Etiology -

Severe acute respiratory syndrome (SARS) is a serious, potentially life-threatening viral

infection caused by a previously unrecognized virus from the Coronaviridae family. This virus
has been named the SARS-associated coronavirus (SARS-CoV). Previously, Coronaviridae were
best known as the second most common cause of the common cold.

Pathophysiology -
SARS is caused by a new member of the coronavirus family (the same family that can cause the
common cold). The discovery of these viral particles represents some of the fastest identification
of a new organism in history.

SARS is clearly spread by droplet contact. When someone with SARS coughs or sneezes,
infected droplets are sprayed into the air. Like other coronaviruses, the SARS virus may live on
hands, tissues, and other surfaces for up to 6 hours in these droplets and up to 3 hours after the
droplets have dried.

While droplet transmission through close contact was responsible for most of the early cases of
SARS, evidence began to mount that SARS might also spread by hands and other objects the
droplets had touched. Airborne transmission was a real possibility in some cases. Live virus had
even been found in the stool of people with SARS, where it has been shown to live for up to four
days. And the virus may be able to live for months or years when the temperature is below
freezing.

With other coronaviruses, re-infection is common. Preliminary reports suggest that this may also
be the case with SARS.

Preliminary estimates are that the incubation period is usually between 2 and 10 days, although
there have been documented cases where the onset of illness was considerably faster or slower.
People with active symptoms of illness are clearly contagious, but it is not known how long
contagiousness may begin before symptoms appear or how long contagiousness might linger
after the symptoms have disappeared.

Reports of possible relapse in patients who have been treated and released from the hospital raise
concerns about the length of time individuals can harbor the virus.

Clinical Manifestations or S/Sx -

* Fever
* Chills and shaking
* Muscle aches
* Cough
* Headache

Less common symptoms include (also in order):

* Dizziness
* Productive cough (sputum)
* Sore throat
* Runny nose
* Nausea and vomiting
* Diarrhea

Treatment -
People suspected of having SARS should be evaluated immediately by a physician and
hospitalized under isolation if they meet the definition of a suspected or probable case.

Antibiotics are sometimes given in an attempt to treat bacterial causes of atypical pneumonia.
Antiviral medications have also been used. High doses of steroids have been employed to reduce
lung inflammation. In some serious cases, serum from people who have already gotten well from
SARS (convalescent serum) has been given. Evidence of general benefit of these treatments has
been inconclusive.

Other supportive care such as supplemental oxygen, chest physiotherapy, or mechanical

ventilation is sometimes needed.

• 4 years ago