Definition:
Severe acute respiratory syndrome (SARS) is a
communicable viral disease, caused by a new
strain of coronavirus, which differs considerably
in genetic structure from previously recognized
coronavirus.
Highly contagious atypical pneumonia
Transmission: primarily through droplet infection,
surface contamination & Airborne.
Incubation period is 2 - 10 days.
Epidemiological Patterns:
• First reported in February 2003 in
Asia through a major outbreak
• No outbreak of SARS seen after that
through other forms such as MERS
(Middle East Respiratory Syndrome)
seen.
Cumulative number of cases of SARS and deaths globally and in Asian-Pacific
Region, November , 2002—August 7, 2003
Host (pt)
Age, Medical Conditions,
occupation
Environmental factors Agent
Cold, weather, Crowdedness, SARS-COV-1
sanitation
Host:
• Genetically: HLA was identified to be correlated to SARS
susceptibility.
• Age : Higher incidence was seen among older age group (
>60 yrs.).
• Sex : Male were more likely to be affected.
• Behavior: Smoking.
• Occupation: Health workers at more risk.
• Residency: Endemic area.
• Comorbid disease associated with high mortality rate.
• Variation in host response to infection.
Agent:
• SARS Coronavirus (SARS-CoV).
• Is RNA virus of coronaviridae family.
Environment:
• Overcrowdings
Primary prevention:
Health education
Personal protective measures
Immunization
Role and regular polices
Regular medical examination
Secondary prevention:
Screening through case definition and Investigations
Diagnosis and treatment
Tertiary prevention:
Disability and rehabilitation
Toward the patient:
Surveillance
Notification
Isolation
Diagnosis And treatment
Toward at risk population:
Screening
Vaccination
Toward population:
Vaccination
Study and survey
Toward environment:
Environmental sanitation
Etiology and Transmission
- Etiological agent: SARS Corona ( SARS-CoV)
- Transmission: primarily through droplet infection
.Other source: surface contamination and Air_borne
- Incubation period is 2 - 10 days
Pathophysiology, Clinical features and Diagnosis
- Pathophysiology: complex processes leading to degradation of
organs
* primary target : lungs and intestines ( epithelial cells, villi,
alveolli)
* Immune system: sever lymphocyte depletion
- Clinical features: fever,myalgia,headache,dry non-productive
cough,
others: Diarrhea(25%), shortness of breath, hypoxemia
- Diagnosis: CXR, pulse oximetry, blood culture, sputum gram
stain and culture, ....etc.
- Treatment: supportive care, infection control measures and broad-
spectrum antibiotics.
- Complications: risk of co-infection, comrbidities, respiratory
failure.
* Most cases occurred in :
• China
• Taiwan
• Canda
• Singapore
• Vietnam
• Philippines
• Some parts of Europe
Boulos International Journal of Health Geographics 2004