SARS.
When we think of a virus, the flu virus is the first that comes to mind.
There are over-the-counter medications and other forms of prevention, but how
do we protect ourselves from a virus when we don't even know where it comes from
or how to prevent it? The SARS virus is slowly creeping into the United States,
and quickly festering itself throughout the world. Will it find its way to Wisconsin?
How can we protect ourselves? What precautions do we need to take when we travel?
It's time that we all learn a little more about SARS.
What is SARS? SARS stands for Severe Acute Respiratory
Syndrome, which is a constellation of symptoms that center around a respiratory
and flu-like illness. The cause
of SARS has been in question, but recent reports from the Center for Disease
Control (CDC) have identified a virus called coronavirus with most cases being
reported in Asia, Europe and North America.
What are the symptoms? The symptoms of SARS are very
nonspecific and may mimic other respiratory illnesses. The illness will usually
begin with a fever, which
is considered a temperature greater than 100.4 degrees Fahrenheit. Chills may
follow the fever. Additionally, a patient may experience a headache and generalized
aches and pains. Initially, the respiratory symptoms may be mild.
As the disease process progresses, the patient may develop a dry, nonproductive
cough. The respiratory illness will progress to a condition of hypoxia, whereby
there is lack of oxygen getting into the blood. The most severe patients may
require being placed on a ventilator, accounting for 20 percent of all cases.
The incubation period for SARS has been thought to be two to seven days. This
means that it may take more than a week for someone to develop symptoms after
they have been exposed to the virus. It may take longer to develop the dry cough
and difficulty breathing, as the progression of the disease may be from three
to 10 days after the development of the initial symptoms.
What are the risk factors? The primary risk for the
development of SARS is travel in an area that has the disease. Thanks to air
travel, we have seen an international
spread of the cases. At present, the areas of the world that have the highest
SARS cases include mainland China, Hong Kong, Singapore and Hanoi, Vietnam. Toronto,
Canada has also been identified as a high-risk area. At the time of this writing,
there have been nearly 250 documented cases in the United States. Wisconsin has
been one of the states with one suspected documented case. No state is immune
to this disease.
How does it spread? The spread of SARS occurs through
direct human-to-human contact. There needs to be travel to an endemic area and
then the disease is spread to
the home environment. People living with a SARS patient are at greatest risk.
The other potential methods of spread include touching the skin of SARS patients
or utensils that have been used. Respiratory droplets can be spread through coughing
as well. The ability of SARS to spread via broad general environmental contact
is not currently known.
What should I do? Most importantly, a health care
provider must see a patient that is suspect for SARS. A very accurate and detailed
travel history must be
obtained. Additionally, a comprehensive physical examination will be performed.
Baseline laboratory testing will be completed and a chest X-ray will be obtained.
This information will only assess the general health of the patient.
At present, there are no tests that can easily identify SARS. The diagnosis is
made on clinical grounds and travel history. The CDC is working on tests that
will identify antibodies for the disease. These tests would eventually be run
in the United States and internationally.
What is the treatment? At present, there is no actual
treatment for SARS, with the exception of supportive treatment including intravenous
rehydration, fever
control and respiratory support. None of the current antiviral agents are effective
in treating the disease.
More importantly, the prevention of the spread of the disease is essential. If
there is risk of exposure, stringent hygiene must be maintained. This includes
possible home quarantine for up to 10 days, frequent hand washing, use of respiratory
masks preventing spread of droplets, use of disposable rubber gloves and appropriate
disinfection of the home.
What else can I do? It is essential for everyone to
remain informed about the changing status of the disease. The CDC maintains surveillance
of the spread
of the disease and is the most up-to-date source. This information can be found
at www.cdc.gov.
As with so many medical conditions, it is important to see your health care provider
for evaluation and treatment. In the event that you feel that you have risk factors
such as having traveled into an endemic area, which was followed by symptoms
of a respiratory illness, you must seek medical attention!
