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