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What
is SARS
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Severe
acute respiratory syndrome (SARS) is a respiratory illness that has recently
been reported in Asia, North America, and Europe.
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Symptoms
of SARS
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In
general, SARS begins with a fever greater than 100.4°F [>38.0°C]. Other
symptoms may include headache, an overall feeling of discomfort, and body
aches. Some people also experience mild respiratory symptoms. After 2 to 7
days, SARS patients may develop a dry cough and have trouble breathing.
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Possible
cause of SARS
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Scientists
at CDC and other laboratories have detected a previously unrecognized
coronavirus in patients with SARS. The new coronavirus is the leading
hypothesis for the cause of SARS.
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Diagnosis
of SARS
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Currently,
no "test" is available for SARS. However, CDC, in collaboration with WHO and
other laboratories, have developed 2 research tests that appear to be very
promising in detecting antibodies to the new coronavirus. CDC is working with
laboratories across the United States and internationally to refine and share
this testing capability as soon as possible. WHO has shown the following tests
that may be useful in detecting the SARS Infection:
1.
Molecular tests (PCR) (As shown by WHO)
Polymerase
chain reaction (PCR) can detect genetic material of the SARS-CoV in various
specimens (blood, stool, respiratory secretions or body tissues
Sampling for Severe Acute Respiratory Syndrome (SARS)
diagnostic tests ). Primers, which
are the key pieces for a PCR test, have been made publicly available by WHO
network laboratories on the WHO web site. A ready-to-use PCR test kit
containing primers and positive and negative control has been developed.
Testing of the kit by network members is expected to quickly yield the data
needed to assess the test’s performance, in comparison with primers developed
by other WHO network laboratories and in correlation with clinical and
epidemiological data.
Principally, existing PCR tests are very specific, but lack sensitivity. This
means that negative tests cannot rule out the presence of the SARS virus in
patients. Furthermore, contamination of samples in laboratories, in the absence
of laboratory quality control can lead to false positive results.
Positive
PCR results, with the
necessary quality control procedures in place.
Recommendations for laboratories testing for SARS-coronavirus , are
very specific and mean that there is genetic material (RNA) of the SARS-CoV in
the sample. This does not mean that there is live virus present, or that it is
present in a quantity large enough to infect another person.
Negative
PCR results
do not exclude SARS. SARS-CoV PCR can be negative for the following reasons:
- The patient is not infected with the SARS coronavirus; the illness is due to
another infectious agent (virus, bacterium, fungus) or a non-infectious cause.
- The test results are incorrect (“false-negative”). Current tests need to be
further developed to improve sensitivity.
- Specimens were not collected at a time when the virus or its genetic material
was present. The virus and its genetic material may be present for a brief
period only, depending on the type of specimen tested.
2. Antibody tests
These
tests detect antibodies produced in response to the SARS coronavirus infection.
Different types of antibodies (IgM and IgG) appear and change in level during
the course of infection. They can be undetectable at the early stage of
infection. IgG usually remains detectable after resolution of the illness.
The
following test formats are being developed, but are not commercially available:
- ELISA (Enzyme Linked ImmunoSorbant Assay): a test detecting a mixture of IgM
and IgG antibodies in the serum of SARS patients yields positive results
reliably at approximately day 21 after the onset of illness.
– IFA (Immunofluorescence Assay): a test detecting IgM antibodies in serum of
SARS patients yields positive results after day 10 of illness. This test format
is also used to test for IgG. This is a reliable test requiring the use of
fixed SARS virus on an immunofluorescence microscope.
Positive
antibody test results indicate
a previous infection with SARS-CoV. Seroconversion from negative to positive or
a four-fold rise in antibody titre from acute to convalescent serum indicates
recent infection.
Negative
antibody test results:No
detection of antibody after 21 days from onset of illness seems to indicate
that no infection with SARS-CoV took place.
3.
Cell culture
Virus
in specimens (such as respiratory secretions, blood or stool) from SARS
patients can also be detected by inoculating cell cultures and growing the
virus. Once isolated, the virus must be identified as the SARS virus with
further tests. Cell culture is a very demanding test, but currently (with the
exception of animal trials) only means to show the existence of a live virus.
Positive
cell culture resultsindicate
the presence of live SARS-CoV in the sample tested.
