Severe Acute Respiratory Syndrome (SARS)

What are the Symptoms?
Fever over 38C, cough, shortness of breath, difficulty breathing.

Who is at risk?
People recently in China, Hong Kong, Vietnam or Singapore; people having close contact with a person diagnosed with SARS.

What to do if you are at risk?
You and anyone in your household should stay home in isolation for 10 days after last exposure; wear a mask and change it twice a day, and do not share personal items; wash hands frequently.

Who to call?
People with symptoms should call 1-866-797-0000 or 416-338-7600. For general SARS queries, call 1-888-668-4636.

You can also visit the following websites:

Protecting Yourself Against Coronavirus Pneumonia

CORONAVIRUS PNEUMONIA (CVP)
(also known as SARS - Severe Acute Respiratory Syndrome)

Mode of Transmission
Coronavirus pneumonia is a type of respiratory tract infection transmitted by
respiratory droplets over a short distance

Preventive Measures

• Build up good body immunity. Ensure a proper diet. Take regular exercise. Have adequate rest. Reduce stress. Avoid Smoking and Passive Smoking
• Maintain good personal hygiene. Cover nose and mouth when sneezing or
  coughing.
• Keep hands clean: wash them frequently and thoroughly. Use liquid soap and dry hands thoroughly.
• Do not rub eyes or nose.
• Wash hands especially after contact with nasal secretions such as sneezing or coughing.
• Do not share towels.
• Use separate chopsticks or spoons for serving food.
• Do not share eating utensils.
• Help to keep the environment clean: cleanse your own office or room properly.
• Maintain good indoor ventilation: open windows if possible.
• Avoid visiting crowded places with poor ventilation.
• Consult your doctor promptly if you develop fever (temp ? 38?) for one day or more. Most sufferers of SARS do not have cough, sneezing or runny nose at the early stage.
• Wear a mask if suffering from respiratory tract infection to reduce the chance of spreading the infection to people around you.

FAQ

Article from: Hong Kong Department of Health

The Illness

1. What is severe acute respiratory syndrome (atypical pneumonia)?
The illness is an acute respiratory infection that has recently been reported in a number of regions, including Hong Kong. It is a form of atypical pneumonia caused by a new agent.

2. What causes severe acute respiratory syndrome?
Latest research by the University of Hong Kong suggests that a coronavirus is the primary cause of the disease.

3. Is the disease fatal?
In most cases no. With early detection and treatment there is a high chance of recovery. Severe cases are usually seen in patients with pre-existing health problems or who seek treatment at a late stage.

4. What is the incubation period of the disease?
The incubation period is typically 2 - 7 days.

5. What are the symptoms of the disease?
The main symptoms include fever (of 38 degrees Celsius or above), malaise, chills, headache and body ache. Chest X-rays show changes compatible with pneumonia. Other symptoms include coughing, shortness of breath or difficulty in breathing.

6. If I think I have the disease, should I go to a Hospital Accident and Emergency Department immediately?
Yes, you should visit the hospital or seek early medical advice from your family doctor if you suspect you are displaying symptoms of the disease.

7. Is there a test for the disease?
A chest X-ray will help confirm the diagnosis. A rapid test has been developed to detect the coronavirus in patients.

8. Is there any treatment available?
Yes, experience in Hong Kong shows that patients react favourably to ribavirin (a broad spectrum antiviral drug) and steroid treatment. Other treatment methods are also being developed and tested.

9. What is the difference between classical/typical pneumonia and atypical pneumonia?
Classical/typical pneumonia is mainly caused by bacteria such as streptococcus.
Atypical pneumonia is mainly caused by viruses such as influenza and adenovirus, bacteria such as chlamydia and mycoplasma, and other unknown agents.

10. What is the difference between influenza and atypical pneumonia?
Influenza symptoms such as fever, cough and headache usually subside within a few days without any serious complications or signs of pneumonia.

Transmission

11. How is severe acute respiratory syndrome transmitted?
Transmission is by respiratory droplets and direct contact with a patient's secretions.

12. Is there any evidence to suggest air-borne transmission?
Based on available information, and the results of scientific analysis, transmission is most consistent with droplets and direct contact with a patient's secretions.

13. Is it safe to use public swimming pools?
There is no evidence of transmission through swimming. In any case, people feeling unwell should not go swimming.

14. Can the disease be contracted by handling money?
There is no evidence of transmission through handling money. However, people should pay careful attention to their personal hygiene and wash hands frequently.

