S E C T I O N S

Special Topic...

Severe Acute Respiratory Syndrome (SARS)

What is SARS? 
SARS is a respiratory illness that has recently been reported in Asia, North America, and Europe.

What are the symptoms and signs of SARS? 
The illness usually begins with a fever (greater than 100.4° F). The fever is sometimes associated with chills, headache, general feeling of discomfort, and body aches. Some people also experience mild respiratory symptoms at the onset.

After 2 to 7 days, SARS patients 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% to 20% of cases, patients will require mechanical ventilation.

If someone were to be exposed to SARS, the incubation period (the time it takes to become sick) is typically 2-7 days and on isolated cases as long as 10 days. If you suspect that you may have been exposed to SARS, you should consult a health care provider. Be sure to tell him or her about any recent travel to regions where cases of SARS have been reported and whether you were in contact with someone who had these symptoms.

What medical treatment is recommended for patients with SARS? 
The Center for Disease Control (CDC) currently recommends the same treatment that would be used for any patient with serious community-acquired atypical pneumonia of unknown cause. Reported therapeutic regimens have included antibiotics to treat known bacterial agents of atypical pneumonia, antiviral agents such as oseltamivir or ribavirin, steroids in combination with ribavirin and other antimicrobials.

How is SARS spread? 
The principal way SARS appears to be spread is through droplet transmission: namely, when someone sick with SARS coughs or sneezes droplets into the air and someone else breathes them in. It is possible that SARS can be transmitted more broadly through the air or from objects that have become contaminated.

How long is a person with SARS infectious to others? 
Information to date suggests that people are most likely to be infectious when they have symptoms, such as fever or cough. However, it is not known how long before or after their symptoms begin that patients with SARS might be able to transmit the disease to others.

Who is most at risk of contracting SARS? 
Cases of SARS continue to be reported primarily among people who have had direct close contact with an infected person, such as those sharing a household with a SARS patient and health care workers who did not use infection control procedures while caring for a SARS patient. In the United States, there is no indication of community transmission at this time and CDC continues to monitor this situation very closely.

What causes SARS? 
Scientists at CDC and other laboratories have detected a previously unrecognized coronavirus in patients with SARS which is the leading hypothesis for the cause of SARS. Other viruses are still under investigation as potential causes. Coronaviruses are a common cause of mild to moderate upper-respiratory illness in humans, and can cause respiratory, gastrointestinal, liver and neurologic disease in animals. Coronaviruses can survive in the environment for as long as three hours.

Is there a test for SARS? 
No "test" is available yet for SARS; however, CDC, in collaboration with other laboratories, has developed 2 research tests that appear to be very promising in detecting antibodies to the new coronavirus. CDC is working to refine and share this testing capability as soon as possible with laboratories across the United States and internationally.

What is CDC doing to prevent and control the spread of SARS among persons traveling by plane? 
CDC's quarantine inspectors or their designees are distributing health alert cards to air passengers returning in airplanes either directly or indirectly to the United States from China, Singapore, and Vietnam. The travelers are advised to monitor their health for 10 days and see a doctor if they get a fever with a cough or have difficulty breathing.

Is there any reason to think SARS is or is not related to terrorism? 
Information currently available about SARS indicates that people who appear to be most at risk are either health care workers taking care of sick people or family members or household contacts of those who are infected with SARS. That pattern of transmission is what would typically be expected in a contagious respiratory or flu-like illness.

What has CDC recommended to prevent transmission of SARS in households? 
CDC has developed interim infection control recommendations for patients with suspected SARS in the household. The basic precautions include the following: 

• Infection control precautions should be continued for SARS patients for 10 days after respiratory symptoms and fever are gone. SARS patients should limit interactions outside the home and should not go to work, school, out-of-home day care, or other public areas during the 10-day period. 

• During this 10-day period, all members of the household with a SARS patient should carefully follow recommendations for hand hygiene, such as frequent hand washing or the use of alcohol-based hand rubs. 

• Each patient with SARS should cover his or her mouth and nose with a tissue before sneezing or coughing. If possible, a person recovering from SARS should wear a surgical mask during close contact with uninfected persons. If the patient is unable to wear a surgical mask, other people in the home should wear one when in close contact with the patient. 

• Disposable gloves should be considered for any contact with body fluids from a SARS patient. However, immediately after activities involving contact with body fluids, gloves should be removed and discarded, and hands should be washed. Gloves should not be washed or reused, and are not intended to replace proper hand hygiene. 

• SARS patients should avoid sharing eating utensils, towels, and bedding with other members of the household, although these items can be used by others after routine cleaning, such as washing or laundering with soap and hot water. 

• Common household cleaners are sufficient for disinfecting toilets, sinks, and other surfaces touched by patients with SARS, but the cleaners must be used frequently. 

• Other members of the household need not restrict their outside activities unless they develop symptoms of SARS, such as a fever or respiratory illness.

Source: Centers for Disease Control and Prevention