Negative
cell culture results do not
exclude SARS (see negative PCR test result).
Researchers
from several laboratories participating in the WHO network have reported the
identification of a virus from paramyxovirus family in clinical specimens from
SARS patients. These laboratories are still investigating the possibility that
a paramyxovirus is a cause of SARS.
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Treatment
of SARS
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CDC
currently recommends that patients with SARS receive the same treatment that
would be used for any patient with serious community-acquired atypical
pneumonia of unknown cause. At present, the most efficacious treatment regimen,
if any, is unknown. In several locations, therapy has included antivirals such
as oseltamivir or ribavirin. Steroids have also been given orally or
intravenously to patients in combination with ribavirin and other
antimicrobials. In the absence of controlled clinical trials, however, the
efficacy of these regimens remains unknown. Early information from laboratory
experiments suggests that ribavirin does not inhibit virus growth or
cell-to-cell spread of one isolate of the new coronavirus that was tested.
Additional laboratory testing of ribavirin and other antiviral drugs is being
done to see if an effective treatment can be found.
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Guidelines
for SARS
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i) Guidelines
for the Travelers
Before
you
leave:
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Assemble
a travel health kit containing basic first aid and medical supplies. Be sure to
include a thermometer, household disinfectant, a supply of surgical masks and
disposable gloves (for use if you or someone you are traveling with becomes ill
with SARS), and alcohol-based hand rubs for hand hygiene.
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Inform
yourself and others who may be traveling with you about SARS.
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Be sure
you are up to date with all your shots, and see your health-care provider at
least 4 to 6 weeks before travel to get any additional shots or information you
may need.
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You may
wish to check your health insurance plan or get additional insurance that
covers medical evacuation in the event of illness. Information about medical
evacuation services can be found at the U.S. Department of State page.
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Identify
in-country health-care resources prior to your trip.
While
you are in an area with SARS:
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To
protect against SARS infection, wash your hands frequently.
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To
minimize the possibility of infection, you may wish to avoid close contact with
large numbers of people as much as possible. CDC does not recommend the routine
use of masks or other personal protective equipment while in public areas.
If
you think you have SARS or symptoms compatible with SARS
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If
you become ill with fever and respiratory symptoms (for example, cough or
shortness of breath), a visit to a health-care provider is strongly
recommended. Inform the
provider of your symptoms prior to going to the office or emergency room so
arrangements can be made, if necessary, to prevent transmission to others in
the health-care setting. The nearest U.S. Embassy or
Consular Office can help you find a provider in the area. Again, you are
encouraged to identify these resources in advance. Do not travel while sick,
and limit your contact with others as much as possible to help prevent the
spread of any infectious illness you may have.
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The
person who is ill should cover their mouth and nose with a facial tissue when
coughing or sneezing. If possible, they should wear a surgical mask during
close contact with healthy people to prevent the spread of infectious droplets.
If the sick person is unable to wear a surgical mask, other persons should wear
surgical masks when in close contact with the person who is ill.
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Use
of disposable gloves should be considered for any direct contact with body
fluids of a person with SARS.
However, gloves are not intended to replace proper hand hygiene.
Immediately after activities involving contact with body fluids, gloves should
be removed and discarded and hands should be cleaned. Gloves must never be
washed or reused. All close contacts with a person with SARS should carefully
follow recommendations for hand hygiene (e.g., frequent hand washing or use of
alcohol-based hand rubs), particularly after contact with body fluids (e.g.,
respiratory secretions, urine, or feces).
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People
with SARS should avoid sharing eating utensils, towels, and bedding with
others, although these items can be used by others after routine cleaning, such
as washing or laundering with soap and hot water.
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Environmental
surfaces (e.g., toilets, sinks) soiled by body fluids should be cleaned with a
household disinfectant according to manufacturer's instructions; gloves should
be worn during this activity. Wash hands afterwards and throw the gloves away.
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Other
close contacts staying with a person with SARS do not need to restrict their
outside activities unless they develop symptoms of SARS, such as a fever or
respiratory illness.
After
your return:
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Persons
returning from one of the affected areas should monitor their health for 10
days. Any family member who becomes ill with fever or respiratory symptoms
during this period should consult a healthcare provider and tell him or her
about their recent travel. Inform
the provider of your symptoms prior to going to the office or emergency room so
arrangements can be made, if necessary, to prevent transmission to others in
the health-care setting.
