Transcript SARS - HowToExam

SARS
Severe acute respiratory
syndrome.
SARS
 SARS is a communicable viral disease caused by a new strain
of coronavirus.
 The most common symptoms in patient progressing to SARS
include fever , chills , headache myelgia , dizziness , cough
sore throat and running nose.
 In some cases there is rapid deterioration with low oxygen
saturation and acute respiratory distress requiring ventilatory
support.
 Chest X-ray findings typically begin with a small , unilateral
patchy shadowing and progress over 1-2 days to become
bilateral and generalized with interstitial or confluent
infiltration .
PROBLEM STATEMENT
 The earliest case was traced to a health care worker
in China in late 2002 , with rapid spread to Hong
Kong , Singapore ,
Vietnam , Taiwan and Toranto.
As of early August 2003, about 8422 cases were
reported to WHO from 30 countries with 916
fatalities.
INCUBATION PERIOD
The incubation period has been estimated to be 2 to
7 days , comonly 3 to 5 days .
MODE OF TRANSMISSION
 Close contact with the patient and infected material
via the eyes , nose and mouth , with infectious
respiratory droplets .
 In Hong Kong sewage, faeces and cockroaches were
suspected transmitters .
 The SARS virus can survive for hours on common
surfaces outside the human body , and up to 4 days
in human waste.
 The virus can survive at least for 24 hours on plastic
surface at room temperature , and can live for
extended periods in the cold.
CASE DEFINITION
 Is based on current understanding of the clinical
features of SARS , and the available epidemiological
data and may be revised as new information
accumulates .
SUSPECT CASE
1.
A person presenting after 1st November 2002 with
history of:
- High fever (>38 degree C) and
-Cough or breathing difficulty and one or more of the
following exposures during the 10 days prior to onset
of symptoms:
-close contact with a person who is a suspect or
probable case of SARS
-history of travel to a SARS affected area.
 2. A person with an unexplained acute respiratory illness
resulting in death after 1st November 2002, but on whom no
autopsy has been performed.
and one or more of the following exposures during 10 days
prior to the onset of symptoms:
-close contact with a person who is a suspect or probable case
of SARS.
-history of travel to an affected area or residing in affected
area.
PROBABLE CASE
1. A suspect case with radiographic evidence of infiltrates
consistent with pneumonia or respiratory distress
syndrome on chest X-ray.
2. A suspect case with autopsy finding consistent with the
pathology of respiratory distress syndrome without an
identifiable cause.
Exclusion criteria
A case should be excluded if an alternative diagnosis can fully
explain the illness.
EPIDEMIOLOGICAL ASPECT
Maximum virus excretion from the respiratory tract
occurs on about day 10 of illness and then declines .
The efficiency of transmission appears to be greatest
following exposure to severely ill patients usually
during the second week of illness.
Children are rarely affected by SARS. To date, there have
been 2 reported cases of transmission from children to
adults and no report of transmission from child to child.
International flights have been associated with the
transmission of SARS from symptomatic probable cases
to passengers or crew.
PREVENTION
1. Prompt identification of persons with SARS , their
movements and contacts.
2.effective isolation of SARS patients in hospitals.
3.appropriate protection of medical staff treating these
patients.
4.comprehensive identification and isolation of suspected
SARS cases.
5.exit screening of international travelers.
6.timely and accurate reporting and sharing of information
with other authorities and governments.
TREATMENT
There is no specific treatment for SARS. No clinical
improvement has been attributable to the use of antibioics.
The antiviral agents ribavirin given intravenously in
combination of high dose of corticosteroids may have been
responsible for some clinical improvement.