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SARS Severe Acute Respiratory Syndrome Virus FAQ


SARS - Severe Acute Respiratory Syndrome

SARS Definition: Synonyms SARS generally refers to severe acute respiratory syndrome
SARS Meaning: Severe acute respiratory syndrome (SARS) is an acute respiratory infectious disease caused by SARS coronavirus (SARS-CoV). The World Health Organization (WHO) named it severe acute respiratory syndrome. The disease is an infectious disease of the respiratory tract, the main mode of transmission is close-range droplet transmission or contact with respiratory secretions of patients.

Nickname:    Severe acute respiratory syndrome, SARS, SARS, atypical pneumonia, infectious atypical pneumonia



English alias:    severe acute respiratory syndrome, SARS

Treatment department:    Infectious Diseases

Common causes:    SARS Coronavirus infection

Common symptoms:    Fever, headache, muscle aches, respiratory failure

Infectious:    Yes

Way for spreading:    Close-up droplet transmission or contact with patients' respiratory secretions

Prevention of respiratory diseases in the elderly in winter
Elderly people should pay attention to prevent respiratory diseases in winter, so as not to delay the best treatment timing and cause serious consequences.

Disease Overview
Table of Content

  1.      Cause
  2.      Clinical manifestations
  3.      Check
  4.      Differential diagnosis
  5.      Treatment
  6.      Prevention

Basic Information

Etiology

On April 16, 2003, the World Health Organization announced that the cause of severe acute respiratory syndrome was one of the causes of a collaborative study of 13 laboratories in 11 countries and regions, including Mainland China and Hong Kong, Canada and the United States. 
A new type of coronavirus is called SARS coronavirus.

What are the Clinical Manifestations of SARS (Severe acute respiratory syndrome)?

The incubation period is 1 to 16 days, usually 3 to 5 days. Quick onset, strong infectiousness, with fever as the first symptom, may have chills. 
Body temperature often exceeds 38 , irregular heat or relaxation fever, staying fever, etc. 

The heat course is usually 1 to 2 weeks with headache, muscle soreness, fatigue and diarrhea. 
Three to seven days after the onset, dry cough, less sputum, occasionally bloody sputum, and no obvious lung signs. 
The condition peaked within 10 to 14 days. 

Symptoms of infection and fever such as fever and fatigue increased, and there was frequent coughing, shortness of breath and difficulty in breathing. 
With slight activity, wheezing and palpitations forced him to rest in bed. This period is prone to secondary respiratory infections.

After 2 to 3 weeks of illness, the fever gradually receded, and other symptoms and signs reduced or even disappeared. 

Absorption and recovery of lung inflammation changes are relatively slow. 
It takes about 2 weeks after normal body temperature to fully absorb and return to normal. 

Mild patients have mild clinical symptoms. Severe patients are seriously ill and prone to respiratory distress syndrome. 
Children's condition seems to be milder than adults.

A small number of patients do not consider fever as the first symptom, especially those with a recent history of surgery or a basic disease.
Microscopic view of SARS Severe Acute Respiratory Syndrome Virus

What are the Tests of SARS (Severe acute respiratory syndrome)?

1. Blood routine

The white blood cell count is usually normal or decreases from the beginning to the middle of the course of the disease. 
Lymphocytes are often reduced, and platelets are also reduced in some cases. 
CD3, CD4 and CD8 T cells in T cell subsets were significantly reduced.

2. Blood biochemical examination

Alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and its isoenzymes can be increased to varying degrees. 
Blood gas analysis can reveal a decrease in blood oxygen saturation.

3. Serological testing

Domestic indirect fluorescent antibody method (IFA) and enzyme-linked immunosorbent assay (ELISA) have been established to detect SARS virus specific antibodies in serum. 

The detection rate of IgG antibodies was low or undetectable in the first week after the onset. 

The detection rate was more than 80% at the second weekend and more than 95% at the third weekend, and the titer continued to increase. 
In the third month after the disease Still maintain a very high titer.

4. Molecular biology testing

Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to examine the RNA of SARS coronavirus in specimens such as blood, respiratory secretions and stool of patients.

5. Cell culture to isolate virus

Inoculate patient specimens into cells for culture. After virus isolation, RT-PCR method should also be used to identify SARS virus.

6. Imaging examination

The vast majority of patients had abnormal chest X-rays at the early stage of onset, and most of them showed patchy or reticulated changes. 

In the initial stage of the disease, it usually presents as a single lesion. 

In the short term, the lesion rapidly increases, often involving the double lungs or multiple leaves of the single lung. 

Some patients progressed rapidly, showing large patchy shadows. The area surrounding the lungs is more common. 

For patients with chest x-rays that are disease-free and clinically suspected of having this disease, chest X-ray examination should be repeated within 1 to 2 days. 

Chest CT examination is most common with glass-like changes. 
The shadows of the lungs are absorbed and dissipated more slowly.
The changes in shadows and clinical signs may sometimes be inconsistent.

What is the differential diagnosis for SARS?

The diagnosis of severe acute respiratory syndrome must exclude other diseases that can explain the patient's epidemiological history and clinical course. 