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Close
contacts of person with SARS who develop fever or respiratory symptoms should
be evaluated by a health-care provider. Prior to
the evaluation, health-care providers should be informed that the individual is
in close contact of a person with SARS. Those with symptoms of SARS should
follow the same precautions recommended for people with SARS.
ii)
Guidelines for the patients
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SARS
patients should limit interactions outside the home and should not go to work,
school, out-of-home child care, or other public areas until 10 days after the
resolution of fever, provided respiratory symptoms are absent or improving.
During this time, infection control precautions should be used, as described
below, to minimize the potential for transmission.
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Each
patient with SARS should be advised to cover his or her mouth and nose with a
facial tissue when coughing or sneezing. If possible, a SARS patient should
wear a surgical mask during close contact with uninfected persons to prevent
spread of infectious droplets. When a SARS patient is unable to wear a surgical
mask, household members should wear surgical masks while in close contact with
the patient.
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Sharing
of eating utensils, towels, and bedding between SARS patients and others should
be avoided, although such items can be used by others after routine cleaning
(e.g., washing with soap and hot water). Environmental surfaces soiled by body
fluids should be cleaned with a household disinfectant according to
manufacturer's instructions; gloves should be worn during this activity.
iii)
Guidelines for the contacts
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All
members of a household with a SARS patient should carefully follow
recommendations for hand hygiene (e.g., frequent hand washing or use of
alcohol-based hand rubs), particularly after contact with body fluids (e.g.,
respiratory secretions, urine, or feces). Use of disposable gloves should be
considered for any direct contact with body fluids of a SARS patient.
However, gloves are not intended to replace proper hand hygiene.
Immediately after activities involving contact with body fluids, gloves should
be removed and discarded and hands should be cleaned. Gloves must never be
washed or reused. Household waste soiled with body fluids of SARS patients,
including facial tissues and surgical masks, may be discarded as normal waste.
Household members and other close contacts of SARS patients should be actively
monitored by the local health department for illness. Household members or
other close contacts of SARS patients should be vigilant for the development of
fever or respiratory symptoms and, if these develop, should seek healthcare
evaluation. In advance
of evaluation, healthcare providers should be informed that the individual is
in close contact of a SARS patient so arrangements can be made, as necessary,
to prevent transmission to others in the healthcare setting.
Household members or other close contacts with symptoms of SARS should follow
the same precautions recommended for SARS patients.
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At
this time, in the absence of fever or respiratory symptoms, household members
or other close contacts of SARS patients do not need to limit their activities
outside the home.
iv)
Guidelines for health care workers
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Transmission
of SARS to health-care workers appears to have occurred after close contact
with symptomatic individuals before recommended appropriate infection control
precautions were implemented. CDC has developed interim infection control
recommendations for the management of exposures to SARS in the health-care and
other institutional settings.
Health-care facilities should be vigilant in conducting active surveillance for
fever or respiratory symptoms among care givers with unprotected exposure to
SARS patients. Health-care workers who develop fever or respiratory symptoms
within 10 days following an unprotected exposure to a SARS patient should not
report for duty. Such workers should stay home and report symptoms to the
appropriate facility point of contact (e.g., infection control or occupational
health) immediately. Exclusion from duty should be continued for 10 days after
the resolution of fever and respiratory symptoms. During this period, infected
workers should avoid contact with people both in the facility and in the
community.
Exclusion from duty is not recommended for an exposed health-care worker if
they do not have fever or respiratory symptoms; however, the worker should
report any unprotected exposure to SARS patients to the appropriate facility
point of contact immediately.
What
precautions should health-care facilities follow regarding visits by close
contacts of SARS patients?
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Close
contacts (e.g., family members or other members of the household) of SARS
patients are at risk for infection. Health-care facilities should implement a
system to screen for fever or respiratory symptoms among such contacts who
visit the facility. Close contacts with fever or respiratory symptoms should
not be allowed to enter the health-care facility as visitors and should be
educated about this policy. Health-care facilities should educate all visitors
about use of infection control precautions when visiting SARS patients and
should emphasize the importance of following these precautions.
v)
Guidelines for staff of ships and planes
What
are CDC's quarantine officials doing to prevent and control the spread of SARS?