Prevention

15. Is there a vaccine against the disease?
A vaccine is not yet available.

16. What steps can be taken to help prevent contracting the disease?

• Maintain good personal hygiene: cover your nose and mouth with a tissue when sneezing or coughing, and wash hands immediately afterwards with liquid soap.
• Use a disposable towel or a hand dryer to dry hands.
• Develop a healthy lifestyle - proper diet, regular exercise, adequate rest and do not smoke.
• Ensure good ventilation at home and in the office.
  
• People with respiratory tract infections, or those caring for them, should wear a face mask.
  
• Consult your doctor promptly if you develop symptoms of a respiratory infection.

Face Masks

24. Can the disease be prevented by wearing a face mask?
Yes, a face mask can help prevent the transmission of the disease. Make sure hands are washed before putting on a mask.

25. Who should wear a face mask?
The following people should wear a face mask:
- People with respiratory infection symptoms
- People who care for patients with respiratory infection symptoms
- People who have been in close contact with confirmed cases of atypical pneumonia should wear a face mask for at least 10 days from the last contact
- Health care workers

26. What type of face mask should be used?
An ordinary surgical face mask is effective in preventing the spread of droplet infections.

27. Is the N95 face mask the only effective model to prevent atypical pneumonia?
Surgical face masks and the N95 face mask are both effective in preventing the spread of droplet infections.

28. How often should a face mask be replaced?
In general, a surgical face mask needs to be changed daily. However, replace the face mask immediately if it becomes worn or damaged.

Wearing Face Masks

Wearing facemask properly offers satisfactory protection against respiratory tract infections. People with respiratory symptoms and those who have close contact with confirmed cases of atypical pneumonia should wear a facemask to reduce the chance of spread of infection. Their carers and those visiting sick people in hospitals should also wear a facemask. The general public may wear a facemask for self protection.

Points to note:

• Wash hands before wearing a facemask.
• Follow the instructions on the packet carefully, if available.

In general, when wearing a surgical facemask, the following should be noted:

• The facemask should fit snugly over the face.
• The coloured side of the facemask should face outside.
• Tie all the strings that keep the facemask in place or fix the rubber bands of the facemask round the ears properly.
• The facemask should fully cover the nose, mouth as well as the chin.
• The metallic wire part of the facemask should be fixed securely over the bridge of the nose to prevent leakage.
• Under general circumstances, the surgical mask should be changed daily
• Put the facemask into a plastic bag and tie it properly before putting it into a rubbish bin.
• Replace the facemask immediately if it is damaged or soiled.

Wearing a facemask is just one of the ways to prevent respiratory tract infections. The most important thing a person should do is to observe good personal hygiene. For example, wash hands frequently with liquid soap, especially after sneezing, coughing or cleaning the nose.

Flush Toilets Properly

To prevent the spread of atypical pneumonia, it is very important to keep the toilet clean. Apart from cleaning toilet facilities with 1:99 diluted household bleach at least once a day, every toilet user should observe good personal hygiene. At home, flush the toilet properly as follows:

Proper procedures:

After using the toilet, dispose of used toilet paper into the toilet bowl.

Lower the lid before flushing to prevent contaminated water from splashing. Then flush the toilet.

Wait for the flushing to cease, then raise the lid.

Wipe the lid, seat and rim of the toilet with a cloth soaked with diluted household bleach (prepared by mixing 1 part of bleach with 99 parts of water), then rinse with water and wipe dry.

Wash your hands thoroughly with soap.

SARS Virus May be from Animal

Both World Health Organization (WHO) and Chinese experts Sunday refused to rule out the possibility that the deadly SARS virus which has triggered a globalhealth scare may have come from animals.

Guo Huiyu, a leading virologistwith the Guangzhou-based Sun Yat-sen University, said the virus found in tests on some of those who have died were similar to those found in animals.

But further scientific tests will have to be conducted to establish the exact source of the virus responsible for the current outbreak of atypical pneumonia, or Severe Acute Respiratory Syndrome (SARS), said Guo.

A total of 1,153 cases of SARS were identifiedbetween November 16 and March 31 in Guangdong, 40 of which proved fatal.

Of those infected by the virus, 361 were diagnosed in March, a drop of 47.5 per cent on the reported numbers in February.

Alan Schnur, a member of the WHO team, echoed Professor Guo. The director of the Infectious Disease Control Department of the WHO's China Representative Office said his team would be collecting more samples from Guangdong to further their research into the source of the SARS virus.

