Search  

 

Everything About SARS

1) What is SARS 

2) Symptoms of SARS 

3) Cause of SARS 

4) Diagnosis of SARS 

5) Treatment of SRAS 

6) Guidelines for SARS 

i) Guidelines for the travelers 

ii) Guidelines for the patients 

iii) Guidelines for the contacts 

iv) Guidelines for health care workers 

v) Guidelines for staff of ships and planes 

7) Prevention of SARS 

8) Deaths Due to SARS 

9) Mortality Rate of SARS 

10) Frequently Asked Questions 

11) Links for SARS

 

 

 

What is SARS

 

Severe acute respiratory syndrome (SARS) is a respiratory illness that has recently been reported in Asia, North America, and Europe.

 Back to top

Symptoms of SARS

 

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.

 Back to top

 

Possible cause of SARS  

 

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.

 Back to top

 

Diagnosis of SARS     

 

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 (€œfalse-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. 

 Back to top

 

Treatment of SARS

 

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.

 Back to top

 

Guidelines for SARS

 

i)     Guidelines for the Travelers

Before you leave:                                                                             

  • 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.

  • Inform yourself and others who may be traveling with you about SARS.

  • 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.

  • 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.

  • Identify in-country health-care resources prior to your trip.

While you are in an area with SARS:

  • To protect against SARS infection, wash your hands frequently.

  • 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

  • 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.

  • 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.

  • 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).

  • 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.

  • 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.

  • 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:

  • 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.

  • 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

  • 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.

  • 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.

  • 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

  • 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.

  • 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

  • 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?

  • 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?

  • 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?

  • SARS information contained on CDC's health alert cards is being provided by the major shipping associations and the International Council of Cruise Lines to people traveling on cargo ships and cruise ships at U.S. ports. Inspectors also are boarding ships if a passenger or crew member has been reported with symptoms matching the case definition of SARS.

What does a quarantine inspector do?

  • Quarantine inspectors serve as important guardians of health at borders and ports of entry into the United States. They routinely respond to illness in arriving passengers and ensure that the appropriate medical action is taken.

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?

  • 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?

  • 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?

  • CDC does not currently recommend that the onward travel of healthy passengers be restricted in the event that a passenger or crew member suspected of having SARS is removed from the ship or airplane by port health authorities. All passengers and crew members may be advised by port health authorities to seek medical attention if they develop SARS symptoms.

What does a quarantine official do if a passenger is identified as meeting the case definition for suspected SARS?

  • 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?

  • 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.

     Back to top

 

Prevention of SARS

 

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                                        

  • 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   

  • 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                                                                

  • 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.

     Back to top

 

Deaths Due to SARS 

 

Visit WHO's SARS page for a daily update of SARS cases and deaths.

 Back to top

 

Mortality Rate of SARS             

 

Visit WHO€™s SARS page for a daily update of SARS cases and deaths.

 Back to top

 

Frequently asked Questions

 
How SARS is spread
  • 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

  • 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;

  • Follow the instructions given by your health care provider

  • Limit your activities outside the home during this 10-day period. For example, do not go to work, school, or public areas.

  • Wash your hands often and thoroughly, especially after you have blown your nose.

  • Cover your mouth and nose with tissue when you sneeze or cough.

  • 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?

  • That is true for many viruses, yet doctors don't know whether SARS survivors develop such immunity. It is possible that a second exposure could be more serious than the first one, says Dr. McGeer.

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?

  • Scientists are gradually optimistic that vaccine candidates will develop quickly, thanks in part to the quick decoding of virus genome. Animal experiments are being done but it may take a few years for the vaccine to be used in human.

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 €œprobable€ SARS case and a €œsuspect€ 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 €œtravel alert€ and a €œtravel advisory€ issued by CDC?

  • CDC issues two types of notices to travelers depending on specific situations: travel alerts and travel advisories. Travel alerts inform travelers of a health concern in a particular area and provide advice about specific precautions that should be taken. A travel advisory notifies travelers of potentially more serious situations and advises that non-essential travel be postponed.

I must travel to a country where there is community spread of SARS: What precautions can I take?

  • As with all infectious illnesses, the first line of defense is careful hand hygiene. As a general rule, it is good practice to wash hands frequently with soap and water; if hands are not visibly soiled, alcohol-based hand rubs may be used as an alternative.

  • 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 while in public areas. For more information, visit CDC€™s website and specifically read the Interim Guidelines about Severe Acute Respiratory Syndrome (SARS) for Persons Traveling to SARS-Affected Areas.

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.

 Back to top

 
 

Defense of Houston was made possible by the Disaster Relief and Emergency Services (DREAMS) program of the US Army based at the University of Texas Health Science Center at Houston and Texas A & M University (DoD grant no.DAMD17-98-1-8002). DREAMS physicians and scientists acknowledge with gratitude the vision, leadership, and advice of Senator Kay Bailey Hutchison, and Congressmen Tom DeLay, Ken Bentsen, Henry Bonilla, and Kevin Brady.