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CDC's
quarantine inspectors or their designees are distributing health alert cards to
air passengers returning in airplanes either directly or indirectly to the
United States from mainland China; Hong Kong; Taiwan; Singapore; Vietnam; and
Toronto, Canada. The notices inform travelers about SARS and its symptoms, and
asks them to monitor their health for 10 days and to see a doctor if they get a
fever with a cough or have difficulty breathing. CDC distributes more than
20,000 health alert notices each day to air travelers returning from the
affected regions. Inspectors also are boarding airplanes if a traveler has been
reported with symptoms matching the case definition of SARS.
What
information about SARS is being provided to people traveling on ships?
What
does a quarantine inspector do?
What
is considered routine health inspections of airplanes or ships versus what is
happening now?
-
Routine
health inspections consist of working with airline, cargo ship, and cruise ship
companies to protect passengers and crew from certain infectious diseases.
Quarantine inspectors meet arriving aircraft and ships reporting ill passengers
and/or crew and assist them in getting appropriate medical treatment.
What
is the risk to individuals who may have shared a plane or boat trip with a
suspected SARS patient?
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Cases
of SARS continue to be reported primarily among people who have had direct
close contact with an infected person, such as those sharing a household with a
SARS patient and health-care workers who did not use infection control
procedures while attending to a SARS patient. SARS also has occurred among air
travelers, primarily travelers to and from Hong Kong, Hanoi, Singapore, and
mainland China. CDC is requesting locating information from travelers who are
on flights with people suspected of having SARS. CDC, with the help of state
and local health authorities, is attempting to follow-up with these travelers
for 14 days to ensure no one develops symptoms consistent with SARS.
Who
actually notifies quarantine officials of potential SARS cases? Is it the crew
of the airplane or ship? The passengers?
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Under
foreign quarantine regulations, the master of a ship or captain of an airplane
coming into the United States from a foreign port is required by law to report
certain illnesses among passengers. The illness must be reported to the nearest
quarantine official. If possible, the crew of the airplane or ship will try to
relocate the ill passenger or crew member away from others. If the passenger is
only passing through a port of entry on his/her way to another destination,
port health authorities may refer the passenger to a local health authority for
assessment and care.
If
I'm on board an airplane or ship with someone suspected of having SARS, will I
be allowed to continue to my destination?
What
does a quarantine official do if a passenger is identified as meeting the case
definition for suspected SARS?
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Quarantine
officials arrange for appropriate medical assistance to be available when the
airplane lands or the ship docks, including medical isolation. Isolation is
important not only for the sick passenger's comfort and care but also for the
protection of members of the public. Isolation is recommended for travelers
with suspected cases of SARS until appropriate medical treatment can be
provided or until they are no longer infectious.
What
does a quarantine official do if a passenger identified as meeting the case
definition for suspected SARS refuses to be isolated?
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Many
levels of government (Federal, State, and local) have basic authority to compel
isolation of sick persons to protect the public. In the event that it is
necessary to compel isolation of a sick passenger, CDC will work with
appropriate State and local officials to ensure that the passenger does not
infect others.
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Prevention
of SARS
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To
contain the spread of a contagious illness, public health authorities rely on
many strategies. Two of these strategies are isolation and quarantine. Both are
common practices in public health, and both aim to control exposure to infected
or potentially infected individuals. Both may be undertaken voluntarily or
compelled by public health authorities. The two strategies differ in that
isolation applies to people who are known to have an illness and quarantine
applies to those who have been exposed to an illness but who may or may not
become
infected.
Isolation:
For People Who Are Ill
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Isolation
of people who have a specific illness separates them from healthy people and
restricts their movement to stop the spread of that illness. Isolation allows
for the focused delivery of specialized health care to people who are ill, and
it protects healthy people from getting sick. People in isolation may be cared
for in their homes, in hospitals, or at designated health care facilities.
Isolation is a standard procedure used in hospitals today for patients with
tuberculosis (TB) and certain other infectious diseases. In most cases,
isolation is voluntary; however, many levels of government (federal, state, and
local) have basic authority to compel isolation of sick people to protect the
public.
