Vivek College of Ayurvedic Science and Hospital
(Bijnor)
Topic:- Severe Acute Respiratory Syndrome (SARS)
Submitted to:- Submitted by:-
Dr. Sumit Kumar Vishnoi Archika chauhan
(Assistant professor) BAMS 2ND PROF
Roll no: 13
Distribution Of The Disease
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 8,422 cases were
reported to the WHO from 30 countries with 916 fatalities
Epidemiological Factors-
1. Agent Factor
2. Host Factor
3. Environmental Fact
Agent factors -
1. Agent- A species of coronavirus (RNA Virus) - SARS Coronavirus (SARS-CoV).
As now a newest strain of coronavirus (SARS-CoV-2) is causing the 2019-2020 pandemic of coronavirus
Infection disease 2019 (COVID-19). The first case of SARS- CoV-2 is reported in humans in the Wuhan city
of China in December 2019 (See in the chaper of Re-emerging diseases - Page No. 358). The SARS-CoV-1
will be considered here.
2. Source of infection - Human cases.
3. Infective material - Nasopharyngeal and bronchial or Oropharyngeal secretions
Host factors -
• 1. Age - All age group.
• 2. Sex - Both male and female are involved but more in males.
• 3. Immunity - No natural immunity.
Environmental Factors
Winter season favors the spread of disease.
Incubation period 2 to 7 days, commonly 3 to 5 days.
Mode of Transmission
Direct or indirect contact of mucous membranes of eyes, nose, or mouth with respiratory droplets or
fomites.
The SARS virus can survive for hours on common surfaces outside the human body, and up to four
days in human waste.
Clinical features -
1. Fever (>38°C)
2. Malaise.
3. Chills.
4. Headache.
5. Myalgia.
6. Dizziness.
7. Cough.
8. Sore throat.
9. Running nose.
Case definition-
1. A history of fever.
2. One or more symptoms of LRTI such as cough, difficulty in breathing, shortness of breath.
3. Radiographic evidence of lung infiltrates consistent with pneumonia or acute respiratory distress
syndrome (ARDS) or autopsy findings consistent with the pathology of pneumonia or ARDS without an
identifiable cause.
4. Close contact with a person who is a suspect or probable case of SARS.
5. History of travel to a SARS affected area or residing in an affected area during the 10 days prior to onset of
symptoms.
6. No alternative diagnosis fully explaining the illness.
Diagnostic tests required for laboratory confirmation of SARS-
A. Conventional reverse transcriptase PCR (RT-PCR) and real-time re transcriptase PCR (real-time RT assay detecting
viral RNA present in at least 2 different clinical specimens. such as nasopharyngeal and stool specimens.
B. Enzyme-linked immunosorbent assay (ELISA) and immunofluorescent assay (IFA).
Complications-
1. Pulmonary decompensation.
2. ARDS occurs in about 16% patients, and about 20-30% of patients require intubation and mechanical
ventilation.
Treatment-
The antiviral ribavirin given intravenously in combination with high dose of corticosteroid shows some
clinical improvement, otherwise there is no specific treatment for SARS. Only symptomatic and supportive
treatment is given to the patient.
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. (use of PPE kit)
4. identification and isolation of suspected SARS cases.
5. Simple hygienic measures such as hand- washing after touching patients, use of appropriate and well
fitted mask.