Severe Acute Respiratory Syndrome (SARS)

Symptoms of SARS appear slowly and may mimic the symptoms of the common cold, which include:

• High fever (temperature above 100.4°F)
• Persistent headache
• Body ache
• Lethargy and discomfort
• Muscle pain
• Diarrhoea
• Dry cough (after 2-7 days)
• Difficulty breathing

Most of the patients develop pneumonia within a week.

SARS is caused by SARS-CoV which is a type of coronavirus that affects humans. Coronaviruses belong to the Coronaviridae family of single-stranded, positive-strand RNA viruses. Amongst all other human coronaviruses, SARS and MERS-CoV (Middle East respiratory syndrome coronavirus) are known to be life-threatening.

SARS seems to spread by close person-to-person contact. It can also spread by the following routes:

• Respiratory droplets produced by an infected person are highly potent to produce SARS infection in the body. Droplet spread occurs when droplets from cough or sneeze of an infected person travel at least a distance of three feet through the air and rest onto the mucous surfaces of the mouth, nose or eyes of a healthy person. 
• If you are living with or taking care of a person with SARS or having direct contact with their respiratory secretions (sputum or cough droplets) or body fluids (sweat, blood, stool, semen), then you are at a high risk of getting the infection.
• Physical interaction like kissing, hugging, sharing eating or drinking utensils or even talking to or touching someone within three feet can transmit the infection.

If you have a person suffering from SARS at home, these are the measures you can follow in order to make sure that the infection does not spread to you or others:

• The affected person must have a separate room and must be kept in isolation. Before isolating the patient, provide them with basic amenities like heat, electricity, water, required medications and telephone access.
• Make sure that the patient uses a separate bathroom, especially if they have diarrhoea. The bathroom used by the patient should be cleaned daily, if possible. Household utility gloves should be worn during the cleaning process.
• Do not let the patient leave home during the isolation period except for necessary medical care. 
• When the patient is going out to the hospital, make them wear a mask and do not make them travel in public transport.
• Older people and people with systemic conditions, underlying heart or lung disease or diabetes mellitus should be relocated to minimise the chances of infection.
• Towels and bedding of the infected person should not be shared. Soiled laundry of the patient should be washed separately. Do not shake the laundry as it will allow the infectious particles to settle in the air.
• Use separate utensils for the infected person. Wash the soiled dishes separately with soap and warm water. 
• You need to continue the infection control precautions for 10 days or until the fever and other respiratory symptoms like cough and difficulty in breathing subside. You should also get a clearance from the health department before discontinuing the home safety precautions. 

These are measures you need to follow in order to prevent yourself from the infection:

• The easiest and most effective way of preventing yourself from the infection is by washing hands. You should maintain your hand hygiene by washing hands with soap and water or by using an alcohol-based hand rub. You must wash your hands thoroughly if you have been in contact with the contaminated respiratory secretions (sputum or cough droplets) or body fluids (sweat, blood, stool, semen) and also if you touch the surfaces involved with the patient. 
• When coming in contact with the affected person, make sure that you are wearing a protective mask. Masks should fit snugly around the face and should not be touched or handled during use. This would prevent you from inhaling the virus present in the air.
• Wear gloves and protective disposable gowns before you come in contact with the infected person or their body fluid (stool, urine, vomit). Wash your hands immediately after the gloves are removed. Do not reuse or wash the gloves. Gloves, tissues, and other waste generated in the care of a SARS patient should be bagged and placed in another container for disposal with other household waste to prevent the spread of infection.

Since SARS does not have any distinct symptoms, it is diagnosed with the help of two different types of serological (blood) tests:

• Molecular tests like real-time reverse-transcription polymerase chain reaction (rRT-PCR) are used to detect the viral RNA in the body. 
• Serology tests like ELISA, or enzyme-linked immunosorbent assay, are done to check for antibodies against the virus. 

Sample of a nasal swab or a sample from your stool or urine can be taken for lab culture test which involves growing of virus in culture (in the lab).

There is no specific treatment available for SARS. Symptomatic relief can be given through:

• Antipyretics like paracetamol for fever and body pain.
• Drinking plenty of liquids to prevent dehydration.
• Antibiotics can be given to the ones suffering from pneumonia. 
• Nebulisers and ventilators could be given to those with breathing difficulty.
• Antiviral drugs are given to fight against infection.

SARS is a highly infectious air-borne condition that caused international panic leading to numerous deaths, highlighting the spread of the disease in just a few months.

With the oncoming of new and unexplained viruses, taking the right preventive measures on time and identifying the underlying causes of infection are critical in stopping it from becoming a widespread epidemic.

The spread of infections like these also highlight the need and importance of maintaining good personal hygiene, which goes a long way in stopping the spread of infectious virus and bacteria.