Quarantine:
For People Who Have Been Exposed But Are Not Ill
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Quarantine,
in contrast, applies to people who have been exposed and may be infected, but
are not yet ill. Separating exposed people and restricting their movements is
intended to stop the spread of that illness. Quarantine is medically very
effective in protecting the public from disease. States generally have
authority to declare and enforce quarantine within their borders. This
authority varies widely from state to state, depending on the laws of each
state. In addition, the Centers for Disease Control and Prevention (CDC),
through its Division of Global Migration and Quarantine, is empowered to
detain, medically examine, or conditionally release individuals suspected of
carrying certain communicable diseases. This authority derives from section 361
of the Public Health Service Act (42 U.S.C. 264), as amended.
SARS
and
Isolation
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SARS
patients in the United States are isolated until they are no longer infectious.
This practice allows patients to receive appropriate care, and contains the
potential spread of the illness. Those who are severely ill are being cared for
in hospitals. Those whose symptoms are mild are being cared for at home.
Individuals being cared for at home have been asked to avoid contact with other
people and to remain at home until 10 days after their symptoms have resolved.
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Deaths
Due to SARS
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Visit
WHO's SARS page
for a daily update of SARS cases and deaths.
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Mortality
Rate of
SARS
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Visit
WHO’s SARS page
for a daily update of SARS cases and deaths.
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Frequently
asked Questions
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How
SARS is spread
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The
primary way that SARS appears to spread is by close person-to-person contact.
Most cases of SARS have involved people who cared for or lived with someone
with SARS, or had direct contact with infectious material (for example,
respiratory secretions) from a person who has SARS. Potential ways in which
SARS can be spread include touching the skin of other people or objects that
are contaminated with infectious droplets and then touching your eye(s), nose,
or mouth. This can happen when someone who is sick with SARS coughs or sneezes
droplets onto themselves, other people, or nearby surfaces. It is also possible
that SARS can be spread more broadly through the air, or through other ways
that are currently unknown.
Who
is at risk for SARS
-
Most
of the U.S. cases of SARS have occurred among travelers returning to the United
States from other parts of the world affected by SARS. There have been very few
cases as a result of spread to close contacts such as family members and health
care workers. Currently, there is no evidence that SARS is spreading widely in
the community in the United States.
What Should I do if I
think that I have SARS
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People
with symptoms of SARS (fever greater than 100.4°F [>38.0°C] accompanied by a
cough and/or difficulty breathing) should consult a health-care provider. To
help the health-care provider make a diagnosis, inform them of any recent
travel to places where SARS has been reported or whether there was contact with
someone who had these symptoms. You should also act upon the following
guidelines;
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Follow
the instructions given by your health care provider
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Limit
your activities outside the home during this 10-day period. For example, do not
go to work, school, or public areas.
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Wash
your hands often and thoroughly, especially after you have blown your nose.
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Cover
your mouth and nose with tissue when you sneeze or cough.
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If
possible, wear a surgical mask when around other people in your home. If you
can’t wear a mask, the members of your household should wear one when they are
around you.
-
Don’t
share silverware, towels, or bedding with anyone in your home until these items
have been washed with soap and hot water.
-
Clean
surfaces (counter or tabletops, door knobs, bathroom fixtures, etc.) that have
been contaminated by body fluids (sweat, saliva, mucous, or even vomit or
urine) from the SARS patient with a household disinfectant used according to
the manufacturer’s instructions. Wear disposable gloves during all cleaning
activities. Throw away the gloves when you are done. Do not reuse them.
-
Follow
these instructions for 10 days after your fever and respiratory symptoms have
gone away.
What
Should I do if I have been caring for a person who has SARS:
-
Ensure
that the person with SARS has seen a health care provider and is following
instructions for medication and care.
-
Be
sure that all members of your household are washing their hands frequently with
soap and hot water or using alcohol-based hand wash.
-
Wear
disposable gloves if you have direct contact with body fluids of a SARS
patient. However, the wearing of gloves is not a substitute for good hand
hygiene. After contact with body fluids of a SARS patient, remove the gloves,
throw them out, and wash your hands. Do not wash or reuse the gloves.
-
Encourage
the person with SARS to cover their mouth and nose with a tissue when coughing
or sneezing. If possible, the person with SARS should wear a surgical mask
during close contact with other people in the home. If the person with SARS
cannot wear a surgical mask, other members of the household should wear one
when in the room with that person.
