on March 25.

Pneumonia Symptoms: How do I know if I have it?

The illness begins generally with a fever greater than 100.4°F [>38.0°C]. The fever is sometimes associated with chills or other symptoms, including headache, malaise, and body aches. Some persons also experience mild respiratory symptoms at the outset.After 3 to 7 days, the person may develop a dry, nonproductive cough that might be accompanied by or progress to the point where insufficient oxygen is getting to the blood. In 10%--20% of cases, patients will require mechanical ventilation.

Go to the CDC for the up-to-date "Case Definition" for SARS.

What do I do if I think I have SARS?

Call your doctor and describe your symptoms. Tell them you think you may have SARS. Your doctor will have to save your sputum (what you cough up) and blood for testing. If you meet the criteria for SARS, you should be admitted to the hospital. Your doctor's initial diagnostic testing should include chest x-rays, pulse oximetry, blood cultures, sputum Gram's stain and culture, and testing for viral respiratory pathogens, notably influenza A and B and respiratory syncytial virus (RSV).

If I have SARS, can I treat it myself with antibiotics?

"Numerous antibiotic therapies have been tried to date with little clear effect. Ribavirin with or without use of steroids has been used in an increasing number of patients. But in the absence of clinical indicators, its effectiveness has not been proven. Currently the most appropriate management measures are general supportive therapy, insuring the person is hydrated and treated for subsequent infections."

You need to be managed by professionals- this is a dangerous and unpredictable pneumonia.

What About a Vaccine?

There is currently no vaccine or specific cure for this strain of pneumonia, but Hong Kong doctors have been treating patients with ribavirin and steroids. Experience showed 70% of patients would improve if treated in good time, Professor Peiris said.

Herbal formulas have been reported to possibly prevent the SARS virus from infecting healthcare workers. More on that in the follow-up article, "Chinese Herbs to Prevent the Deadly SARS Pneumonia."

Viral Infection: What Causes SARS?

The director of the US Centers for Disease Control and Prevention, Dr. Julie Gerberding, reported that the agency now has "very strong evidence supporting coronavirus in the etiology of severe acute respiratory syndrome or SARS."

"We know from sequencing pieces of the virus DNA that it is not identical to the coronaviruses that we have seen in the past. This may very well be a new or emerging coronavirus infection, but it is very premature to assign a cause," Dr. Gerberding told reporters.

What Tests Will My Doctor Use to Diagnose It?

Initial diagnostic testing should include chest radiograph, pulse oximetry, blood cultures, sputum Gram's stain and culture, and testing for viral respiratory pathogens, notably influenza A and B and respiratory syncytial virus. Clinicians should save any available clinical specimens (respiratory, blood, and serum) for additional testing until a specific diagnosis is made. Clinicians should evaluate persons meeting the above description and, if indicated, admit them to the hospital. Close contacts and healthcare workers should seek medical care for symptoms of respiratory illness.

If I'm a healthcare provider, and I think my patient has it, what should I do?

If your patient fits the case definition, send them to the hospital and report the case to your local or state health department.

For more information, contact either your state or local health department or the CDC Emergency Operations Center at 770-488-7100.

Links for up-to-date info:

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All information herein provided is for educational use only and not meant to substitute for the advice of appropriate local experts and authorities.
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