Severe Acute Respiratory Syndrome (SARS)

What is severe acute respiratory syndrome (SARS)?

Severe acute respiratory syndrome (SARS) is a viral respiratory illness. Usually the illness is mild and people fully recover, but it can cause pneumonia and sometimes causes death.

SARS was first reported in Asia in February 2003, and over the next few months the illness spread to more than two dozen countries in North America, South America, Europe, and Asia. By late July 2003, the outbreak seemed to be contained, but new outbreaks are possible.

How does it occur?

SARS is caused by a virus. The SARS virus is probably most easily spread by the respiratory droplets produced when an infected person coughs or sneezes. The droplets might land on your nose, mouth, or eyes if you are nearby. You might also get the virus if you touch the skin of other people or objects that are contaminated with infectious droplets and then touch your eyes, nose, or mouth. It also is possible that SARS can be spread more broadly through the air or by other ways that are not yet known.

The main way that SARS seems to spread is by close person-to-person contact. Close contact might occur among people who live together or if you are providing care to a SARS patient. Examples include kissing or embracing, sharing eating or drinking utensils, close conversation (within 3 feet), giving a physical exam, and any other direct physical contact between people. Close contact does not include activities such as walking by a person or sitting across from someone in a waiting room or office for a brief time.

What are the symptoms?

The symptoms of SARS usually start 2 to 7 days after you have been exposed to SARS, but it may take up to 10 days before the first symptoms appear. The symptoms are similar to the symptoms of influenza (flu). Usually the first symptom is:

• fever.

Other symptoms may include:

• chills
• headache
• a general ill feeling
• body aches
• nasal congestion
• runny nose
• dry cough
• trouble breathing
• shortness of breath
• diarrhea.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, recent travel history, and possible exposure to someone infected with SARS. Your provider will also examine you.

Tests you may have include:

• chest X-ray
• blood tests
• tests of sputum (fluid from your lungs)
• throat culture
• urine tests.

Some of these lab tests can detect either the SARS virus or antibodies to the virus.

If your provider suspects SARS, he or she must report it to the public health department.

How is it treated?

If you have a SARS infection, you will stay at the hospital. Currently there is no specific medicine that will cure SARS. Researchers are testing various antiviral drugs to see if an effective treatment can be found. Currently the treatment is similar to the treatment for other types of pneumonia.

Medicines you may be given to help prevent your illness from becoming worse and to treat your symptoms include:

• antibiotics (to prevent bacterial infections, which sometimes happen when you have a viral infection, especially in the lungs)
• antiviral drugs
• steroids.

You may also be given oxygen and IV (intravenous) fluids.

How long will the effects last?

At this time doctors do not have a full understanding of the natural course of illness in people infected with SARS. Research is being done to learn what factors make the illness more serious and recovery more difficult.

How can I help take care of myself?

One of the most important things you can do is know the symptoms of SARS and what you should do if the symptoms develop. If you know that you have been exposed to SARS, watch for the symptoms of fever, cough, or trouble breathing for the next 10 days. Check for fever by measuring your temperature every day. You do not need to limit your activities unless symptoms start.

If you have symptoms of SARS, stay at home and call your healthcare provider right away. This is especially important if you have traveled outside the country to an area where SARS has been reported or if you know that you were exposed to someone with SARS. If you are having symptoms, always tell your provider about any travel out of the country or exposure to SARS. You may need to take precautions to protect others.

How can I help prevent the spread of SARS?

If you are diagnosed with SARS, or it is suspected that you might have SARS, you must take certain precautions to limit your exposure to other people and help prevent spread of the virus. Until you have been checked by a healthcare provider, take the following precautions if you think you may have SARS. These precautions include:

• Stay at home and limit your contact with others.
• Cover your mouth and nose with a new tissue when you cough or sneeze.
• Wash your hands often with soap and water, especially after coughing or sneezing.
• Do not share silverware, dishes, towels, or bedding. Wash these items with hot water and soap before others use them.
• Use a household disinfectant often to clean surfaces that you have touched or used, including toilets and sinks.

If you are diagnosed with SARS, you must follow these precautions for 10 days after the fever and other symptoms are gone.

People who live with a person or care for a person who has SARS must use the same precautions. Hand washing is very important, especially after contact with someone who has SARS.

The Web site for the Centers for Disease Control and Prevention (CDC) has posted travel advisories for people who plan to travel. Travel may be discouraged to certain countries or areas. Anyone who has traveled to or changed planes in an area where cases of SARS have been reported should monitor their health for 10 days after their return. Follow the recommended actions if you develop a fever or other respiratory symptoms.

SARS is a serious disease but will not affect most people. Following all precautions can help prevent it from becoming a more serious health problem. For more information, visit the CDC Web site at http://www.cdc.gov or the World Health Organization Web site at http://www.who.int.