-
Do
not use silverware, towels, bedding, clothing, or other items that have been
used by the person with SARS until these items have been washed with soap and
hot water.
-
Clean
surfaces (counter or tabletops, door knobs, bathroom fixtures, etc.) that have
been contaminated by body fluids (sweat, saliva, mucous, or even vomit or
urine) with a household disinfectant used according to the manufacturer’s
instructions. Wear disposable gloves during all cleaning activities. Throw away
the gloves when done. Do not reuse them.
-
Follow
these instructions for 10 days after the infected person’s fever and
respiratory symptoms have gone away.
-
If
you develop a fever or respiratory symptoms, contact your health care provider
immediately and inform him or her that you have had close contact with a SARS
patient.
Ho
Why does the virus cause harm?
-
Viruses
can't proliferate outside the living organisms. Once they are inside the
living organisms they start replication and harm the cells of the organs in
which they are multiplying. Once destroying one cell, they continue infect the
other cells of the organs. So in this way they infect the whole organ.
How
long is a person with SARS infectious to others?
-
Information
to date suggests that people are most likely to be infectious when they have
symptoms, such as fever or cough. However, it is not known how long before or
after their symptoms begin that patients with SARS might be able to transmit
the disease to others.
We
have a flu season every year. Will we have a SARS season?
-
Most
researchers assume that SARS will return in force next winter. For reasons that
are not fully understood, many respiratory viruses are more prevalent in the
cold weather. SARS may smolder during the summer months only to reignite in
late autumn, or it may die out completely.
There
are some reports that some patients in Hong Kong have relapsed. What does it
mean?
-
The
patients who have relapsed must be studied further, scientists say. Its not
clear whether these patients have contracted a new infection or have not
recovered from the previous infection. One possibility is that these patients
may have been treated with steroids, and their immune system has been so
suppressed by these drugs that they did not develop the enough antibodies to
combat SARS. The apparent relapse also raises the question of the ability of a
convalescing patient to infect the others.
Aren't
patients who have had a virus immune to getting it again?
What
are coronaviruses?
-
Coronaviruses
are a group of viruses that have a halo or crown-like (corona) appearance when
viewed under a microscope. These viruses are a common cause of mild to moderate
upper-respiratory illness in humans and are associated with respiratory,
gastrointestinal, liver and neurologic disease in animals.
How
long do coronaviruses survive in the environment?
-
In
general, enveloped viruses such as coronaviruses do not last a long time in the
environment. In earlier studies, a different coronavirus was shown to survive
for up to 3 hours on surfaces. At this time, it is uncertain how long the newly
discovered coronavirus associated with SARS can survive in the environment. In
one preliminary study, researchers in Hong Kong found that both dried and
liquid samples of the new coronavirus survived as long as 24 hours in the
environment. Additional studies are under way to examine this important
question.
-
-
WhWhy
do some patients with SARS test negative for Coronavirus?
-
Viruses
are hard to isolate from blood or tissue. In some phases of the disease the
virus may be difficult to recover at all from blood, as seen with other
diseases such as AIDS. Tests currently in use are for the detection of
antibodies in the patients who have recovered from the disease, or are late in
the course of disease. In addition, some of the patients may not have the
disease and may be suffering from another illness.
What
about a SARS vaccine?
How
would a vaccine work?
-
One of
the proteins of the virus, spike protein, seems to be related to the virulence
of the virus. Scientists are trying to isolate the genome responsible for this
spike protein, so they can use it as a substance to stimulate the immune system
of the body to develop the antibodies against this protein and the SARS virus.
Some scientists believe that the immune system itself may be causing damage to
the body. If this is correct, then stimulating the immune system may be may be
more dangerous.
Can
coronaviruses be found in feces?
-
It is
not uncommon for respiratory viruses to be found in feces for a period of time.
Some laboratories in the WHO network have reported finding the new coronavirus
in stool specimens. Research is under way in the United States and other
countries to learn more about the presence and concentration of the virus in
different body fluids, including feces. Researchers also are trying to determin
if the virus can spread to others through different bodily fluids.
What
evidence is there to suggest that coronaviruses may be linked with SARS?