Clinical attention should be paid to exclude upper respiratory tract infections, influenza, bacterial or fungal pneumonia, acquired immunodeficiency syndrome (AIDS) combined with lung infections, legionellosis, tuberculosis, epidemic hemorrhagic fever, non-infectious interstitial respiratory system diseases such as sexual lung disease, pulmonary eosinophil infiltration, and pulmonary vasculitis.

What is the Treatment for SARS?

Treatment for Severe Acute Respiratory Syndrome Virus:

I. General treatment

  1.  Rest in bed.
  2.  Avoid severe coughing, those with severe coughing should be given antitussives. 
  3. Those with coughing should be given expectorants.
  4.  Antipyretic and analgesic drugs may be used in patients with fever exceeding 38.5 . Aspirin is contraindicated in children, because it may cause Reye syndrome; or give physical cooling such as ice compress and alcohol rubbing bath.
  5.  If there is functional damage to organs such as heart, liver and kidney, it should be dealt with accordingly.

II. Oxygen therapy

In case of shortness of breath, continuous nasal cannula or mask oxygen should be given.
  1.  The common and simple method of nasal catheter or nasal congestion oxygen supply is suitable for low concentration oxygen supply, which is easy for patients to accept.
  2.  The mask oxygen supply mask has an adjustment device that can adjust the oxygen concentration in the mask, without humidification, and less oxygen consumption.
  3.  The tracheal intubation or incision, the intubation or incision, the jet oxygen supply effect is good, and it is conducive to the discharge of respiratory secretions and keep the airway smooth.
  4.  Oxygen supply to the ventilator is the best way and method of oxygen therapy, and it is often used to rescue critical patients.

III. Application of glucocorticoids

Treatment with glucocorticoids should have one of the following indications.
  1.  There are severe symptoms of poisoning, and the fever persists for 3 days.
  2.  The shadow area of ​​the lungs expanded by more than 50% within 48 hours.
  3.  Acute lung injury (ALI) or ARDS.

IV. Application of antibacterial drugs

In order to prevent bacterial infections, antibiotics should be used to cover common pathogens of community-acquired pneumonia. 

Macrolides (such as azithromycin, etc.), fluoroquinolones, β-lactams, and tetracyclines can be used clinically. 

Clinically, there are methicillin-resistant Staphylococcus aureus infections or penicillin-resistant Streptococcus pneumoniae infections. (Demethylation) vancomycin can be used.

V. Antiviral drugs

So far, there is no surely effective antiviral treatment, and you can choose to try antiviral drugs during treatment.

VI. Treatment of severe cases

  1.  Strengthen the dynamic monitoring of patients: Enter the intensive care unit as much as possible.
  2.  Use non-invasive positive pressure mechanical ventilation (NPPV).
  3.  After NPPV treatment, if the improvement of oxygen saturation is not satisfactory, invasive positive pressure mechanical ventilation treatment should be performed in time.
  4.  For cases of ARDS, invasive positive pressure mechanical ventilation should be used directly. Shock or MODS should be supported accordingly.

What is the Prevention against SARS?

Prevention against Severe Acute Respiratory Syndrome Virus:

I. Control the source of infection

(1) Epidemic situation report China has listed severe acute respiratory syndrome as the first category of legal infectious diseases Class B implemented by the Law of the People’s Republic of China on the Prevention and Control of Infectious Diseases on December 1, 2004, and provides for reporting and isolation according to category A infectious diseases Treatment and management. 

When you find or suspect this disease, you should report to the health and epidemic prevention agency as soon as possible. Do early detection, early isolation, and early treatment.

(2) Patients with isolation treatment Clinical diagnosis cases and suspected diagnosis cases should be separately observed and treated according to respiratory infectious diseases in designated hospitals.

(3) Isolation and observation of close contacts: For medical observation cases and close contacts, if conditions permit, they should be isolated and observed in designated locations for a period of 14 days. 

When receiving isolation observation at home, pay attention to ventilation, avoid close contact with family members, and conduct medical observation by the health and epidemic prevention department, and measure body temperature every day.

II. Cut off the transmission route

  1.  Comprehensive community prevention Reduce large-scale mass gatherings or activities. Maintain ventilation and air circulation in public places. Eliminate hidden dangers of sewage blockage of residential buildings.
  2.  Maintain good personal hygiene habits without spitting, avoid sneezing, coughing, cleaning nasal cavities in front of people, and wash hands afterwards. Ensure ventilation of residences or activities. Wash hands frequently. Avoid going to crowded or relatively closed places. Pay attention to wearing a mask.
  3.  The hospital should set up fever clinics and establish special channels for this disease.

III. Protect susceptible people

  • Maintain an optimistic and stable state of mind
  • Take a balanced diet
  • Drink more soup and water
  • Pay attention to keeping warm
  • Avoid fatigue
  • Take enough sleep
Exercise in an appropriate amount in open spaces, etc. These good habits help to improve the body’s resistance to severe acute respiratory syndrome ability.


 

Author's Bio

Doctor Shawna Reason, Virologist
Dr. Shawna Reason
Name: Shawna Reason

Education: MBBS, MD

Occupation: Medical Doctor / Virologist 

Specialization: Medical Science, Micro Biology / Virology, Natural Treatment

Experience: 15 Years as a Medical Practitioner

About Me | Linkedin | Quora Profile | Medium Profile | Twitter



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