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'SARS is a new disease which
has its origins in Guangdong Province, China. The earliest known cases
were identified in mid-November 2002.' 1 SARS is an acute respiratory infection that has recently been reported
in a number of regions, including Hong Kong, and SARS is a form of atypical
pneumonia caused by a new agent,
2
Department of
Health stated.
The following is the preliminary
clinical description of severe acute respiratory syndrome
from World
Health Organization.
Severe Acute Respiratory Syndrome
(SSARSSS)
is a disease of
unknown etiology that has been described in patients in Asia, North
America, and Europe. The information in this report provides a summary of
the clinical characteristics of SARS
patients treated in Hong Kong Special
Administrative Region (China), Taiwan (China), Thailand, Singapore, the
United Kingdom, Slovenia, Canada and the United States since mid-February
2003. This information is preliminary and subject to limitations because
of the broad and non-specific case definition.
Most patients identified as of March 21, 2003 have been
previously healthy adults aged 25-70 years. A few suspected cases of
SARS have been reported among children (≤15 years).
The incubation period of SARS is usually 2-7 days but may
be as long as 10 days. and the illness generally begins with a fever (>38°C), which is often high, sometimes associated with chills and
rigors and sometimes accompanied by other symptoms including headache,
malaise, and myalgias. At the onset of illness, some cases have mild
respiratory symptoms. Typically, rash and neurologic or gastrointestinal
findings are absent, although a few patients have reported diarrhoea
during the febrile prodrome.
After 3-7 days, a lower respiratory phase begins with the
onset of a dry, non-productive cough or dyspnea that may be accompanied by
or progress to hypoxemia. In 10%-20% of cases, the respiratory illness is
severe enough to require intubation and mechanical ventilation. The case
fatality among persons with illness meeting the current WHO case
definition for probable and suspected cases of SARS is around 3%.
Chest radiographs may be normal during the febrile
prodrome and throughout the course of illness. However, in a substantial
proportion of patients, the respiratory phase is characterized by early
focal infiltrates progressing to more generalized, patchy, interstitial
infiltrates. Some chest radiographs from patients in the late stages of SARS
have also shown areas of consolidation.
Early in the course of disease, the absolute lymphocyte
count is often decreased. Overall white cell counts have generally been
normal or decreased. At the peak of the respiratory illness, up to half of
patients have leukopenia and thrombocytopenia or low-normal platelet
counts (50,000 – 150,000 / μl). Early in the respiratory phase,
elevated creatine phosphokinase levels (up to 3000 IU / L) and hepatic
transaminases (2- to 6-times the upper limits of normal) have been noted.
Renal function has remained normal in the majority of patients.
Treatment regimens have included a variety of antibiotics
to presumptively treat known bacterial agents of atypical pneumonia. In
several locations, therapy has also included antiviral agents such as
oseltamivir or ribavirin. Steroids have also been given orally or
intravenously to patients in combination with ribavirin and other
antimicrobials. At present, the most efficacious treatment regime, if any
is unknown. 3 Reference
1 Severe
Acute Respiratory Syndrome (SARS)
Website:
http://www.phls.co.uk/topics_az/SARS/health_professional_page.htm
2
Atypical Pneumonia - Frequently Asked Questions [What is severe acute respiratory syndrome (atypical
pneumonia)?]
Website:
http://www.info.gov.hk/dh/ap.htm
3 Preliminary Clinical Description of Severe Acute
Respiratory Syndrome
Website:
http://www.who.int/csr/sars/clinical/en/
[SARS Characteristic] [SARS Disease] [SARS Prevention] [SARS Symptom] [SARS Transmission]
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