-
CDC
scientists isolated a virus from the tissues of two SARS patients, and then
used several laboratory methods to characterize it. Examination by electron
microscopy revealed that the virus has the distinctive shape and appearance of
coronaviruses. Genetic analysis suggests that this new virus belongs to
the family of coronaviruses but differs from previously identified family
members. Tests of serum specimens from people with SARS indicated that they
appeared to have been recently infected with this virus. Other tests
demonstrated that this previously unrecognized coronavirus was present in a
variety of clinical specimens (including specimens obtained by nose and throat
swab) from other SARS patients with direct or indirect links to the outbreak.
These results and other findings reported from laboratories participating in
the World Health Organization (WHO) network provide growing evidence in support
of the hypothesis that this new coronavirus is the cause of SARS. Additional
studies of the link between this coronavirus and SARS are under way.
If
coronaviruses usually cause mild illness in humans, how could this new
coronavirus be responsible for a potentially life-threatening disease such as
SARS?
-
There is
not enough information about the new virus to determine the full range of
illness that it might cause. Coronaviruses have occasionally been linked to
pneumonia in humans, especially people with weakened immune systems. The
viruses also can cause severe disease in animals, including cats, dogs, pigs,
mice, and birds.
What
is the status of the SARS outbreak in the United States?
-
In the
United States, cases of SARS continue to be reported primarily among people who
traveled to affected areas; a small number of other people have become ill
after being in close contact with (that is, having cared for or lived with) a
SARS patient while in the United States. Currently, there is no evidence that
SARS is becoming widespread in the community in the United States.
To minimize the risk for SARS among U.S. residents, the public health system is
taking careful and thorough precautions to stop the spread of SARS. People who
are suspected of having SARS are being isolated from others while receiving
care. People arriving from affected parts of the world (who might have been
exposed to SARS) are receiving information about SARS and instructions on what
they should do if they become ill. SARS patients and their contacts are being
monitored to help prevent spread of the disease
WHO Website regarding SARS.
What
is the status of the SARS outbreak outside the United States?
-
Most
cases of SARS have been reported from China. In addition, SARS cases have been
reported from more than 20 other countries. Measures to control the spread of
SARS continue to be used in countries worldwide in an effort to contain the
outbreak. You can get the latest information from
WHO Website regarding SARS.
What
is the difference between a “probable” SARS case and a “suspect” SARS case?
-
Suspect
SARS cases have fever, respiratory illness, and recent travel to an affected
area with community transmission of SARS and/or contact with a suspected SARS
patient. Probable cases meet the criteria for a suspect case and also have
evidence (e.g., chest X-ray) of pneumonia or respiratory distress syndrome.
Are
there any travel restrictions related to SARS?
-
At this
time there are no travel restrictions in place that are directly related to
SARS. However, a CDC travel advisory recommends that individuals who are
planning nonessential or elective travel to mainland China, Hong Kong and
Singapore, postpone their trip until further notice. CDC also has issued travel
alerts for Hanoi, Vietnam; Taiwan; and Toronto, Canada, to recommend that U.S.
travelers to any of these places observe precautions to safeguard their health.
What
is the difference between a “travel alert” and a “travel advisory” issued by
CDC?
I
must travel to a country where there is community spread of SARS: What
precautions can I take?
What
should I do if I have recently traveled to a country where cases of SARS have
been reported?
-
You
should monitor your own health for 10 days following your return. If you become
ill with a fever of more than 100.4°F [>38.0°C] that is accompanied by a
cough or difficulty breathing or that progresses to a cough and/or difficulty
breathing, you should consult a health-care provider. To help your health-care
provider make a diagnosis, inform him or her of any recent travel to regions
where cases of SARS have been reported and whether you were in contact with
someone who had these symptoms.
CDC
has recommended guidelines for medical aircraft that transport SARS patients.
Should commercial airlines also follow these guidelines?
-
No.
Guidance is intended specifically for air medical transport (AMT) service
providers that use specialized aircraft to transport SARS patients. It should
not be generalized to commercial passenger aircraft. The interim
recommendations for AMT are based on standard infection control practices, AMT
standards, and epidemiologic information from ongoing investigations of SARS,
including experience from transport of 2 patients during this outbreak.
Specific guidelines for airline crew and flight personnel of commercial
aircrafts are available at
CDC’s page.
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