piratory SARS (1).ppt HEALTH EDUCATION About SEvere res[

SARS

1. SARS

2. What is SARS?
•Severe Acute Respiratory Syndrome
•Respiratory illness
•Asia, North America, and Europe
•Previously unrecognized coronavirus

3. Symptoms
•Fever of greater than 100.4
o
F
•Cough or difficulty breathing
•Headache
•Body aches

4. Spread of SARS
•Primary method appears to be close
person-to-person contact
•Potentially by fomites, or air-borne
routes

5. Incubation period for SARS
•2-7 days
•May be as long as 10 days

6. Who is at risk?
•Most US cases occur in travelers with
history to areas with ongoing
transmission
•China, Hong Kong, Singapore, Hanoi
•Household contacts of people with SARS
•Healthcare workers exposed to SARS
patients

7. Case Definition
•Clinical Criteria
•Epidemiologic Criteria
•Laboratory Criteria

8. Clinical Criteria
•Asymptomatic or mild respiratory
illness
•Moderate respiratory illness
•Severe respiratory illness
•Radiographic evidence of pneumonia OR
•Respiratory distress syndrome

9. Epidemiologic Criteria
•Travel (including transit in an airport)
within 10 days of onset of symptoms to an
area with current or recently documented
or suspected community transmission of
SARS
•Close contacts within 10 days of onset of
symptoms with a person known or
suspected to have SARS infection

10. Laboratory Criteria
•Confirmed
–Detection of SARS-CoV antibody less than 21
days after the onset of illness or
–Detection of SARS-CoV RNA using RT-PCR
then confirmed using a second PCR assay
using separate specimens and primers
–Isolation of SARS-CoV
•Negative
–Absence of antibody in convalescent sera
obtained more than 21 days after onset of
symptoms.
•Undetermined
–laboratory testing not preformed or incomplete

11. Case Classification
•Probable Case:
–meets the clinical criteria for severe
respiratory illness of unknown etiology with
onset since 2/13/03 and epidemiologic criteria
and laboratory criteria confirmed, negative or
undetermined.
•Suspect Case:
–meets the clinical criteria for moderate
respiratory illness of unknown etiology with
onset since 2/13/03 and epidemiologic criteria
and laboratory criteria confirmed, negative, or
undetermined.

12. Treatment of SARS
•Should be similar to that used for
patients affected with serious
community acquired atypical
pneumonia
•Antivirals and steroids have not been
tested in clinical trails and their
effectiveness is unknown

13. Mortality of SARS
•As of 5/15/03 8% overall
0 to 50% depending on the age group
–Overall 14-15%
Canada: 15-19%
China: 3-13%
Hong Kong: 11-17%
Singapore: 13-15%
Vietnam: 8%

15. Travel
•Travel Alert-Informs travelers of a health
concern in a particular area
No recommendation against nonessential
travel to the area.
Singapore, Hanoi, Toronto (WHO removed
Toronto as of 5/14, CDC still lists Toronto as area
under Travel alert)
•Travel Advisory-Potentially more serious
situation
There is a recommendation against
nonessential travel to the area
China, Hong Kong, and Taiwan

16. Quarantine
•CDC quarantine officers are
distributing health alert cards to all
passengers returning from areas on
travel alerts or advisories
•Cards inform travelers about SARS,
asked to monitor health for 10 days
•Procedures for airlines and ships

17. Cumulative # of Reported Probable
Cases in Selected Countries
Country Total # of
Cases
# of Deaths
Canada 143 23
China 5124 267
Hong Kong 1698 227
Singapore 205 28
Thailand 8 2
United States65 0
Vietnam 63 5

18. Michigan cases
•3 suspect cases as of 5/15/03
•All with travel history to Asia
•All have recovered

19. Misconceptions
•No reason to believe related to
terrorist activities
•Does not appear to be caused by a
paramyxovirus
•No travel restrictions, instead travel
advisories and alerts
•No evidence of spreading disease
within the USA

20. References
•www.cdc.gov
•www.cdc.gov/mmwr/
•www.who.int/en/