Severe Acute Respiratory Syndrome (SARS)
24 March 2003
Q : What are the symptoms of SARS ?

A : The main symptoms of SARS are high fever (> 38°
Celsius), dry cough, shortness of breath or breathing
difficulties. Changes in chest X-rays indicative of
pneumonia also occur. SARS may be associated with
other symptoms, including headache, muscular
stiffness, loss of appetite, malaise, confusion, rash
and diarrhoea.

Q : How contagious is SARS ?

A : Based on currently available evidence, close
contact with an infected person is needed for the
infective agent to spread from one person to another.
Contact with aerosolized (exhaled) droplets and bodily
secretions from an infected person appears to be
important. To date, the majority of cases have
occurred in hospital workers who have cared for SARS
patients and the close family members of these
patients. However, the amount of the infective agent
needed to cause an infection has not yet been
determined.

Q : How should SARS patients be managed?

A : Patients should be placed in an isolation unit.
Strict respiratory and mucusol barrier nursing is
recommended. It is very important that suspected cases
are separated from other patients and placed in their
own hospital room. Health care workers and visitors
should wear efficient filter masks, goggles, aprons,
head covers, and gloves when in close contact with the
patient.

Q : What is the treatment for SARS ?

A : While some medicines have been tried, no drug can,
at this time, be recommended for prophylaxis or
treatment. Antibiotics do not appear to be effective.
Symptoms should be treated by adequately protected
health professionals. As a result of good supportive
care, some patients in Hanoi have been transferred
from critical care wards to regular wards.

Q : When will this disease be identified ?

A : An international multicenter research project to
expedite identification of the causative agent was
established on Monday 17 March. Eleven top labs in ten
countries are consulting daily and are working
together to identify the causative agent. Various
specimens have been collected from cases and
post-mortem examinations. Laboratory tests are ongoing
and a candidate causative infectious agent is under
investigation.

Q : How fast does SARS spread ?

A : SARS appears to be less infectious than influenza.
The incubation period is short, estimated to range
from 2-7 days, with 3-5 days being more common.
However, the speed of international travel creates a
risk that cases can rapidly spread around the world.

Q : Where and when was the first case of SARS reported
?

A : On 26 February, a man was admitted to hospital in
Hanoi with high fever, dry cough, myalgia (muscle
soreness) and mild sore throat. Over the next four
days he developed increasing breathing difficulties,
severe thrombocytopenia (low platelet count) and signs
of adult respiratory distress syndrome requiring
ventilator support.

Q : How many cases of SARS have been reported to date
?

A : From 1 February to 24 March, 456 cases including
seventeen deaths have been reported. In the early
stages the symptoms are similar to those of many
diseases including influenza. Heightened awareness
about the disease, and the vigilance of health
authorities around the world, have resulted in a close
watch for suspected cases and rapid and thorough
reporting. Not all of these suspected cases may prove
to be SARS. There are many reports and rumours coming
in from around the world, but quite a few of these
will turn out to be normal wintertime activity of
diseases like influenza whose early symptoms are
similar. The cumulative number of cases and deaths is
continuously updated on the

Q : How many countries report cases of SARS ?

A . As of 24 March, cases had been reported from
thirteen countries. Of these, four countries have only
imported cases with no documented local transmission,
indicating that the disease is not spreading in these
countries and residents are not at risk.

Q : Is the outbreak in Guangdong Province, China
linked ?

A : Extensive investigation is under way to better
understand the outbreak of atypical (unusual)
pneumonia that began in Guangdong province in November
2002. Findings from this investigation should help
clarify possible links with cases of SARS.

Q : Could this result from bioterrorism ?

A : There is no indication that SARS is linked to
bioterrorism.

Q : Should we be worried ?

A : This illness can be severe and, due to global
travel, has spread to several countries in a
relatively short period of time. However, SARS is not
highly contagious when protective measures are used,
and the percentage of cases that have been fatal is
low. Since the WHO global alert issued on only
isolated cases have been identified and no secondary
outbreaks have occurred.

Q : Is it safe to travel ?

A : WHO has not recommended restricting travel to any
destination in the world. However, all travellers
should be aware of the main symptoms and signs of
SARS, as given above. People who have these symptoms
and have been in close contact with a person who has
been diagnosed with SARS, or have a recent history of
travel to areas where cases of SARS have been
spreading, should seek medical attention and inform
health care staff of recent travel. Travellers who
develop these symptoms are advised not to undertake
further travel until fully recovered.

Q : What is the purpose of a global travel advisory ?

A : The purpose of the advisory WHO issued on 15 March
is to tell people what SARS looks like and what they
need to report to a physician. The WHO alert does not
recommend cancellation of, or change in, travel plans.
Trade and tourism should not be restricted. The
purpose of the alert is to heighten the awareness of
travellers, health authorities, and physicians, not to
restrict travel.

Q : Could this be the next flu pandemic ?

A : Tests have not yet conclusively identified the
causative agent of SARS. The possible involvement of
an influenza virus was an initial concern.

Q What does WHO recommend ?

A : WHO recommends that global surveillance continue
and that suspected cases are reported to national
health authorities. WHO urges national health
authorities to remain on the alert for suspected cases
and followed recommended protective measures. SARS
patients should be isolated and cared for using
barrier nursing techniques and provided with
symptomatic treatment.

Q : How can the public keep apprised of the situation
?

A : The public is advised to consult the home page of
the WHO website : for daily updates on the outbreak
and relevant press releases. More information is
available on the WHO SARS web page which is easily
accessed through the WHO home page or through: Severe
Acute Respiratory Syndrome (SARS) Many national
authorities have also established web sites with
excellent information for both the general public and
the medical profession.

Website:www.mmhrcaidsinfo.org

*********************************************

Four Pakistanis were travelling in a train and spotted
Santa Singh
visiting a Sikh shrine in Pakistan. One guy said he
was going to
piss him off. He walked over to the Santa Singh and
tapped him on
the shoulder. 'Hey, I hear Indian Prime Minister is a
Coward.'
Santa replied,'Oh really, hmm, I didn't know that.'

Puzzled, the Pakistani man walked back to his buddies.
'I told him
Indian Prime Minister was a sissy and he didn't care!'

'You just don't know how to set him off, watch and
learn.' The
second Pakistani man walked over and tapped the Santa
Singh on the
shoulder. 'I hear Indian Prime Minister is a
transvestite!' 'Oh,
wow, I didn't know that, thank you.' Shocked beyond
belief, the
Pakistani man went back to his buddies. 'Your right,
he is
unshakable!'

The third Pakistani man said: 'No, no, no, I will
really piss him
off, you just watch.' The Pakistani man walked over to
Santa
Singh, tapped him on the shoulder and said. 'I hear
Indian Prime
Minister is an imbecile!' 'Really, I didn't know that,
thank you.'
Shocked, the Pakistani man went back to his buddies.
'He is really
unshakable!'

The fourth Pakistani man said: 'No! All of you are
fools. See how
I piss him off.' The Pakistani man walked over to
Santa Singh,
tapped him on the shoulder and said, 'I hear Indian
Prime Minister
is really a Pakistani!'

Santa replied, 'Yeah, that's what your buddies were
trying to tell
me.'




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http://groups.yahoo.com/group/paediatrics




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