Sars: Global update, A BBC Story
Severe
Acute Respiratory Syndrome (SARS)
By Dr
Trisha Macnair
What causes SARS?
What are the symptoms of SARS?
Doctors use the internet to share
information
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HOTSPOTS: KNOWN DEATH TOLLS
Mainland China: 327 (328)
Hong Kong: 273 (274)
Taiwan: 81
Singapore: 31
Canada: 26 (29)
Source: WHO/local health
authorities
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| Tune in: Horizon |
Sars has shaken the world. Stock markets
have crashed, millions have fled infected countries and panic
has swept the globe. But have we overreacted to the strange
pneumonia-like disease?
Horizon
travels to countries that have been struck and speaks to the
World Health Organisation.
Thursday 29 May 2003, BBC2 9pm
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News of an unidentified and potentially fatal respiratory infection
spreading from South East Asia has sent shivers down the spine of many
health professionals. For some it rang warning bells of the long
heralded arrival of a new form of flu
that might have the potential to repeat the epidemic that killed
millions around the world in the early 20th century. For others it
brought back memories of the early days of HIV
and AIDS, when unusual and severe lung infections were one of the
major features of a mysterious new illness that couldn't be explained
by the medical knowledge of the day.
The syndrome first appeared in the Guangdong
province of China in November 2002 but was not reported to the World
Health Organisation (WHO) at that time. Then one of the doctors who
had been treating people with the syndrome, a Chinese professor of
respiratory medicine, became ill. Travelling to Hong Kong, he carried
the highly contagious virus that causes SARS with him, leading to an
explosion of cases in the province towards the end of February 2003.
Since then, in just a few weeks, international
air travel has spread it around the world. By the end of March 2003 a
total of 1,622 cases and 58 deaths had been reported (for updated
figures see the World Health Organisation (WHO) site: www.who.int/csr/sars/en/).
Cases have been reported in China, Canada,
Italy, Thailand, the UK, the USA and many other countries. In four of
these countries, including the UK, there have only been 'imported
cases' in travellers from abroad, with no known local transmission.
This means that the disease is not spreading in these countries and
residents of the country are not at risk.
But despite early reports that the outbreak had
peaked and the number of those infected was falling, new reports
(including an outbreak in a Hong Kong apartment block) are causing
renewed concern. In the USA, the Center for Disease Control and
Prevention (CDC) has said that the new developments may point to what
could become a much larger epidemic. The CDC have useful advice on
SARS and how to prevent it at www.cdc.gov/ncidod/sars/faq.htm#illness.
What causes Severe Acute
Respiratory Syndrome (SARS)?
Severe Acute Respiratory Syndrome (SARS) doesn't
seem to be related to influenza, and it certainly has nothing to do
with HIV, but scientists have yet to pin down exactly what infectious
organism is to blame.
The prime suspect at the moment is a type of
virus called a coronavirus which is known to cause respiratory
infections. But scientists who have sequenced the DNA of the virus say
that it is not identical to known coronaviruses seen before, and it
may be a new strain. Alternatively there may be a combination of
different infectious organisms, especially in severe cases.
Researchers in Hong Kong have developed a test
to rapidly identify cases of SARS based on a coronavirus test, and
have recommended that the syndrome is renamed 'coronavirus pneumonia'
or CVP.
What are the symptoms of
SARS?
| Symptoms
of Severe Acute Respiratory Syndrome |
The main symptoms
of SARS are:
High fever (> 38°C).
Dry cough.
Breathing difficulties or shortness of breath.
Headache.
Muscular aches and stiffness.
Loss of apetite.
Malaise or tiredness
Confusion.
Rash.
Diarrhoea.
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The symptoms of SARS are the typical symptoms of a
severe respiratory infection. There have only been a few cases of SARS
reported in the UK so far, so if you have symptoms like these it is
far more likely that you don't have SARS but instead have a more
typical form of pneumonia usually seen in this country (more on
pneumonia at www.lunguk.org/info/Lung2_pneumonia.pdf.)
However if you have recently returned from abroad, particularly South
East Asia where the outbreak began, you may be at risk.
For SARS to spread there must be close contact
with an infected person. Most of those who have developed SARS in
South East Asia have been either hospital workers caring for SARS
patients, or close family members based in those countries. However,
because of the speed of international travel, cases have rapidly
spread around the world. SARS appears to be less infectious than
influenza, and the incubation period is short, from 2-7 days.
Doctors use the internet
to do a global 'ward round' of cases
Responding to urgent worries about the syndrome,
the World Health Organisation set up a 'virtual grand round' which
allowed doctors around the world to discuss their patients with the
condition and share information.
There was general agreement among the doctors
that there is no particular treatment that appears to be especially
effective against SARS. Many antibiotics have been tried with little
effect. Antiviral drugs such as ribavirin (used with or without
steroids) have been used in an increasing number of cases but the
value of this therapy has not been proven. However, with supportive
care the majority of patients start to show improvement by day 6 or 7
of the infection. But the doctors on the global ward round agreed that
about 10% of patients with SARS get rapidly worse and need mechanical
help (i.e. a ventilator) to breathe. In this group of people there are
more likely to be other illnesses which complicate the syndrome, and
it is more likely to prove fatal (about 4% of those who develop SARS
die).
Although there is no specific treatment and SARS
is causing considerable concern, scientists are confident that by
keeping a close watch on cases around the world and rapidly isolating
new cases, they have already managed to prevent some further
outbreaks.
| Top Tips |
If you or one of your family develop symptoms of breathing
problems of any sort, talk to your doctor as soon as possible.
Try not to worry too much about SARS - it is still very rare
especially if you haven't been abroad recently.
If you have recently travelled, particularly to countries like
China or Hong Kong, you may be at greater risk.
The Department of Health now recommend that people travelling
to Hong Kong Special Administrative Region of China and
Guangdong Province, China should postpone all but essential
travel until more is known about SARS (see www.phls.org.uk/press_media/press_releases/archive/03pr/04032pr.htm
for further information). There is not yet any need to cancel
or change travel arrangements to any other country. |
To keep up-to-date with the latest news about
SARS, keep an eye on BBC
Health News.
You can talk to others about SARS on our Hot
Topics message board
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