SARS: Question mark over origin

Questions as to the origin of the outbreak, until widely reported as the south of China, are also being raised.

A Xinhua News Agency report quoted James Maguire from the WHO team as saying that scientists suspect that the source of the SARS virus may originate from a particulartype of animal and possibly not from China.

Maguire said he and his colleagueshad some primary conjectures on SARS, but had not come to any firm conclusions.

After four days of examination and investigation, the WHO team has found that most of the SARS patients in Guangdong, apart from local medical workers, are employed in the province's restaurant and food industries.

"It is useful and valuable for experts to study the transmission channels of SARS in the coming months,'' Schnur said.

The WHO team Sunday visited Guangzhou Centre for Disease Control and Prevention and had talks with local officials, experts, doctors, nurses and even patients.

They continued to exchange views on the prevention and treatment of SARS with their local counterparts.

In the four days since their arrival in the province last Thursday, the team have visited Guangdong Provincial People's Hospital, the First Hospital affiliated to Sun Yat-sen University, Guangdong Provincial Centre for Disease Control and Prevention, Guangzhou No 8 People's Hospital, which specializes in treating infectious diseases, and Foshan People's Hospital.

The WHO team have also had talks with Deputy Minister of Public Health Ma Xiaowei and Lei Yulan, vice-governor of Guangdong Province, on Saturday.

Vice-Premier Wu Yi also urged local officials, experts and doctors to do all they can to treat those currently infected and prevent further spread of the disease.

The central government has already instructed health departments in Guangdong and Hong Kong to directly exchange data on SARS, including the number of SARS patients, deaths and treatment methods without having to wait for specific approval.

Both the WHO and Chinese experts believe that SARS has been basically brought under control in Guangdong, with the number of new cases falling since March.

Guangdong Vice-Governor Lei Yulan Sunday reiterated that Guangdongremains safe for investors and tourists from both home and abroad.

SARS has had little affect on local society, Lei said, with local hospitals, schools, kindergartens, shopping centres and entertainment venues all operating as usual. And the coming 93rd Chinese Export Commodities Fair, the country's biggest trade event, will get underway as scheduledon April 15 in Guangzhou, the provincial capital.

The WHO team which consists of experts from the United States, Britain and Germany will continue to visit more hospitals and patients in the coming days to collect more detailed and valuable materials and samples aimed at finding an effective way of treating SARS.

The WHO team are expected to leave Guangzhou Tuesday.

(China Daily April 8, 2003)

US Scientist Sees Vaccine for Pigs as Clue to Fighting SARS

A vaccine used to treat viral respiratory infections among pigs could prove useful in finding a cure for a mysterious pulmonary ailment that has killed more than 100 people worldwide, the top US epidemiologist said.

Doctor Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases, told Congress Monday there was a mounting body of evidence that Severe Acute Respiratory Syndrome (SARS) is caused by a novel coronavirus that may have crossed species from an animals to humans.

Coronaviruses, which have been known to US scientists for years, are usually not seen as a major public health hazard because they cause no more than the common cold.

But Fauci said the coronavirus believed to be associated with SARS is a previously unidentified type. Moreover, there was some evidence that in its attacks on humans, the coronavirus was aided by a second yet to be identified pathogen.

"Fortuitously, vaccines against common veterinary coronaviruses are routinely used to prevent serious diseases in young animals, such as a vaccine given to pigs to prevent serious enteric coronavirus disease," Fauci told the Senate Committee on Health, Education, Labor and Pensions.

"These models could prove useful as we develop vaccines to protect humans," the researcher added.

The word of optimism came as the mysterious epidemic continued to spread across Asia and the rest of the world, curbing international travel and business contacts.

Fauci said work on an anti-SARS vaccine was already under way at his institute.

"We now have that virus growing," he said in a later interview with PBS Television. "Once have you it growing in a laboratory, then you can do things with it that can speed the process enormously, with regard to vaccine, therapeutics and diagnostics."

But he cautioned that researchers still had "a long way to go" in creating a viable vaccine because they had much to learn about the disease.

Fauci said he had seen no evidence the virus had been created as a biological weapon in laboratory conditions, but refused to entirely dismiss that theory pending further study.

"Until then, we will keep our minds open to these possibilities, however remote," he pointed out.

(People’s Daily April 9, 2003)

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Traditional Chinese Medicine Treatment for SARS

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