Community Health Nursing - Severe Acute Respiratory Syndrome

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in February 2003 in Asia. The illness quickly spread over the next few months to more than two dozen countries in North America, South America, Europe, and Asia before the global outbreak of 2003 was contained. According to the World Health Organization over 8,000 people were affected and more than 700 died. (WHO, 2003).

The symptoms of SARS and Influenza are often very similar. SARS patients will notice fever (temperature greater than 100.4 degrees F) followed by a headache, body aches, and overall discomfort. Some people also have mild respiratory symptoms at the onset and usually develop a dry cough after 2 to 7 days. These symptoms, if not treated, may turn into pneumonia.

Also, like Influenza, SARS is spreads by close person to person contact, respiratory droplets (droplet spread), and more specifically because SARS builds up in the respiratory tract, when a person coughs or sneezes, this is more likely to cause a person in close contact (generally up to 3 feet) to contract the disease.

The disease can also be spread by touching things or areas recently touched by someone infected with SARS. Close contact with infected persons places you at greater risk for contracting the disease. For example, if you lived with or cared for someone who had SARS, then you would be considered at high risk. It is also possible that SARS may be spread broadly through the air (airborne spread) or by other ways that are not now know.

Epidemiological data suggests that the virus is excreted from the respiratory tract starting on 0-2 days from illness onset, this increases between 3-5 days, while the most degree of virus excretion is found within 6-14 days of disease. The shed of the virus declines between 15-17 days, and a further decline is noted between 21-23 days following onset.

Virus shedding in stool was seen within 3-5 days following onset up to 14 days. A decline in virus shedding was observed at 15-17 days following onset of disease. The virus was still found in urine on the 10th day of onset in most cases. There is some clinical evidence that communicability starts in the early prodromal period and at 1-2 days after the onset of symptoms. Transmission is the highest in the second week of the disease.

WHO guidelines on the clinical management and medical follow-up of patients with SARS were reviewed in light of the epidemiological findings on the period of transmission. There were no data of transmission or infectious agent transmission after ten days following the resolution of fever. This is consistent with the total period of isolation following fever resolution recommended by WHO.

During the SARS outbreak, the CDC and the World Health Organization partnered to make a global effort to address the needs and concerns of people. The two