Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS is a seasonal illness transmitted by civets (and other animal hosts) to humans in Asia. The first cases of SARS were noted in Guangdong province, China, in November 2002 and it was recognized as a global threat in mid-March 2003. Before the chain of human transmission was broken in July 2003, SARS had spread internationally and affected over 8,000 people in 26 countries with 774 deaths. Since that time, only 4 community-acquired cases, all in China, have been identified (WHO). The vast majority of patients with SARS-CoV disease 1) develop pneumonia and 2) have a clear history of exposure either to a SARS patient(s) or to a setting in which SARS-CoV transmission is occurring. Laboratory tests can be helpful but do not reliably detect infection early in the illness CDC. |
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SARS Infection Control and Clinical Evaluation
- Healthcare facilities should re-emphasize the importance of basic infection control measures for respiratory infections and consider adopting a "respiratory hygiene/cough etiquette" strategy.
- All patients admitted to the hospital with radiographically confirmed pneumonia should be:
- Placed on Droplet Precautions
- Screened for risk factors for possible exposure to SARS-CoV
- Evaluated with a chest radiograph, pulse oximetry, complete blood count, and etiologic workup as indicated.
- If there is a high index of suspicion for SARS-CoV disease (by clinicians and health department), the patient should immediately be placed on SARS isolation precautions, and all contacts of the ill patient should be identified, evaluated, and monitored. Prompt SARS-CoV laboratory diagnostics should be arranged through the health department.
Source: CDC, May05
Key Clinical Features of SARS-CoV Disease
- Incubation period of 2-10 days
- Early systemic symptoms followed within 2-7 days by dry cough and/or shortness of breath, often without upper respiratory tract symptoms
- Development of radiographically confirmed pneumonia by day 7-10 of illness
- Lymphopenia in most cases
Source: CDC, May 05
SARS Case Definition
Severe respiratory illness in the context of a documented exposure risk is the key to diagnosing SARS-CoV disease. Providers should therefore consider SARS-CoV disease in patients requiring hospitalization for:
- Radiographically confirmed pneumonia or acute resp-iratory distress syndrome of unknown etiology, AND
- One of the following risk factors in the 10 days before illness onset:
- Travel to mainland China, Hong Kong or Taiwan, or close contact with an ill person with a history of recent travel to one of these areas, OR
- Employment in an occupation associated with a risk for SARS-CoV exposure (e.g., HCW with direct patient contact; laboratory worker that contains live SARS-CoV), OR
- Part of a cluster of cases of atypical pneumonia without an alternative diagnosis
Source: CDC, May05
Content last reviewed on March 2nd, 2009.