Introduction

Severe Acute Respiratory Syndrome (SARS) is an infectious disease that is caused by a virus called coronavirus (SARS-CoV), which was identified in early 2003.1 SARS first appeared in Southern China in late 2002. From China it spread to more than two dozens countries in North America, South America, Europe and Asia.2 According to the World Health Organization (WHO), during the 2003 outbreak there were more than 8,000 probable cases of SARS and 774 deaths. In the United States there were eight confirmed cases of SARS with no deaths. While currently SARS is not a threat, a second outbreak is possible. This fact sheet provides information about SARS and what government agencies and school systems can do to prepare for a possible reemergence of the disease.

How does SARS spread?

  • SARS is spread by close human contact with an infected individual. Close contact is defined as having cared for someone who had SARS and/or having a high likelihood of contact with respiratory secretions of an individual diagnosed with SARS.
  • The virus can spread when a person touches a surface or other objects contaminated with infectious droplets, and then touches their mouth, nose or eyes. These droplets are produced when a person sneezes or coughs and they are emitted into the atmosphere.3

Who is at risk for contracting SARS?

  • Anyone who has recently traveled to a country where SARS has spread.
  • People who have had direct contact with a person who has been diagnosed with SARS.4

What are the signs and symptoms?

  • In most cases SARS begins with flu-like symptoms, including high fever (greater than 100.4° F), headaches, muscle aches, cough, and shortness of breath.5
  • In about 20 percent of cases patients develop diarrhea.6
  • Most SARS patients later develop pneumonia.

How is SARS diagnosed?

  • In order for an individual to be diagnosed with SARS they must meet specific criteria:
  • A fever greater than 100.4° F.
  • One or more symptoms of lower respiratory tract illness such as cough, difficulty breathing, and shortness of breath.
  • Radiographic evidence of pneumonia, a disease that results from the infection of the air passages and lungs.
  • No other alternative diagnosis can fully explain illness. 7

How is SARS treated?

  • Although there are no specific treatments for SARS, the National Institutes of Health is researching possible antiviral drugs to treat infected individuals.
  • Currently, common pneumonia drugs, such as azithromycin and penicillin are being used for patients with confirmed or suspected cases of SARS to treat the pneumonia caused by SARS.

How can SARS be prevented?

  • Good personal hygiene can reduce the risk of spreading SARS from an infected person to a healthy individual.
  • Avoid sharing eating and drinking utensils.
  • Wash hands often and well, especially after one blows their nose.
  • Cover mouth and nose with a tissue when sneezing or coughing.
  • One should avoid public transportation if they suspect they may be in infected with the disease.
  • Clean all surfaces that are possibly contaminated with SARS. Use a household cleaner while wearing disposable gloves.
  • If a person thinks they have been exposed to SARS, they should contact their healthcare provider immediately. Alert the healthcare provider if you suspect SARS before the visit so precautions can be taken to prevent exposing others.9

What should schools do if students are exposed to SARS?

 

  • Exposed students who develop fever or respiratory symptoms should stay home from school to avoid contact with others.
  • If symptoms do not meet SARS criteria within 72 hours, the student may be allowed to return to school.
  • Suspected SARS cases should be reported to local health authorities, school officials and other healthcare providers immediately.
  • Schools should educate students and parents of signs and symptoms of SARS.10

How have states and municipalities responded to SARS outbreaks or prepared for future infections?

New York State Preparedness Plan for Possible Reappearance of SARS http://www.health.state.ny.us/nysdoh/sars/q_and_a.htm

  • Educating healthcare workers about SARS diagnosis and reporting.
  • Developing SARS surveillance systems to determine if and where SARS have reemerged.
  • Developing guidelines for preventing transmission in different settings.
  • Improving laboratory tests for SARS.11

Health Canada’s Activities with respect to SARS
http://www.hc-sc.gc.ca/english/protection/warnings/sars/update_jan_2004.html

Health Canada is continuing to maintain vigilance at airports

  • Quarantine Officers are available at the Toronto, Vancouver, Montreal, Calgary and Ottawa international airports. Health Canada continues to provide up to date information to Quarantine Officers and Canadian Customs officials about any suspected or confirmed cases of SARS worldwide.
  • Travelers are asked to continue to monitor their health and report signs of illness.
  • Infectious disease brochures have been placed at major Canadian international airports, train stations, and ferry stations.
  • If there is another SARS outbreak, screening measures will be reinstated at Canada’s airports within 24-96 hours.12

Additional information

Clean Hands:

http://www.cdc.gov/handwashing/
An Ounce of Prevention: Keep the Germs Away
http://www.cdc.gov/ounceofprevention/

Guidelines for Close Contacts:
http://www.cdc.gov/ncidod/sars/ic-closecontacts.htm

Ongoing research by the NIH:
http://www.niaid.nih.gov/factsheets/sars.htm

World Health Organizations case definition:
http://www.who.int/csr/sars/casedefinition/en

REFERENCES:
1National Institutes of Health. NIAID Research on Severe Acute Respiratory Syndrome (SARS). March 2004. Available at http://www.niaid.nih.gov/factsheets/sars.htm. Accessed October 2004.
2Center for Disease Control and Prevention. Fact Sheet for SARS Patients and Their Close Contacts. Available at http://www.cdc.gov/ncidod/sars/factsheetcc.htm. Accessed October 2004.
3
ibid
4
Commonwealth of Massachusetts Department of Public Health. Public Health Fact Sheet: Severe Acute Respiratory Syndrome (SARS). Available at http://www.mass.gov/dph/cdc/factsheets/sars_fs.htm. Accessed October 2004.
5National Institutes of Health, op.cit.
6 Center for Disease Control and Prevention, op.cit.
7World Health Organization. Alert, verification and public health management of SARS in the post-outbreak period. August 2003. Available at http://www.who.int/csr/sars/postoutbreatk/en/. Accessed October 2004.
8Minnesota Department of Health. Severe Acute Respiratory Syndrome (SARS): Frequently Asked Questions. Available at http://www.health.state.mn.us/divs/idepc/diseases/sars/index.html. Accessed October 2004.
9Center for Disease Control and Prevention, op.cit.
10State of New Jersey: Department of Health and Senior Services. Statement to the Public. Available at http://www.state.nj.us/health/er/documents/sarsguidancetoschools.pdf . Accessed October 2004.
11 New York State Department of Health. Info for Consumers: Frequently Asked Questions About SARS. Available at http://www.health.state.ny.us/nysdoh/sars/q_and_a.htm. Accessed October 2004
12Health Canada. Update: Health Canada activities with respect to SARS.
Available at http://www.hc-sc.gc.ca/english/protection/warnings/sars/update_jan_2004.html. Accessed November 2004.

  • Physicians who suspect SARS must gather an accurate history of the patient because SARS symptoms are similar to the flu and other respiratory illnesses.8
  • A laboratory must collect a sample of sputum, saliva mixed with discharges from the respiratory passages, and find it positive for SARS for a person to be diagnosed with SARS.